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10/20/1954 - Nairobi Hospitals by Robert F. Gray

INSTITUTE OF CURRENT WORLD AFFAIRS RF6 October Nairobi Hospitals Barc1ays Bank ueensway Mr Walter S Rogers Nairobi Kenya Institute Current World Affairs Fifth Avenue New York No Dear Mr Rogers The Kenya Medical Department understaproud King George VI Hospital Nairobi Built operated Kenya Government institution theory races European community King George VI project which still quite finished At present capacity takes about ients It _anned purpose serving general hospital Nairobi vicinity providing specialist center which difficult cases could bereferred other parts country Dr Rigby Senior Medical Officer estimates about patients being other hospitals Nairobi The umber referred cases would normally greater emergency regulations limiting movements natives Nairobi patients serious ailments The clininal staff which includes about graduates medical schools headed specialists In addition number specialists private practice positions honorary surgeons physicians King George VI There African graduates akerere Medical School Kampala these senior three would interns The other three interns Europeans United Kingdom being woman The nursing orderly services hospital directed staff European nurses routine African being trained different grades medical iliaries girls training student nurses Altogether nearly Africans employed Hospital These people vided modern living quarters special school their children The building hospital consists separated wings connected central corridor which gives access block receiving rooms nistration offices The wings three stories floor having wards 1rivo_ rooms Thus there which _equally divided between medical surgical services This building arrangement provides wards maximum sunshine ventilation retaining reasonable degree compactness whole hospital In regard standards RFG1 King George cleanliness neatness compared large municipal hospitals Bellevue New York Cook County Hospital Chicago pressions favorable The bedsteads irony accessory furniture bedside tables stools cribs locaIly enameled stainless steel Supplies linen medical instruments facilities sterilization laundry The X rment centrally located building possesses modern gnostic equipment including portable machines emergency The surgical block comprises furnished operating heatres which about major operations performed The laboratory hospital except simple tests routine urinalyse Medical Research Laborary institution number other functions located short distoonce hospital The laboro standard appears entirely satisfactory specimens different institution analysis Zhere developing clinical Oratory integral King George YI A pointed criticism present arrangement lecture East African Medical Society October Sir Philip anson Bahr A others Babies referred impossible circumst zhich hospitals required specimens laboratory analysis The overlapping interlocking diferen insiu characteristic medical services Itenya makes difficul presen concise outline Nairobi hospital system As indirec resul Mau errorism iting George VI Hospital efficien blood After L assacre patients panga ounds burns operating heares being continuously handling The difficulty obtaining blood needed simultaneous ransfurions indicatedheneedfor apermanenbloodbawhichhas organized Although Variety ropical diseases appears Wa during course proiding clinical material raining research patients admitted nesses zhiCh wellPneonias anemias neurological _condiions diseases liver stomac kidneys The proportion ofexoic ropical diseases unusually emergency restrictions movements Na irobi reserves In diaric broncho pneumonia couns larges issio gasro enteritis Close sec0nd folioed various conditions mlnutriion C severe_ nemia Three alloed pediatrics sevic children being wards according their groups equipped cribs infan nursing mother Another 0ntenighof rchfiT MauauerrorissRcRed wives ldren IiIu Guard Lari Locai0n miles Nairobi hacIed burned death zhile Trement alnourished Child Teaching Toile IIabits P JG mother takes mothers where leave their nursing infants while staying hospital Dr cDougall woman physician charge pediatrics finds African children manageable patients White children These wards unusually quiet orderly children rarely where In attempt inculcate toilet habits according Western standards younger infants placed little chamber regular intervals The infants respond quickly potty parade acquire regular toilet habits In cases docility these African children simplN apathy malnutrition other disease doubt psychological manifestation early experience training The surgical service subdivided vario special general surgery thoraco abdominal E N T others Two adjacen suical wardsare designated security wards carefully guarded armed askaris Wounded Mau Mau gangsters treated these wards while other contains Mau Mau victims protective custody during their hospital treatment Nearly Man Mau patts being treated serious gunshot wounds Most charges terrorist activities which carry death penalty staff Is patiently restoring health All critical ptients group manacled their bedsteads nevertheless several escapes month The victims Hau Violence suffer mostly panga East African machete wounds burns Other common wounds result attempted strangling gougin beaingso A number patients fingers chopped sIulis badly hacked apparently tryin protect their heads their