The Medieval Pattern

In the years before Congolese independence, Belgium's starchly paternalistic colonial officials were fond of boasting that the standard of medical care in the Congo was the highest in all Africa. Last week the boast sounded more hypocritical than Hippocratic.

Within one short week after Belgium turned the Congo over to Patrice Lumumba last June 30, all but 100 of 1,200 Belgian doctors hastily packed their bags and fled--some of them alarmed by the breakdown of order, the stories of white nuns raped, the feeling that in many places a Belgian was no longer safe. Their departure left all but six of the fledgling nation's 400 hospitals manned only by nurses and semi-trained "medical assist ants." There were no Congolese doctors to fill the gap: the first Congolese admitted to medical school in more than a half-century of Belgian rule have yet to finish their training.

The Belgian doctors were quickly followed in their flight by Belgian public health inspectors and sanitation engineers, and the result was both inevitable and 'catastrophic. From the far corners of the sprawling nation, ominous reports began filtering back to Leopoldville: eruptions of bubonic and pneumonic plague, outbreaks of smallpox, widespread increases in serious but less spectacular diseases such as malaria, filariasis, meningitis and pneumonia.

No News. To meet the emergency, the U.N.'s World Health Organization began rushing in hastily recruited medics, and by last week 22 Red Cross teams, totaling 104 doctors and nurses, were in the Congo. Fifty hospitals have been reopened, and each province except rebellious Katanga now has its own U.N. squad of public health engineers, water sanitation experts and epidemiologists.

But in the Congo's chaotic political climate, communications are so bad that not a single official item of information on births, deaths and disease has been reaching the central government at Leopoldville. As beleaguered U.N. medics struggled to undo the damage wrought by the Belgians' abrupt departure, the job still looked almost hopeless. Said one U.N. doctor: "It is inconceivable that such a breakdown in health services should occur in the 20th century. The Congo is just a few months short of returning to a medieval health pattern."

The Unknown Animal. By current Congolese standards one of the bright spots in the nation's health picture is Beni --a village at the northeast tip of remote Kivu province. Beni's modern. Belgian-built hospital is staffed by two physicians on loan from the Irish Red Cross; a new X-ray machine and cases of operating-room equipment are stacked against its walls, and the dispensary is equipped with large stocks of antimalaria drugs. But the U.N.'s Irish doctors found the Belgians had made no attempt to control the spread of malaria by clearing swamps or spraying trouble spots with DDT. And a mere two miles from Beni, the U.N. men discovered an entire village of leprosy victims living without medical aid in complete isolation and poverty.

"The situation at the moment is serious enough," says Beni's Dr. Joseph Barnes, "but it is rosy compared with what might happen three months from now." Beni Hospital has only a two-month supply of antibiotics, and unless more drugs arrive soon, Dr. Barnes predicts a skyrocketing rate of meningitis, pneumonia and leprosy--plus an outbreak of sleeping sickness. Worse yet, most of the U.N. doctors are scheduled to leave in De cember. Says Dr. Barnes: "What we need here is an almost unknown animal: a specialist in tropical diseases, surgery and obstetrics, with good French and Swahili, who is utterly unconcerned by a total lack of civilized social life."

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