News on medical issues from Africa and other parts of the Global South often come with triumphant images of biomedical personnel fighting scary diseases using sophisticated technologies that are met with local incomprehension or rejection. Ebola workers are depicted in their white body suits; coverage on aids interventions emphasizes the seemingly strange reactions that those therapeutic and preventive measures provoke. To the historian, the colonial heritage of such global health interventions is rather obvious.
Historical research on medicine in Africa and other colonial contexts frequently analyzes what might be called the domineering side of biomedicine. Studies that examine health policies, public health campaigns, or public-private cooperation often focus on the spectacular aspects of colonial medicine, on what today are represented by the white suits or antiretroviral drugs. 1 Such scholarship illustrates how racist and forcible biomedicine can be. It stresses biomedicine’s top-down nature and explains how it suppresses vernacular practices and knowledge. Emphasizing global or inter-colonial transfers, research of this kind frequently neglects to assess how biomedicine is transformed locally.
Historical research that focuses on how biomedicine is instantiated in the colonies, on local incomprehension, or on the agency of the colonized often analyzes what can be called biomedicine’s interactive side.
2
Such studies, frequently drawn from missionary contexts, investigate biomedicine’s contact with other forms of healing and with local conceptions of health and disease. They illustrate that biomedicine was highly adaptive: it incorporated local ideas and practices, and it was incorporated by them. Concerned with issues of translation and hybridity and often working with memories and material evidence, this strand of scholarship frequently disregards how biomedicine aims for dominance and suppression. Many historical studies, of course, examine both the domineering and the interactive aspects of biomedicine.
3
What is poorly understood about colonial medicine, and about global health today, despite this rich literature, is how it operated on a daily basis. Routines and practices have rarely been the focus of historical or anthropological studies on colonial medicine. Medical historians working on Europe or North America, on the other hand, have recently started to acknowledge the importance of practical work in medicine. They have, however, rarely been interested in Africa. My study, while not necessarily limited to an African context, aims to be locally grounded.
My monograph shows how an examination of practices and routines increases our understanding both of everyday medical work and of biomedicine itself. The domineering and interactive sides of biomedicine are equally important in this respect. My focus demonstrates, however, the centrality of uncertain theories and unproven experimentations, therapeutic half-successes and half-failures – in short, improvisations – to the practice of biomedicine. Equally importantly, this approach takes a step toward better comprehending local experiences and understandings of medicine, illness, misfortune, and health, as patients and their kin, auxiliaries and nurses, come to the fore as individuals and subjects.
A microhistorical lens is the most useful tool for an in-depth study of daily routines. 4 Considering the hospital as a microcosm for biomedical practices allows us to study not only processes, connections, and blind spots within the institution, but also interactions with individuals and structures outside the institution. An extensive and deep archive and a careful scrutiny of the material therein are central for recreating such a microcosm. While analyzing the various wards and treatments of a hospital reveals patterns, it uncovers even more incoherences. Practices that were instantiated differently within the same institution can be considered examples of the ‘normal exception’. 5 Such an analysis thus avoids quick conclusions and illuminates the complex links between the micro- and macro-levels. It allows for multiperspectivity, prevents the formation of reductionist arguments, and reveals the improvised nature of biomedicine.
Biomedicine, in theory, functions with respect to various key concepts. Among them, I have chosen to analyze order, control, knowledge, standardized experimentation, and ‘civilization’, because these are also helpful for studying colonial relations. In practice, these ideas and ideals are very brittle in their application. The pursuit of control in surgery and trial-and-error testing in the
The Albert Schweitzer Hospital in Lambaréné, established in 1913, is particularly well suited for conducting a microhistory of biomedical practices, given the extraordinary amount of source material that it left behind. It provides an alternative vantage point that looks beyond the dominant governmental or missionary institutional frameworks of colonial medicine. In discussions on the spread and adaptation of biomedicine, Nobel Peace laureate Albert Schweitzer from Alsace and his hospital in the French territory of Gabon quickly come to the fore. Yet, no historian has considered the institution in detail, and thus far no scholarly book has examined its medicine within its spatial and temporal context (Maps 1–3). An analysis of the hospital’s medical practices thus also contributes to revising the myth surrounding the institution.
The location of Gunsbach and Lambaréné on the globe
1 Utilizing a Colonial Archive in Gunsbach, Alsace
In 1967, two years after Albert Schweitzer died, the Dutchwoman Ali Silver, who had served at the Albert Schweitzer Hospital as a nurse and secretary since 1947, began transferring Schweitzer’s papers to what had been the hospital’s organizational base in Europe until his death. This was a house that had been constructed in 1928 in Gunsbach, the small Munster Valley village where Schweitzer had grown up. Sonja Poteau, who had worked in Lambaréné as a nurse for four years during the late 1950s, soon came to Silver’s assistance in the immense task of cataloguing the documents, before taking over full responsibility for this work herself in 1990. Assisted by their friends, family, and volunteers, Silver and Poteau classified correspondence, manuscripts, and photographs, while seeking to acquire as many additional letters as possible that Schweitzer had sent to his countless correspondents all over the globe. In 2010, a new team assumed the running of the Maison Albert Schweitzer Gunsbach, which became the headquarters of the Association Internationale de l’Oeuvre du Dr. Albert Schweitzer de Lambaréné in 1966, the year the organization was founded. Its goal is ‘the diffusion of the ethical values proposed by Albert Schweitzer’; to this end, ‘the conservation and maintenance of the archives in Gunsbach are a major contribution’, they claim on their website. 6
Today the Maison Albert Schweitzer Gunsbach houses a comprehensive library of books by and on Schweitzer, as well as a museum containing, among many other things, the piano on which he used to play after dinner in Lambaréné and the bed in which he slept when in Europe for his extensive fund-raising tours. In addition to a number of his philosophical and theological manuscripts, drafts of sermons he gave, and a collection of photographs taken by various visitors and numbering in the thousands, the archive holds at least 70,000 letters addressed to Schweitzer as well as 10,000 letters that he composed. These are arranged by topic rather than in a strictly alphabetical or chronological order, but an alphabetical card index of correspondents aids research. The archive is currently being reorganized and partly digitized; nevertheless, many uncategorized documents that are held in the cellar still await filing, including the medical records used for this study, such as operation protocols and patient lists. For this book, I have consulted all catalogued letters
Letters to Schweitzer proved to be the most useful sources, with staff frequently writing about medical practices. The letters composed by Schweitzer concern themselves overwhelmingly with organizational and financial affairs, especially with issues of how to recruit personnel or acquire, pay for, and ship medication and other material. A large number of published memoirs by hospital employees and travel accounts by visitors also describe aspects of life at the hospital, including some that offer valuable insights into the daily practices of biomedicine. To supplement my research, I conducted interviews with Swiss medical personnel who were employed at the hospital as well as with Gabonese who lived on the hospital grounds during Schweitzer’s lifetime, usually the children of hospital personnel. I have also consulted the archives of the colonial administration, maintaining a particular focus on records relating to its health services. 9
The archival documents relating to the Albert Schweitzer Hospital are extraordinary in their narrative quality. They are exceptionally detailed and varied, not only for an African hospital, but in a global context. It is important, however, to recognize that these records are colonial sources. Scholars have long cautioned about the validity of colonial historical material, outlining how their authors drew from a long tradition of fiction and travel writing that had combined to produce a prejudiced image of Africa and the colonial world. In these works, whole territories and their inhabitants were feminized, infantilized, and/or romanticized, while at the same time rendered as dangerous and unhealthy.
