There was a famous American Broadcaster who always finished his daily broadcast with a signature line, "And now you know the rest of the story" As a former missionary and ongoing radio broadcaster I had heard some of the classic descriptions of "Mission in Africa". 

So I embraced this project and looked forward to giving voice and hearing to this story... As I told Dr. Ray when he approached me about this project, "If it is important it must be heard".  And now you have heard the story, and I would encourage you to go now and read it.

This has been more than a project, but the rest of the story spoke deeply to me in so many ways.  Yes, good and great and well-intentioned men and women can do much good, but alas there is always a "rest of the story.  

Now Dr Ray takes over in full to finish the story and gives us ways to see that the story of them, is in many ways a story about us?  And in classic words, "Let him who has ears, let him hear."  I trust your hearing has changed you, as it has me in speaking.

Stan Hustad

Narrator

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Dr. Albert Schweitzer, at one time the best known of all our global health pioneers, came to Africa in 1913. His time overlapped with Cook, Macvicar, Gilks, Jamot, Chesterman, and Berry - and he died - in Africa - after two-thirds of African countries had gained independence from their colonial masters. He is still revered as a theologian, an expert on Bach, and a recipient of the Nobel Peace Prize.

But what of his legacy in Africa? If he is remembered at all, it is as a gentle self-assured old European man practicing the piano in the village of Lambarene in Gabon, a man who loved plants and animals.

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WTC Berry is a nearly unknown global health worker whose family had the foresight to encourage him to write his memoirs as therapy for a stroke. Berry had the honesty to tell us that his influence for going to Africa was watching a movie portraying the adventure of working for the colonial service. One of the actors in that movie, Paul Robeson, had the bravery to declare that the movie was an embarrassment to him and that he hated the way it - and he - portrayed Africans. In this song, Robeson’s character praises not Africans, but the colonial governor Sanders. And finally, Berry had the foresight to title his memoirs Before the Wind of Change, and leave unresolved the ambiguity of what he felt about that wind.

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Artists are some of the first people to tell us when something is wrong - wrong with our lives, wrong with the world. This music, written by Stravinsky in the second decade of the 20th century, is clashing, jarring; telling us something is wrong; seeking not to please and sedate us, but to disturb and awaken us. Yet it was written at a time when industrial and technological progress were on a steep upward curve. Why is he raining on our parade?

Some of the progress was truly helpful: think of medical research. But within medicine there was a desire not only to treat disease, but to improve normality. Eugenics viewed many biological and social problems as being genetic, and sought to improve the human race by selective breeding. And, in its worst moments, by eliminating the people that were ruining the gene pool.

This chapter recounts some research that took eugenics to a new low, proposing that the entire black race had sub-optimal genes and needed improvement. This proposal deserves clashing and jarring music.

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Was it a hymn that prompted Dr Clement Chesterman to become a medical missionary in Congo? And if so, which hymn?

This well-known gospel song says “Bear the news to every land/ Climb the steeps and cross the waves.” A call simply to go.

Other hymns described the “heathen” people that missionaries would find there as “oppressed”, “forever weeping”, “groping to find light”, and “in blindness bowing down to wood and stone”. There was even a vignette of child sacrifice.

One mid 19th century hymn tried to understand these “heathen” practices:

   “Still God looks on human faces

Heavenward turned, but not to Him;

Slaves in bondage, worse than of fettered limb.”

Why did this writer think that the human faces were not turned to God? Most missionaries had no idea how to tell the difference between superstition and God-given traditional understandings of life.

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Several years ago the medical school I worked for in western Kenya began a massive door to door Home Counseling and Testing program for HIV. It seemed unique: we hadn’t done this extensive screening for any other major chronic disease. It was part of a “population health” approach that was new, perhaps even cutting edge in public health.

Except that it wasn’t new. In the 1920s a French doctor, Eugene Jamot, pioneered this approach to detect sleeping sickness in what was then French Equatorial Africa. The French were very proud of him for this, and called this technique “Jamotique”. But his program backfired, as we will see.

At our medical school in Kenya they didn’t call the program “Jamotique”, they called it HCT - home counseling and testing. They had likely never heard of Jamotique. Was it that they didn’t know history? Or that they didn’t know French? Or perhaps both?

And will they, some years from now, find their program backfiring?

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Dr. John Gilks was “one of the least-liked but perhaps most efficient colonial officers” in the Kenya Crown Colony. Efficiency was certainly important - but being least liked did not help him with the task facing him. He needed to convince Kenyans that the government was doing something for them so they would be compliant healthy workers on settler farms. And what better way than to attack a very visible and easily treatable disease of the skin: yaws.

But his problem was not only being least-liked; there was also his competition: the medical missionaries, who he felt were getting more attention. That’s tough competition, considering their Patron.

Though it is unlikely that Gilks knew much about the music “back home” in the 1920s, it is a tempting thought that if he had listened to it and relaxed a bit, he may have been more likable - and more effective. It might have even prompted him to listen to the music of the people whose hearts and minds he wanted to win - and maybe they would have won his heart.

But we can’t rewrite history.

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John D Rockefeller started funding global health in 1910, and 3 years later set up the Rockefeller Foundation - long before there was a WHO or USAID. The Foundation is still funding global health today. Rockefeller made his money from energy, necessary for the massive industrial progress of the 20th century.

This George Gershwin tune, the theme song for the 1939 New York World’s Fair, capsulizes the optimism of this technological age, which by the middle of the century was making rapid progress in medicine. It was the dawn of a new day, they felt; “Better times, here to stay, as we live and laugh the American way.”

They just didn’t mention the dark sides.

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Now, is it really fair to use Gilbert and Sullivan’s satire of British military bureaucracy to introduce serious global health research? This was real research, uncovering complex life cycles of parasites and their vectors, knowledge necessary to control these diseases. This was not smoke and mirrors; the new knowledge was true, verifiable today.

The problem with research then, and today, is the games every researcher must play to get funding, to get attention, to get a name. We still struggle with whose names to put on the published paper, and it what order. There are plenty of door handles to polish, plenty of exams to pass, plenty of partnerships to develop. And sometimes, as at the end of this song, the casualty is no longer thinking for ourselves.

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Scott Joplin heard about, and perhaps even saw, a collision between two locomotives in Texas, and memorialized the event in his classic style in the Crush Collision March. Someone recently called it the best silent film villain song he had heard; someone else imagined a robber getting away while the damsel in distress was about to be hit by the train. 

The real story is more bizarre. The villain here was the MKT Railroad who staged the collision as a publicity event in Texas in 1896. It was witnessed by 40,000 people, 3 of whom were killed when the boilers of the two locomotives exploded during the collision. Americans do some pretty crazy stunts.

Henry Morton Stanley was working for an American newspaper when he “staged” the finding of Livingstone, who did not think he was lost and was not interested in being found. In this chapter, the American Creighton Wellman begins his career as a medical missionary, and performs some amazing feats among the “natives” - much of it sleight of hand. Then he returns to the US, and his self-promotion and deception start ballooning. He created the template for smoke and mirrors in tropical medicine.

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