CHAPTER ONE GENERAL INTRODUCTION
8. Overview of Chapters
Despite this, the space provided by the MLC was conducive to research and studying.
The large collection of photographs from the southern African mission field was valuable as one could put faces to the many names that passed through the mission field. Here also, there was a South African missionary on furlough, Rev. Christoph Weber, who spent some time helping the present author to translate some of the difficult German sentences into the English language. Since the archive was not yet organized for easy use, there were many extra copies of documents from reports and minutes from where I could extract information for later reference later in South Africa.
The South-Eastern Diocese (SED) of the Evangelical Lutheran Church in Southern Africa (ELCSA) has kept the archives of the many Lutheran mission societies that worked in Natal and Zululand in the head office in Umpumulo near Kranskop in KwaZulu-Natal. The office has a staff member who among many other duties, boxes and files all the documents previously scattered haphazardly in the archives room.
The work of finding documents proved quite tedious as the archivist had not completed the task of sorting out all the documents regarding the medical missions.
Private archives have also proved to be valuable in this study. For instance, a short unpublished history of the Kashile Hospital in Swaziland compiled by the retired Reverend Leonora Schiele could only be found from Schiele’s archives. Similarly, other people like the Schmidts in Pretoria were the only people who had photographs and copies of their awards while they were working in the BLH in Ramotswa. These bits and pieces of information form an integral part of the entire study because without them, there would be gaps begging to be filled.
ii. Chapter Two: This chapter provides an historical overview of the founding and operation of the mission hospitals in southern Africa. It locates the Lutheran mission hospitals within the wide spectrum of medical mission activities from the 1930s to the 1970s. The two graphs, Figure 2,49 and Figure 3,50 show how, in 1972, each medical mission society featured with regard to the number of hospitals in the various southern African countries. One should not assume that the Lutherans were the only players in the field of medical missions at that time.
iii. Chapter Three: Since the thesis deals with biomedicine as introduced by missionaries from Europe and the USA, this chapter will seek to show that by the time of the introduction of biomedicine and during the founding of mission hospitals, other health systems were used by the indigenous people of southern Africa. Entitled Conceptions of Disease, Restoration of Health and Dependency, this chapter looks at the health system practiced by the Nguni group of the Zulus and the Xhosas and the Sotho group of the Sothos and the Tswanas. The other health system considered is the one practiced in churches, especially the Zionist-type and Pentecostal churches.
iv. Chapter Four: Entitled Acculturation and Cultural Assimilation, this chapter will show that the introduction of biomedicine in southern Africa in the late 1800s and early 1900s cannot be seen as having been parachuted onto the indigenous people. That encounter between the missionaries and the indigenous people was a time of compromise and negotiation as to what was acceptable and what was not. Biomedicine was introduced at the time when missionaries were trying to convert and change the tradition of the indigenous people. The period was also a period of colonialism during which indigenous people were dispossessed of their land by the White people who were similar to missionaries. This chapter shows that the missionary cultures and the cultures of the indigenous people influenced each other to the point that biomedicine was accepted by the indigenous people when the mission hospitals were established in the 1930s.
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v. Chapter Five: Entitled The Four Mission Hospitals, this chapter will look at each of the four mission hospitals, at the circumstances of their foundation and at the challenges they faced in their development. Issues discussed are issues of the pioneers, buildings, doctors and nurses, staffing, expansion, financing, and relationship with the local communities. The chapter leads towards the period where due to expansion and other reasons, the governments of South Africa and of Botswana intervened in the mission hospitals in order to provide subsidies.
vi. Chapter Six: Entitled Mission Authorities and the Nationalization this chapter will discuss the nationalization of mission hospitals. It describes the events and circumstances that caused both the South African government to nationalize mission hospitals, and the Botswana government to become a major partner in the Lutheran Bamalete Hospital in Ramotswa. Financial, medical, ecclesiastical and political needs caused the two governments to be involved in the running of mission hospitals in the 1960s. In the 1970s, the South African the government’s intervention ultimately led to the nationalization of mission hospitals and to the later handing-over of mission hospitals to the newly-created homelands in South Africa. This chapter will show that disproportionate power relations in the hospital setting could marginalize some people and put others at the centre.
vii. Chapter Seven: Entitled The Churches’ Responses to Nationalization, this chapter will analyse the responses to the nationalization of the Lutheran mission hospitals by the various bodies that were directly involved, viz., the Lutheran mission societies and the Lutheran national churches that “inherited”
those mission hospitals in the late 1960s. The lack of meaningful response to the nationalization process by the mission societies and by individual doctors and nurses raises questions on the motives which prompted the mission societies to provide health care to the indigenous people in the 1930s.
viii. Chapter Eight: Entitled General Conclusion, this chapter forms the conclusion of the thesis by showing that health care has been so politicised,
ARVs in the case of HIV/AIDS—there are chances that many may still not access it. The fact that the government can nationalize and privatize health care as is the case in southern Africa, indicates that the Poor may be excluded from accessing it. One can argue that local communities living far away from health centres can manage their health with basic health facilities like clinics in their neighbourhood, complemented by traditional health care centres, also in their neighbourhood.