10
The images invoked in the process could then serve to justify colonial penetration and exploitation, as well as the imposition of radical changes in colonized societies.
11
In Gabon itself, colonial officials and
Sources by and on Schweitzer borrowed from and contributed to all of these genres, as identified by Osaak Olumwullah, who starts his study on colonial medicine in Kenya by quoting from the first page of Schweitzer’s memoir On the Edge of the Primeval Forest, in which he wrote: ‘out there in the colonies … sits wretched Lazarus’. In this book, Schweitzer compared himself and his fellow Europeans to the rich man of the biblical parable: despite possessing superior medical knowledge and means, they had long ignored the health of Africans. Olumwullah highlights how such narratives fed into ‘the idea of Africa as both patient and nature’. 15 Identifying these limitations in the archival record is the first and perhaps most important step for the historian to take when engaging with such sources.
Thereafter, a range of strategies presents themselves for analytical purposes, of which reading against the grain is one of the most promising. I understand this approach as the distilling of information from a source that its author did not intend to provide, a method especially useful for microhistories such as this study.
16
While this technique is crucial for uncovering patients’ perceptions and their attitudes towards biomedicine, the reconstruction of medical practices often follows the grain; it was usually medical practitioners’ intention to inform their superiors about treatments and challenges. Ann Laura Stoler shows how a critical reading along the grain corrects the ‘familiar plots’ of colonial knowledge production. She demonstrates that colonial power was intent on a ‘selective winnowing and reduction’ rather than an accumulation of
2 Theorizing Hospitals in Africa and the Practice of Biomedicine
Biomedicine is an imprecise yet useful term; despite its shortcomings, the expression is worth retaining, as its alternatives are even more misleading. 19 Commonly, it refers to the body of medical practices that rely on the biological sciences to explain life processes. The term is notoriously ambiguous, as it describes research as well as practice. The close interaction between theory and praxis results in varieties of biomedicine that take on diverse local forms. 20 This perspective is particularly valuable for historical empirical studies of biomedicine in general and its practices in particular. Both Claire Wendland and Julie Livingston have highlighted the improvised aspects of biomedicine. These become especially obvious when analyzing how biomedicine is practiced in twenty-first century Africa. Their studies reveal that it is an adaptable field that manifests itself in different configurations depending on its specific context. 21
In this book, I concentrate on an understanding of practice in its plural form, namely as ‘a sequence of activities’ rather than the ‘generic […] work of
Historians of medicine are increasingly following the ‘practice turn’ in science studies, an approach that has been the subject of much recent scholarly discussion, 25 but they still lament the lack of understanding of physicians’ daily routines. 26 Publications that aim to fill this gap usually rely on practice records or casebooks, both of which are particularly well suited to answering questions on medical practices. 27 Other potentially relevant sources include a great variety of records, from doctors’ diaries to invoices and medical instructions for patients. These documents draw attention to the recording process and the fact that writing has always formed an essential part of clinical practice. They are also particularly useful for reconstructing everyday clinical practices. 28
The operation and delivery protocols, monthly patient lists, patient casebooks, and annual statistics for the Albert Schweitzer Hospital – and even Schweitzer’s notebooks
29
– are notably less discursive than those used for
Most practice-oriented studies by medical historians focus on individual doctors. Although the hospital, alongside the laboratory, is considered the quintessential setting in which biomedicine takes place, 30 scholarship that explores the medical practices of individual hospitals is more rare, possibly due to the limitations of the archival record. Hospitals are by their very nature local institutions. They have been defined by and reflect the political, social, and economic power structures that manifest themselves in architectonic and organizational preferences as well as medical principles. 31 Because of these interactions, historians of colonialism often view individual hospitals as offering ‘important case (studies) in tensions between tradition and modernity’. 32 Historical studies on medicine in Africa that rely heavily on hospital sources exemplify this point. Often using mission records they frequently explore these tensions. 33 Contributions on hospitals in South Africa have concentrated on how political and social contestations unfolded around biomedicine. 34
This book regards biomedicine as a lens through which to study the colonial encounter and the tensions to which it gave rise. It pays particular attention to daily hospital routines and where they collapse. It is precisely here where we can discern agency and learn more about African patients as they went about negotiating their hospital stays. Despite every hospital’s unique local form, it is important to emphasize that hospital treatment represents an exceptional experience for each patient. As patients leave their familiar social setting, they
An important exercise throughout this book is to place my findings in their local and global contexts, and to compare them to contemporary medical trends and broader colonial socio-political patterns. Early colonial governments established medical services in their respective colonies for the primary benefit of European officials and settlers. From the second half of the nineteenth century, missions were the main providers of biomedical services in rural parts of Africa. 36 A number of historians have observed that Africans often preferred attending mission hospitals due to these institutions’ propensity to adapt to local demands, their more compassionate staff, and their less rigid rules. 37 Initial attempts to secularize missionary medicine occurred in the interwar period. 38 After World War Two, governments in much of the colonial world, including Gabon, started to expand their medical services, becoming more interventionist in the process. 39
Recent research highlights that medical missions likewise implemented preventive medicine programs. They trained Africans, provided healthcare education, offered pre- and postnatal care, and participated in or planned vaccination campaigns; their focus on curative services, meanwhile, was often a response to the demands of the local population.
40
Missions were thus pivotal for the ‘popularization of biomedicine, or at least certain aspects of biomedicine’, as David Hardiman argues.
41
The hospital under study in this book also played a role in popularizing biomedicine, but in many of its other features represented an alternative model to the prevailing missionary- or government-led approaches to healthcare in Africa.
3 The Context: Trade, Politics, and Health in Colonial Lambaréné
The settlements on the confluence of the Ngounié and Ogooué rivers were important nodes in far-reaching African trading networks of the nineteenth century. The Galoa king Nkombe founded Adolinanongo in about 1860 on the same land to which Schweitzer would move his hospital in 1927. 42 The two decades following Adolinanongo’s establishment marked the first economic boom of the region around the town, which is today known as Lambaréné. Nkombe encouraged trading companies and factories to establish their headquarters in the vicinity, possibly to decrease his reliance on middlemen to facilitate trade. Missions as well as the French army soon established their own bases in the area, but many were moved further up the Ogooué River to the town of Ndjolé in the late 1880s and early 1890s. 43 In 1910, Gabon became one of the four territories that made up the new French colony of Afrique Equatoriale Française (aef); it retained this status until it gained its political independence in 1960.