hands panga attacks It sometimes happens patient victims principle witness Mau Mau casualty adjacent Survivor aulau Violence Attempted Strangling Gouging Eyes Operating Mau Gangster Gunshot Wound Hip Several attempts poison these witnesses strict precautiona exercised tokeep groups apart The orthopedics service headed Kro Kirkaldy Vill often listed separate institution Kenya Medical Department Orthopedic Centre It locoted block temporary buildings about hospital administered integral King George VI makes facilits andoperati theatres hospital Of orthopedics Centre hospital If seems anticipated Orthopedic Centre develops independently might limited treatment chronic conditions leaving fractures acute orthopedic conditions treated surgical wards hospital At present fractures constitute unduly large proportion violence The common chronic diseases tuberculosis bones oints poliomyelitis usual mixed congenital traumatic deformities Attached Orthopedic Centre establishment making artificial limbs A staff African Asian workmen under direction European experts trained Kenya I00 artif limbs addition variety orthopedic apliances Yhile Kenya Government undertaes provide Africans complete medical service extend bstetrics which regarded responsibility tunicipal Councils Reserves District Native Councils T gynecology department King George VI unconnected obstetrical services which ynecological pathology arises The Government gynecologist Dr Candler notes common condition among ptients vaginal fistula resulting lacerations childbirth This disease almost entirely By British usage surgeons usually addressed rferred Mr while medical specialists generl practitioners called Dr RFG1 confined women Kikuyu Kamba tribes narrow pelvises He suggests three possible explanations anomaly first unlikely narrov pelvis racial trait these related tribes secondly condition arise idespread subcIinical rices finally custom these women carry heevy suppored tumpline forehead result pelvic deformity early The correct answer found ofter careful cooper obste rical orkers controv ertial question female circumcision among Kikuu women Dr Candler little pathology result operaion except occasional childbirth lacerations which sometimes might prevented unusual opera anterior episiotomy Another pathological condi common among African women living nNairobi result generalized pelvic inflamation again state predominant cause Attempted abortio common cause pelvic inflamation other countries seems unlikely because strong desire African women children In complaint frican women sterility sufficient fertility attempt present these conditions In regard other presumptive gon0coccal infection statistics Nairobi Health Department variance hospital statistics difficult estimate incidence gonorrhea among I airobi women Strenuous efforts being improve accuracy diagnoses routine labortory tests Diff erences culture difficulto adequate medical histors African women children fuller ledge about peral background African women patients essentie further advance gynecology Better coordination velfre obstetrical ynecologicl services should possible acquire knowledge On rhole King George VI IIospital aaxiliary institutions prepared provide addquate hospital treatment quality Africans Nairobi there admitted shortcomings present The spiLal located wrong place thing It Lhe native locations nearly fricns It sever miles Central Dispensary majority patients before being admitted ospital The medical functions fulfils treatment cener whole country District Hospitc The European General ospital Nairobi Area different respects might perhaps better served separate institutions On other pital exists dapted teaching offers interns other grades medical students variety acute chronic diseases including concentration difficult cases which occur Kenya In subject hospitalization Europeans necessary describe facilities detail compare favorably pital services American conunities similar The center European hospital system General Hospital which opened months The system includes Princess Elizabeth Hospital severa nursing homes European children treated Gertrude Garden Children IIospital All I shalI attempt ownership financing management these hospitals something interracial complications which arisen The European hospitals exception Children Hospital owned managed Kenya European Hospital Association which taxpayers country members The Association organized alimited liability corporation membership subscript shillings The members appoint Board anage which controls management hospitals As suggests membership Association Iimited Whites Item Art iclesofAssociationreads NopersonhoisnotofpureEuropean shall admitted membership Association By dividends members entitled reduction shillings hospital expenses The Gen Hospital Half remainder being provided Association Government under policy encouraging community initiative building hospite certain schools matching community funds government approprietions Up field hospitalization European community taken advantage offer policy sometimes represented government subsidy European private hospitals prejudice other racial groups I Ismailia community Nairobi planning hospital Asians along lines European General Hospital wlich financed scheme Even capital expense European hospitals taken Association Government still remains midable operating aintaining hospitals This mainly througl special _statutor hospital levied