The Galoa and the Fang formed the two largest groups of patients who attended the Albert Schweitzer Hospital. Each group had their own separate accommodation there, while the hospital employed resident interpreters for both languages.
44
The Galoa people, who speak a language belonging to the Myene cluster of Bantu languages, had been present in the Lambaréné region since at least the early nineteenth century.
45
They were known for embracing Catholic and Protestant missionary education, both of which were represented in local schools.
46
The Galoa were sandwiched between Gabon’s two biggest
Movement and migration was routine for people of the Lambaréné region throughout the first half of the twentieth century. Local residents usually relocated their settlements after a maximum of ten years.
50
The pressures of World War One as well as the colonial administration’s resort to forced labor for the construction of roads and the Congo-Ocean Railway in the 1920s compelled men to leave their families, which then drove women to seek work, such as the gathering of rubber, beyond their settlements.
51
The colonial government unsuccessfully tried to control these movements of men and women by enacting a series of ‘village regroupement’ schemes,
52
which aimed to facilitate tax collection and to satisfy the exigencies of capitalism and the monetary system.
53
Scholars emphasize the dramatic impact of global trade on the region, which transformed disparate structures ranging from modes of agricultural
Throughout the study period, Gabon’s most important export was Okoumé, a relatively soft wood. Timber extraction was a seasonal activity as it depended on the water level of the rivers for transportation. Its production intensified after 1900, attracting a large number of migrant laborers. Despite various economic crises, such as during the world wars or the Great Depression, the local timber industry usually recovered quickly. In time, the dominant lumber companies strengthened their influential position in the relevant political and economic circles of the colony. 56 Sanitary conditions in the lumber camps were often substandard and accidents occurred frequently. 57 A considerable percentage of the patients who sought care at government healthcare facilities or at Schweitzer’s hospital came from lumber camps, as will be discussed in Chapter 2. Many of those patients came to repair hernias, which was a very common intervention in various hospitals of the region.
In the late 1920s, up to 25,000 workers were employed in the industry in Lower Ogooué and Middle Ogooué, the two administrative districts that stretched from Ndjolé westwards to the mouth of the river.
58
The colonial administration counted 6,000 laborers under contract plus an unknown number of workers ‘in an irregular situation’ in the Lambaréné Subdivision alone.
59
During the 1930s, the town itself was estimated to have approximately 1,000 inhabitants,
60
while the wider subdivision had an estimated population of about 15,000 people.
61
The period after World War Two until Gabonese independence is less
Many Gabonese historians underline the complicit attitude adopted by missions towards these overtly colonial and capitalist processes, as missionaries were concerned with assimilating Gabonese into a European value system. To this end, they fought against what they perceived as local ‘superstitions’, seeking to eradicate ‘fetishism’ and reconfigure the relationship between individuals and their communities, for example by aiming to alter family structures. Schooling was envisaged to play a pivotal role in this process. 65 Chapter 5 describes how Schweitzer positioned himself in this ‘civilizing mission’.
European and North American scholars, on the other hand, have often focused on the aspects of central African life that missionaries meant to eliminate. They show how Gabonese resorted to the ‘supernatural’ and how this was intertwined with what is commonly labeled as the separate spheres of religion and politics, a distinction that most present-day scholars of central Africa consider misleading or useless.
66
The Gabonese sociologist Joseph Tonda insists that commodity capitalism was and still is entangled in this complex too, a nexus that also included healing and medicine.
67
The exertion of power in all these domains relied on forces that could simultaneously strengthen and weaken, heal and harm. 68 In precolonial Gabon, the indigenous term for ‘medicine’ or ‘remedy’ went well beyond the biomedical conception attached to pharmaceutical products. Medical objects were not only used to combat disease, but also to attract good fortune, attain greater success in trade, or repel bad luck, among other objectives. Colonial observers termed such objects ‘fetishes’. 69 Jan Vansina, the eminent historian of Central Africa, refers to them as ‘charms’. He notes that they were regarded as being able to function on a collective level, often targeting ‘crucial problems: control of the rains, defense of the village, help in war and hunting, and, not least, detection and eradication of witchcraft’. 70 Tonda confirms that this broad conception of the term ‘médicament’ is still maintained in the region today. 71 This is not to say that local inhabitants did not exploit plants with the aim of inducing effects that more closely corresponded to the biomedical concept of a drug; a wide range of herbal medications have long been employed to treat a large variety of afflictions in Gabon. 72 Chapter 1 will provide more details on local vocabulary and actors of healing.
The interrelatedness of what Western scholars would label religion, politics, economics, and healing is often exemplified in the (diseased) body, which can be presented as a fertile site to demonstrate where the views of colonizers and the colonized differed and where they overlapped, as Florence Bernault convincingly does. As she writes, the ‘fetish value of the human body, far from being confined to African societies during colonialism, haunted the minds, the laboratories and the markets of French rulers’; one of their main shortcomings
Since the various healthcare services offered by the colonial government will be discussed in detail in each of the main chapters, I will now provide only a very short overview of government medical services in Gabon, doing so by drawing from the comprehensive histories written by Hines Mabika Ognandzi and Rita Headrick respectively. Headrick underlines that while there were more doctors per inhabitant in aef during the 1920s than in other French colonies, much less money was spent on healthcare than in other colonies.
77
Gabon itself, meanwhile, received 24 percent of the medical supplies allocated to aef, but made up only 12 percent of its population.
78
The first biomedical services in Gabon were offered in the 1860s on an army ship off the coast of Libreville. A hospital was established there in 1896, and three years later ‘medical posts’ had been founded in Port-Gentil and Ndjolé.
79
The colonial government made some efforts to expand healthcare provision during the interwar years,
80
but only after World War Two did medical funding, personnel, and facilities increase significantly. For example, the total number of hospital
The Gabonese colonial government first opened a healthcare facility in Lambaréné in 1921. This was closed when Schweitzer returned to Gabon in 1924, but was reopened in 1926. 84 There is evidence to suggest that Schweitzer urged the authorities to do so to offer his hospital a respite from the increasing numbers of patients arriving with beriberi and sleeping sickness. 85 Subsequent government reports occasionally express a relatively hostile attitude towards Schweitzer and his hospital, a perspective usually infused with anti-German and anti-Protestant sentiments. 86 However, this did not prevent the two clinics in Lambaréné from cooperating in certain areas, including their agreement that all sleeping sickness patients would be treated at the government facility. 87 Comparisons between the two institutions are made throughout this book. Towards the end of the 1950s, Balandier visited the government facility, whose status had been upgraded from ‘infirmerie’ to ‘hospital’. The resident physician there, a former student of philosophy, was rather disillusioned by the state of the hospital’s equipment and its general condition, comparing it unfavorably to the Albert Schweitzer Hospital:
Look, I was called to a hospital without any equipment. What you see here is fictional, out of order. The autoclave is from the founding days, we could make it a pantry. Do you take your meals at the hotel? Then you risk appendicitis. I’ll operate on you and you’ll have every chance of staying for lack of asepsis. Dies irae, dies illa … No, I’ll send you to Schweitzer. That’s what I’m reduced to! I become a supplier, while I should be a competitor. 88
4 Albert Schweitzer and His Hospital in Lambaréné: a Short Historiography
Books on Schweitzer often indulge in colonial genre-writing, as outlined above, thereby focusing on particular stories. Like Schweitzer’s own account of his life in Lambaréné, many memoirs of visitors or employees start with a description of their author’s outward voyage by ship or, later, airplane. Most biographers repeat what Schweitzer had written himself, such as when recounting the reasons behind his initial decision to move to Lambaréné or how he put together the final pieces of his ethical philosophy. 89 Bertrand Taithe and Katherine Davis remind us that Schweitzer played an active role in molding his own legacy. They argue that he lived long enough to ‘be able to shape his own reputation’, labeling scholarship on him as ‘something of a cottage industry’. 90 Ruth Harris observes that biographies do not situate Schweitzer, his thought, or his hospital into the broader context of colonial medicine, humanitarianism, or missionary endeavors, with their authors ignoring relevant historiographical trends, such as transnationalism. 91
Most publications on Schweitzer rely heavily on already published secondary sources or on material published by Schweitzer himself. One explanation for this is that much of this writing is concerned with his theology or philosophy.
92
Schweitzer held a doctorate in the latter discipline and a habilitation in the former. While current research agrees that his prospects for an academic
According to his own narrative, Schweitzer quit both disciplines in 1905 at the age of thirty and began to study medicine with the goal of traveling to Africa to salvage the African ‘Lazarus’ already referred to and redeem the sins of colonialism.
94
Balandier, writing during Schweitzer’s lifetime, and James Carleton Paget, writing more recently, have both underlined how uninterested he was in the fate of the continent and its people, and how marginal a role the local context that he encountered in Lambaréné played in his writing and thinking.
95
His estimations of the local people to whom he administered medical care did not improve during his long stay in Gabon; rather they lowered over time even though he refrained from saying so publicly. In private letters and in conversations with visitors, Schweitzer voiced a particular distaste towards the new African elite.
96
He was disillusioned about their embrace of Western political and economic values in particular. In his view – an opinion that he shared with many contemporaries, notably Protestant Swiss
97
– ‘European civilization’ was on the decline due to the rise of materialism and nationalism as well as technology’s ever-increasing permeation of society. Schweitzer specifically lamented that those trends were not accompanied by a corresponding shift in ethical thinking. For him, the two world wars were proof of this development.
98
Nevertheless, he still believed in the superiority of ‘European civilization’, an argument that he justified by invoking a cultural rather than a racial discourse.
99
Given his sentiments described above, it would appear surprising that Schweitzer showed any interest in going to Gabon at all. Indeed, Carleton Paget concludes that his ‘decision to go to Africa arose almost by chance’. 100 Prior to this, Schweitzer had attempted to participate in a number of charitable endeavors, such as looking after orphans. In such activities, however, he was forced to adhere to the narrow prescripts of charities or governments, a circumstance that conflicted with his strong desire for personal independence. 101 ‘In seeking to distance himself from the restraints of European civilization, he was not unlike other adventurers and explorers of a more openly imperialistic cast of mind’, Harris argues. 102 Schweitzer’s reasons for joining the Paris Evangelical Missionary Society, an organization that was highly suspicious of his liberal theological views as well as his German origins, are similarly obscure. With this decision, he might have sought to nurture a peculiar form of Alsatian transnationalism; alternatively, he may have recognized in the society’s call for missionaries to salvage Africa a personal vocation from Christ. 103
Schweitzer’s move to Lambaréné – and, indeed, his whole life thereafter – is probably best understood as an enactment of his own ethics, the moral system that he termed ‘Ehrfurcht vor dem Leben’ and which is commonly translated as ‘Reverence for Life’. Its basic tenet is that all living beings, including animals, share the same will to live, and thus possess an identical inherent value and right to life. That Schweitzer’s life and hospital represented an embodiment, a practice so to speak, of this theory had already been argued during his lifetime.
104
The British reporter Gerald McKnight suggested in 1964 that Schweitzer ‘went to Lambaréné to serve his own purpose, not primarily to heal sick primitives’.
105
There is evidence that Schweitzer himself saw his life in a similar light.
In order to contextualize these interpretations and gain initial insights into the Albert Schweitzer Hospital, I now provide a brief overview of how the institution has been evaluated. A more detailed analysis on three of the hospital’s most remarkable features is conducted in another book. 108 It sketches out how Schweitzer’s international networks were created and maintained. These were also important for sustaining what we call the ‘Lambaréné Spirit’, which was the ideal atmosphere under which living and working at the institution occurred. This concept included, among many other things, to consider the hospital’s offers as simple medical services, which people were free to use or not.
Negative assessments of the hospital increased in the late 1950s, a time during which Schweitzer’s global reputation was growing.
109
Replies that defended the hospital suggest that there was indeed something more to the endeavor than the desire to care for sick Africans. Furthermore, many reports reveal that improvisation was important at the hospital not only in medical matters. It was also a central feature of its general organization, as will be examined in Chapter 2; and indeed, Schweitzer’s hospital as such is sometimes regarded as an improvised enactment of the ‘Reverence for Life’.
110
André Audoynaud, the government physician in Lambaréné in the early 1960s and perhaps Schweitzer’s harshest critic, compared the hospital to a ‘bidonville’, a slum. 111 The well-known anthropologist James Fernandez, who traveled to Gabon with his wife in 1958 to conduct fieldwork for a period of two years, spent some time at the hospital towards the end of his stay. In a stimulating article about this visit, Fernandez recounted that he was not overly mystified by what he observed at the hospital. ‘Unlike those many visitors who were yesterday in Paris or New York we were not especially struck with the hurly-burly of hospital life’, he wrote. 112 ‘The ragged inmates in barracks’ and a ‘Teutonic desire for order’ reminded him of a concentration camp, but he recognized that ‘a humanitarian ethic is the organizing rationale at work at Lambaréné, and that is the crucial difference’. 113 Jacques Bessuges, the government physician in Lambaréné in the early 1950s, maintained good relations with Schweitzer. During his first visit, he also associated Schweitzer’s hospital with a concentration camp, mainly due to its architectural style and overcrowded conditions. The large number of domestic animals roaming freely all over the hospital grounds caused him added disconcertion. When Bessuges left, however, he sensed that the patients at the hospital were happy; he now bemoaned the contrasting conditions in more conventional hospitals that saw patients left to give birth or die without the support of their families, who were encouraged to stay at the Albert Schweitzer Hospital. 114
A reevaluation of first impressions is a typical feature of accounts of the Albert Schweitzer Hospital, as exhibited in a letter by Dr. Victor Nessmann, the first physician to practice alongside Schweitzer in Lambaréné. In October 1924, Nessmann wrote to his parents about how he had been initially struck by the disorder that he found at the hospital. However, this feeling soon dissipated, and two weeks after his arrival he had already come to appreciate Schweitzer’s ‘wise and powerful spirit and methods and his guiding ideas’.