Europeans The Hospito Tax assessed ording income special called I European Hospita I Fund Authority The present example incomes shillings 10000 15000 00000 The Hospital Fund functions insura society reimbursing patients portion their hospitv expenses rather paying hospitals directly Thus hospitals operate private institutions collecting bills patients compensated their exmses Hospital Fund Europeans other East African Territories other nationalities received Nairobi hospitals charged rates Kenya Europeans course receive benefits Hospital Fund As further hospital finances Government Itospital Fund general revenue equivalent annual receipts Hospital Tax Each taxpayer entitled ecover hospital expenses himself dependants expenses first himself The Hospital Fund applies European hospita Kenya details ovnership gement hospiJals parts colony differ Nairobi So I visited Nirobi hospitals The European hpital systen undoubtedly complex appears understood taxpayers mselves Branich Superintendent General Hospital explaining puzzled taxpayers their rights obligations regard hospitalization The situation further complicated ecial provisions hospit alization Governme Servants constitute larvae proportion European population Government undertaken provide hospitalization officials eml_loyees which simply paying hcital bills But obligted rovide discharging staff I edical Department invades European hospitals Wnereas private citizens hospital private practitioners Government Servants attended hospital government doctors specil dispensries outpatient treatment For purpose G neral I osital maintains government doctors residence visited consulting specialists serve staff King George VI The Asi unity airobi present served hospitalization either Africans ICuropeans An Asian hospital planned o_ened This built jointly Government arivate endonent cabled ahimtulla Suleman Virjee Trust managed Government Located blocI Government A frican tospital usually referred Asian I George VI deends larger instit ution facili sterilization The permanent The Asian Hospital RFG1 kitchens installed patient space being temporary living quarters Asian staff pending construction nurses Patients Asian Hospital choose treated staff King George VI It ospital their private physicians tIospital bills charged individual patients there Asian organization comparable Kenya European Hospital Associ Asians agreed submit Hospital Tax Kenya Europeans According Cruikshank Superintendent King George VI handles accounts Asian Hospital collections hospital bills majority patients being unble unwilling charges In addition Asia Hospital several small hospitals Asi operated privately Nairobi there multi racial hospital natively called Rainbow Nursing Home The standards these institutions generally recognized hospitals economically unfeasible Nairobi A large number Asian ptients treated present growing aareness benefits hospital treatment create demond better facilities The Ismailia community Aga Kh start construction modern hospital which European General Hpital Government project funds Even assuming races equally provided pitals serious problem relstions vould still remain The problem plagued American policy equal separ educational facilities Negroes exists Nirobi doubt increase The European itals carry prestige superiority equipment which possess upper class Asians their social position entitles these hospitals In recognition potentially serious inter tionl incidents which might arise score racial European hopitals absolute occasionally lifted discretion Board anagement For example exception Sultan Zanzibar pneumonia while official guest Goverhment Ilouse It impos treat Government House because needed other offici visitors thought would appear derogatory Asian Hospital The European Board Of anagement approached Sultan accepted Carberry Nursing tIome European hospitals Other icate situations arise increasingly frequent mixed marriages usually between European woman Indian Such might cepted European hospital ordinary pttient matern since infant could lification European descent As possible cases settled other principles For instance married women usually apear register husband Asian family ttospital Tax woman legally entitled subsidized hospitalization uropee hospitals RFG The number Africans Ienya reached educational cultural level opeans small those selves embarrassing situt being barred European Asian hospitals admitted African Hospital which primarily lanned serve uneducated masses Africans The injustice educated Xricans sometimes perhaps apparent Asians because become closely assim ilated uropean culture religious beliefs dietary habits standards hygiene Somalis Comorans refuse African tIospital generally treated Asian Hospital TheSeychellese represent every color shade often insist European French descent demand entrance European hospitals The prosperous Africans dissatisfied existing arrangements ouptient office treatment They reluctant petronize Governmen Dispensary hardly afford private practitioners It gested these people represent potential private patients African graduates iakerere htedic School This pr0blem however outside subject hospitalization Before ending letter I shall mention Eas African Railways Harbors Administration provide excellent medical hpital their employees races This example followed other large firms might Colony direction development hospitalization Sincerely Robert F Gray Received New York IO