115
The South African surgeon Jack Penn, who visited Lambaréné in 1956, subsequently wrote an article about his stay in a medical journal. He noted how ‘the wards at first glance look overcrowded and shocking’; the practice of permitting family members to stay alongside patients and cook in front of their wards particularly
Former nurses whom I interviewed were appalled by the unhygienic conditions that they discovered on arrival. 117 The numerous animals and cooking fires on the hospital grounds also generated further dismay among newly arriving nurses. 118 Dr. Walter Munz, who would become the hospital’s medical director after Schweitzer’s death, was similarly perturbed by the conditions that he encountered on arrival, but soon recognized that Schweitzer had created order in this apparent chaos that could be understood by patients and staff only. 119 Cousins held a similar view:
much of what you saw for the first time at the Hospital seemed so primitive and inadequate as to startle. But when Dr. Schweitzer walked through the grounds, everything seemed as it should be. More than that: the profound meaning of Lambaréné suddenly came to life. 120
Dr. Greet van der Kreek, who completed a total of almost six years of service at the hospital in the late 1950s, recalled her stay in much the same manner. Like Penn and others, she compared the hospital to a village. ‘In my memories, Lambaréné is first and foremost this fascinating village, living and alive, whose rhythm the Great Doctor regulated like a poet’, she recounted in an interview. 121 In 1931, the nurse Emma Haussknecht, who would become one of the hospital’s most dedicated staff members and serve as a secretary and nurse until her death in 1956, wrote that Africans spoke of the ‘village of the doctor’. 122 When Schweitzer described the design and construction of the hospital’s second site, he wrote that ‘the new hospital will become a real village’. 123 One of the first additional physicians to arrive at the hospital, the Alsatian surgeon Frédéric Trensz, later claimed that this had been planned to make the patients feel at home. 124 Van der Kreek repeated this argument, explaining to Cousins that the hospital was
a jungle village with a clinic. If Dr. Schweitzer had put up a fully equipped modern hospital of the kind you see in large cities, I am not sure the natives would come to it. They would probably be afraid of it. The hospital here they understand. It is very simple. If a person gets sick and the local remedies are of no use and the sickness stays on, the entire family gets into a pirogue and paddles – sometimes many, many miles – to the clinic here at Lambaréné. When they arrive, they find an African village very much like the one they left. 125
Although the village metaphor still finds currency in current research on Schweitzer, it was already under challenge in the 1960s. 126 Fernandez highlighted that the ‘crowded sick huts’ were also found in mission hospitals. In his experience, African settlements were less crowded and offered ‘more healthy space and orderly living arrangement’, adding that ‘the virtue of equatorial life lies in moving the village to a completely fresh site every eight or nine years’. 127 Two nurses noted independently, and not without surprise, that the settlements that they visited appeared to be much cleaner than the hospital. 128 The Gabonese jurist Augustin Emane conducted approximately sixty interviews with people who had stayed at the hospital as patients or attendants. In addition to the points already identified, they specified a range of further differences. A Gabonese village housed fewer people per room than the Albert Schweitzer Hospital and did not see women cooking outside, as the courtyard was a masculine space. Unlike the hospital, a village had toilets and no one imposed a night-time curfew from 8 p.m. A patient’s stay at Schweitzer’s hospital was transitory; a village, meanwhile, implied sedentariness. 129
Fernandez observed that the living quarters for African staff were significantly inferior to those of their European colleagues, remarking that ‘when one compares them to the quarters available to the infirmier working for the administration, one asks how Schweitzer can keep any competent Africans at all’.
130
This sentiment is supported by the fact that these facilities were among
My interviews similarly suggest that the quality of their living quarters was not considered particularly important by African staff. Not unlike medical personnel from Europe, Africans who were involved in Schweitzer’s work for a longer period of time assessed it in an overwhelmingly positive light. Children of Schweitzer’s African staff members emphasized that he represented a sort of father or grandfather who cared well for them, for instance by providing clothing, food, and school utensils, as well as paying for their school fees. 133 They also insist that the salary offered to African employees was more than sufficient. 134 Emane summarizes his interviewees’ points of view: ‘what seemed most important to them was that this man who had left his country had come to settle among them and really behaved as someone from elsewhere should. He did not disrupt their lives or beliefs’. 135 This book will shed light on the specific ways and areas in which Schweitzer and the medical practices at his hospital disturbed, ignored, and/or reinforced African ways of life and beliefs.
More critical African voices are persistent, but usually mediated by visitors. Notable exceptions can be found in a recent collection of essays from Gabonese scholars.
136
More prominent is the Nobel Laureate in Literature V.S. Naipaul who contends that Schweitzer’s reputation among Africans remains ‘that of a man who was “harsh” to Africans and was not interested in their culture’.
137
This introduction has revealed considerable ambiguities in Schweitzer’s ideas and actions, as well as in the way that these have been assessed by colleagues, visitors, staff, and scholars alike. These contradictions cannot be fully explained by analyzing the medical practices at the Albert Schweitzer Hospital, nor is this my book’s primary aim. It will show that practices, including improvised biomedical ones, often are contradictory. It is crucial to consider, however, the thought and motivations that enabled and framed these practices, as well as the social environment in which they occurred and by which they were shaped.
Recent examples of studies with such a focus include: Lachenal, Le médicament qui devait sauver l’Afrique; Ngalamulume, Colonial Pathologies, Environment, and Western Medicine in Saint-Louis-Du-Senegal, 1867–1920; Pearson, The Colonial Politics of Global Health. For a chronological overview of the historiography, see: Hunt, ‘Health and Healing’.
Recent examples include: Hardiman, Missionaries and Their Medicine; Kalusa, ‘Medical Training, African Auxiliaries, and Social Healing’; Langwick, Bodies, Politics, and African Healing.
Greenwood, Beyond the State; Hokkanen, Medicine, Mobility, and the Empire; Tappan, The Riddle of Malnutrition.
For informative discussions on microhistory see chapters 8–11 of: Renders, Theoretical Discussions of Biography.
For a discussion of the value of this concept, first developed by Italian historian Edoardo Grendi and also translated as ‘exceptional normal’ or ‘exceptional typical’, see: Peltonen, ‘Clues, Margins, and Monads’.
http://www.schweitzer.org/aisl/qui-sommes-nous (2 June 2020).
Namely ‘Médecine’, ‘Hôpital’, ‘Lambaréné’, ‘Gabon’, ‘Lambaréné Personnel’, ‘Lambaréné Malades’, and ‘Lambaréné Hôpital’; a total of roughly 900 letters, which have all been digitized.
These letters amount to 900–1000 pages.
The records of the French colonial Service de Santé are now archived at the Service Historique de la Défense (shd) in Toulon. This proved to be the most useful state archive for the purposes of this study. I have also consulted documents in the Archives Nationales d’Outre-Mer in Aix-en-Provence (anom), in the Archives Nationales du Gabon in Libreville (ang), as well as in the archives of the Wisconsin Historical Society in Madison (awhs).
Bhabha, ‘Signs Taken for Wonders’; Comaroff and Comaroff, Christianity, Colonialism and Consciousness in South Africa, 109–17.
See Mudimbe, The Invention of Africa, 69. Valentin Mudimbe identifies ‘three complementary genres of “speeches” contributing to the invention of a primitive Africa: the exotic text on savages, represented by travelers’ reports; the philosophical interpretations about a hierarchy of civilizations; and the anthropological search for primitiveness’.
Pourtier, Le Gabon: espace, histoire, société, 1:220–22.
For an insightful discussion of colonial writings on Gabon, see: Cinnamon, ‘Of Fetishism and Totemism’.
Vaughan, Curing Their Ills, 5.
Olumwullah, Dis-Ease in the Colonial State, 4. See also: Schweitzer, Zwischen Wasser und Urwald, 1.
For a discussion of this concept, see: Myscofski, ‘Against the Grain’; Ratschiller and Weichlein, ‘Der schwarze Körper als Missionsgebiet 1880–1960. Begriffe, Konzepte, Fragestellungen’, 23. Classic works that apply the approach include: Ginzburg, The Cheese and the Worms; Spivak, ‘Can the Subaltern Speak?’.
Stoler, Along the Archival Grain, 50.
Historians of colonial medicine have typically concluded that colonial medical practitioners, missionary and governmental alike, neglected preventive and rural medicine while dismissing traditional local forms of healthcare. In his microstudy, Bruchhausen shows that while missionaries in particular were engaged in rural areas and attempted to implement some forms of preventive medicine, they failed for a variety of complex reasons relating to the nature of both biomedicine and African societies. See: Bruchhausen, Medizin zwischen den Welten, 23–24.
For a discussion of the term and its scholarly history, see: Bruchhausen, ‘“Biomedizin” in sozial-und kulturwissenschaftlichen Beiträgen’; Löwy, ‘Historiography of Biomedicine’.
For the value of conceptualizing biomedicine as localized, see: Anderson, ‘Making Global Health History’.
Livingston, Improvising Medicine; Wendland, A Heart for the Work.
Pickering, The Mangle of Practice, 4–5.
Rouse, ‘Two Concepts of Practices’, 204. Italics in the original.
Wendland, A Heart for the Work, 23.
Dinges, ‘Arztpraxen 1500–1900. Zum Stand der Forschung’; Schatzki, ‘Introduction: Practice Theory’.
Dinges and Stolberg, ‘Medical Practice, 1600–1900, Introduction’, 1–2; Löwy, ‘Historiography of Biomedicine’, 122.
See the many contributions in this edited volume: Dinges et al., Medical Practice, 1600–1900: Physicians and Their Patients. The pioneering study in this regard was: Duffin, Langstaff.
Hess and Schlegelmilch, ‘Cornucopia Officinae Medicae: Medical Practice Records and Their Origin’; Hess, ‘Krankenakten als Gegenstand der Krankenhausgeschichtsschreibung’; Warner, ‘The Uses of Patient Records by Historians’.
Schweitzer’s original 123 notebooks are held at Syracuse University. The ams has copies, which were scanned for the purposes of this study. In these notebooks, Schweitzer recorded his observations on what he read in books, newspapers, and letters. They include his thoughts on philosophy and theology, notes on contemporary political events and scientific findings, and quotations from famous persons. Addresses of individuals with whom Schweitzer wanted to remain in contact or names of drugs that he considered useful are also recorded. I have closely examined those nine notebooks with a title suggesting medical content.
Cunningham and Andrews, Western Medicine as Contested Knowledge, 5.
Borck, ‘Quo vadis, Krankenhausgeschichte?’, 20; Howell, ‘Hospitals’, 503; Risse, Mending Bodies, Saving Souls, 5; Van Der Geest and Finkler, ‘Hospital Ethnography’.
Harrison, Jones, and Sweet, From Western Medicine to Global Medicine, 23.
Linda B. Kumwenda examines how missionaries saw the training of biomedical personnel as a means to ‘Westernize’ Africans, an endeavor that was understood quite differently and used to dissimilar ends by the latter. See: Kumwenda, ‘African Medical Personnel of the Universities’ Mission to Central Africa in Northern Rhodesia’. Markku Hokkanen investigates biomedicine’s relationship to local forms of medicine and religion. See: Hokkanen, ‘Quests for Health and Contests for Meaning’. Walima Kalusa discusses how Africans incorporated biomedicine and its practitioners into their own medical world. See: Kalusa, ‘Missionaries, African Patients, and Negotiating Missionary Medicine’.
Digby and Phillips, At the Heart of Healing; Horwitz, Baragwanath Hospital; Parle and Noble, The People’s Hospital.
Howell, ‘Hospitals’, 511; Lammel, ‘Das Hospital als Raum dazwischen’, 125; Risse, Mending Bodies, Saving Souls, 9–10.
Wall, Into Africa, 4; Hardiman, Healing Bodies, Saving Souls, 1; Harrison, Jones, and Sweet, From Western Medicine to Global Medicine, 15; Giles-Vernick and Webb Jr, Global Health in Africa, 4.
Debusmann, ‘Médicalisation et pluralisme au Cameroun allemand’, 234; Good, The Steamer Parish, 261; Kalusa, ‘Christian Medical Discourse and Praxis on the Imperial Frontier’, 249.
Bruchhausen, ‘Medicine between Religious Worlds’, 188; Wall, Into Africa, 8–9.
Hardiman, Healing Bodies, Saving Souls, 20; Mabika Ognandzi, Médicaliser l’Afrique, 220.
Bruchhausen, Medizin zwischen den Welten, 110–11; Jennings, ‘Healing of Bodies, Salvation of Souls’, 43–47.
Hardiman, Healing Bodies, Saving Souls, 48.
For more on the move of the hospital, see Chapter 1. The location of Nkombe’s house, where Schweitzer would build his own, was slightly above that of the landing site on the river, where the main hospital buildings would emerge. Pounah translates ‘Adôlinanôngô’ as ‘Looking over the nations’. Pounah, Notre passé, 37.
On the history of Lambaréné and Adolinanongo, see: Ambouroue-Avaro, Un peuple gabonais à l’aube de la colonisation, 222–32; Gardinier, Historical Dictionary of Gabon, 179; Merlet, Légendes et histoire des Myéné de l’Ogooué, 63–66; Pounah, Notre passé, 32–37; Raponda-Walker and Soret, Notes d’histoire du Gabon, 67.
Joy, Arnold, and Schweitzer, The Africa of Albert Schweitzer, 144; Munz and Munz, Mit dem Herzen einer Gazelle und der Haut eines Nilpferds, 116; Nessmann, Avec Albert Schweitzer de 1924 à 1926, 198.
On the history of the Galoa, or the Galwa as they are also known, see: Ambouroue-Avaro, Un peuple gabonais à l’aube de la colonisation, 219–21; Gaulme, Le pays de Cama, 65; Deschamps, Traditions orales et archives au Gabon, 21. 107; Pounah, Notre passé, 11–13, 22–28; Weinstein, Gabon : Nation-Building on the Ogooué, 22, 81.
Gardinier, Historical Dictionary of Gabon, 180; Mebiame Zomo, ‘Le travail des missions chrétiennes au Gabon pendant la colonisation’, 55; Weinstein, Gabon : Nation-Building on the Ogooué, 40–44.
Weinstein, Gabon : Nation-Building on the Ogooué, 37.
Bernault, ‘Dévoreurs de la nation’; Cinnamon, ‘Colonial Anthropologies and the Primordial Imagination in Equatorial Africa’.
Gray, Colonial Rule and Crisis in Equatorial Africa, 209; Weinstein, Gabon : Nation-Building on the Ogooué, 38–43, 68.
Grébert, Au Gabon, 64–65. In the ethnographic section of his book, the missionary Grébert explained that villages had to be relocated due to soil exhaustion. Sixty years later, the geographer Roland Pourtier argued that this relocation process also served to resolve social tensions, but was less certain of the exact reasons that motivated its participants. In his view, residents may have moved simply because the surrounding land was empty enough to allow them to do so. See: Pourtier, Le Gabon: espace, histoire, société, 1:233–35.
Gardinier, Historical Dictionary of Gabon, 140, 145–46; Gray, Colonial Rule and Crisis in Equatorial Africa, 154–57; Gray and Ngolet, ‘Lambaréné, Okoume and the Transformation of Labor’, 87; Weinstein, Gabon : Nation-Building on the Ogooué, 49–51.
The first was enacted in 1911, the final one after World War Two. Gray, Colonial Rule and Crisis in Equatorial Africa, 111, 179–81; Sautter, De l’Atlantique au fleuve Congo, 772–73; Weinstein, Gabon : Nation-Building on the Ogooué, 67.
Nzenguet Iguemba, Colonisation, fiscalité et mutations au Gabon, 393.
Metegue N’Nah, Histoire du Gabon, 80–81; Pourtier, Le Gabon: espace, histoire, société, 1:217–19; Jean-Baptiste, ‘A Black Girl Should Not Be With a White Man’, 66.
Balandier and Pauvert, Les villages gabonais, 9.
Gray and Ngolet, ‘Lambaréné, Okoume and the Transformation of Labor’, 99, 103–4; Metegue N’Nah, Histoire du Gabon, 138; Ombigath, ‘La Crise économique de 1930’, 150–53, 165; Sautter, De l’Atlantique au fleuve Congo, 757, 768.
Gray and Ngolet, ‘Lambaréné, Okoume and the Transformation of Labor’, 102–3.
Ibid., 100.
Sautter, De l’Atlantique au fleuve Congo, 769.
Metegue N’Nah, Histoire du Gabon, 118.
The 1932 politcal annual report for Gabon mentions 14,815 inhabitants. The one for the second semester of 1936 mentions 15,734. 4(1)D 36–38 (1930–32) and 4(1)D 44 (1936), anom.
According to Mabika, an estimated 430,000 to 450,000 people lived in Gabon in the mid-1930s, while approximately 440,000 people were resident in the country at the time of its first census after independence in 1960/61. His population estimates for the early 1950s are slightly lower, ranging from 388,000 to 405,000. Headrick has also commented on Gabon’s remarkably stable population in the period from 1920 to 1960. Her estimates range from 370,000 in 1921 to 404,000 in 1935. She estimates that Gabon had a population of 384,000 in 1950. See: Mabika, ‘Médicalisation de l’Afrique centrale’, 352–57; Headrick, Colonialism, Health and Illness in French Equatorial Africa, 106–7.
The 1953 annual report of the Service de Santé of Gabon mentions 17,249, ZK 005-005, shd.
Metegue N’Nah, Histoire du Gabon, 138; Pourtier, Le Gabon: état et developpement, 2:158–60.
Mebiame Zomo, ‘Le travail des missions chrétiennes au Gabon pendant la colonisation’; Mekodiomba, ‘Rôle et influence des églises missionnaires dans la mission civilisatrice au Gabon’; Nguema Minko, ‘L’évangélisation comme forme religieuse de la conquête politique du Gabon’.
Bernault, ‘De la modernité comme impuissance’, 764–66; MacGaffey, ‘Changing Representations in Central African History’, 205–7; Schatzberg, Political Legitimacy in Middle Africa, 107.
Tonda, ‘Capital sorcier et travail de Dieu’.
Cinnamon, ‘Spirits, Power and the Political Imagination in Late-Colonial Gabon’, 192. The close association between healing and harming has been widely observed across the African continent. See: Hunt, ‘Health and Healing’.
Bernault, ‘Witchcraft and the Colonial Life of the Fetish’; Cinnamon, ‘Of Fetishism and Totemism’.
Vansina, Paths in the Rainforests, 96. In Fang, ‘charms’ were called ‘Biang’. According to the anthropologist James Fernandez, they served ‘to increase or decrease the capacities of whatever they were applied to, whether inanimate objects or living beings’. Fernandez, Bwiti, 221.
Tonda writes that: ‘the “natives” do not use the word “fetish”, they speak of medicines (“medicaments”), an ambivalent and polysemous term: medicine is also what would correspond to the biomedical meaning of this word, but it is also a poison, real and not only symbolic – in the fictional sense – it is also an object supposed to act at a distance against a person or against forces in nature and that can be inscribed in the magical, in the technical meaning of this term’ Tonda, ‘Capital sorcier et travail de Dieu’, 56.
Morel, ‘Au Gabon avant l’arrivée du Docteur Schweitzer’, 186; Grébert, Au Gabon, 142; Fernandez, Bwiti, 625; Vansina, Paths in the Rainforests, 96.
Bernault, ‘Carnal Technologies’, 185.
Tonda, La guérison divine en Afrique centrale, 107, 227.
On Bwiti, see: Fernandez, ‘Symbolic Consensus’, 904–5; Mary, ‘L’alternative de la vision et de la possession’, 283–84. On Mademoisselle, see: Tonda, ‘Capital sorcier et travail de Dieu’, 61–63; Weinstein, Gabon : Nation-Building on the Ogooué, 53–55.
Cinnamon, ‘Spirits, Power and the Political Imagination in Late-Colonial Gabon’, 201.
Headrick, Colonialism, Health and Illness in French Equatorial Africa, 405–7.
Ibid., 216.
Mabika Ognandzi, Médicaliser l’Afrique, 126.
Ibid., 203.
Ibid., 220.
Mabika, ‘Médicalisation de l’Afrique centrale’, 288.
Emane, Docteur Schweitzer: une icône africaine, 56–57; Morel, ‘Au Gabon avant l’arrivée du Docteur Schweitzer’; Schweitzer, Zwischen Wasser und Urwald, 65.
This information is taken from a historical overview of the Assistance Médicale Indigène in: ‘Rapport Annuel du Service de Santé de la Colonie du Gabon 1932’, ZK 005-127, shd.
Mai, Albert Schweitzer und seine Kranken, 115. Mai does not provide any references for this statement.
As he suggested in the Service de la Santé’s 1932 annual report, the Médecin Général spoke of Schweitzer’s ‘German or pro-German ties’ that weren not broken by his recent French nationalization, ‘whose degree of sincerity should be questioned and clarified’. ‘Rapport Annuel du Service de Santé de la Colonie du Gabon 1932’, ZK 005-127, shd. Jacques Bessuges, the colonial government physician in Lambaréné during the early 1950s, claimed that Schweitzer was not always on best terms with government representatives. See: Bessuges, Lambaréné à l’ombre de Schweitzer, 92.
Schweitzer claimed that this arrangement had been in place since 1928. See: Schweitzer, Das Spital im Urwald: Aufnahmen von Anna Wildikann, 11–12. It was not strictly implemented or would be lifted, as sleeping sickness patients are listed in the monthly patient records, the appels mensuels, that commence in 1932. More details on this arrangement, which was definitively in place by 1936, will be given in Chapter 4, on the appels mensuels in Chapter 2.
Balandier, Afrique ambiguë, 218.
Oermann, Albert Schweitzer 1875–1965.
Taithe and Davis, ‘Heroes of Charity?’, 915. On how Schweitzer shaped his own reputation, see: Moll, Albert Schweitzer: Meister der Selbstinszenierung.
Harris, ‘Schweitzer and Africa’, 1110.
For a recent example of this kind of writing, see: Spangenberg and Landman, The Legacies of Albert Schweitzer Reconsidered. See also the contributions to the series Études Schweitzeriennes: revue annuelle de l’Association française des Amis d’Albert Schweitzer, sometimes with the alternative subtitle: revue d’étique, de théologie et de philosophie (Strassbourg 1990–2003). This series was then renamed as the Cahiers Albert Schweitzer.
Carleton Paget and Thate, ‘Introduction: Questioning the Relevance of Albert Schweitzer’, 2; Körtner, ‘“Ehrfurcht vor dem Leben” – Zur Stellung der Ethik Albert Schweitzers in der ethischen Diskussion der Gegenwart’, 100.
Schweitzer, Zwischen Wasser und Urwald, 161–62. Schweitzer wrote there: ‘We and our civilization are burdened, really, with a great debt. We are not free to confer benefits on these men or not, as we please; it is our duty. Anything we give them is not benevolence but atonement’.
Balandier, Afrique ambiguë, 225; Carleton Paget, ‘Albert Schweitzer and Africa’; See also: Harris, ‘The Allure of Albert Schweitzer’, 804.
Schweitzer to Thiébaud, 24 July 1953, ams; Barthélemy, Wie ich Lambarene erlebte, 57–58; Günther and Götting, Was heisst Ehrfurcht vor dem Leben?, 153–54; Jilek-Aall, Working with Dr. Schweitzer, 114–15; McKnight, Verdict on Schweitzer, 242. See also Chapter 5.
Harries, ‘From the Alps to Africa’, 215.
Oermann, Albert Schweitzer 1875–1965, 151–59; Rehm-Grätzel, ‘Albert Schweitzers Philosophie der “Ehrfurcht vor dem Leben” und der Friedensgedanke’, 95–96; Scholl, Von der Ehrfurcht vor dem Leben zur transkulturellen Solidarität, 93.
Arnold, ‘Vous les noirs, nous les blancs’, 438; Harris, ‘Schweitzer and Africa’, 1110.
Carleton Paget, ‘Albert Schweitzer and Africa’, 301.
Ibid., 281.
Harris, ‘The Allure of Albert Schweitzer’, 813.
Carleton Paget, ‘Albert Schweitzer and Africa’, 283; Harris, ‘Schweitzer and Africa’, 1112–13.
For an overview of the various thinkers, from W.E.B. Du Bois in the 1940s to Ludwig Watzal in the 1980s, who suggested such an interpretation, see: Thate, ‘An Anachronism in the African Jungle?’.
Italics in the original. McKnight went even further by arguing that Schweitzer wanted to prove that any person with sufficient willpower can become a new Jesus Christ. McKnight, Verdict on Schweitzer, 241. Shortly after its publication, The New York Review of Books commented on McKnight’s book as follows: ‘having shattered the Legend of Lambaréné—no difficult task, since the camera does most of it—he pursues the Man (i.e. Schweitzer) with a dull, pertinacious hostility, an obsessive anxiety to find discreditable interpretations of the most innocuous biographical data, which can only make one reflect how much greatness must still smoulder, even in the wreck of Schweitzer, to arouse so much envious malice’. Italics mine. http://www.nybooks.com/articles/archives/1964/aug/20/the-schweitzer-legend (2 June 2020).
Cousins, Dr. Schweitzer of Lambaréné, 191. In general, Cousins interprets Schweitzer’s work in a very positive, almost allegoric, light: ‘the point about Schweitzer is that he brought the kind of spirit to Africa that the dark man hardly knew existed in the white man’ (ibid., 215); and: ‘if Albert Schweitzer is a myth, the myth is more important than the reality’ (ibid., 219).
Melamed and Melamed, ‘Albert Schweitzer in Gabon’, 191. Melamed and Melamed took this quotation from a poster advertising the ‘Albert Schweitzer International Symposium on Health’, which was held at the United Nations in New York in 1994.
Mabika Ognandzi, Steinke, and Zumthurm, Schweitzer’s Lambaréné: A Hospital in Colonial Africa.
For an overview of Schweitzer’s global reception, see: Mbondobari, Archäologie eines modernen Mythos.
An argument put forward by: Ohls, Improvisationen der Ehrfurcht vor allem Lebendigen. Walter Munz claims that Schweitzer himself also suggested such a reading, see: Munz, Albert Schweitzer im Gedächtnis der Afrikaner und in meiner Erinnerung, 28.
Audoynaud, Le docteur Schweitzer et son hôpital à Lambaréné, 14. Audoynaud’s poorly structured book reads like a personal attack on Schweitzer, his legacy and the medicine that was practiced at the hospital.
Fernandez, ‘The Sound of Bells in a Christian Country’, 540.
Ibid., 557.
Bessuges, Lambaréné à l’ombre de Schweitzer, 65–72.
Nessmann, Avec Albert Schweitzer de 1924 à 1926, 62.
Penn, ‘A Visit to Albert Schweitzer’, 165.
Schnee et al., Group Interview Speicherschwendi; Interview Munz and Munz.
Stocker, ‘Diary 1961–63’, 2.
Interview Munz and Munz.
Cousins, Dr. Schweitzer of Lambaréné, 11.
Becht, ‘Témoignage d’une chirurgien, Mme Le Docteur Greet Barthélémy’, 170.
Schweitzer, ‘Briefe aus dem Lambarene Spital Pfingsten 1931’, 12.
Schweitzer, Mitteilungen aus Lambarene. Drittes Heft, 1925–1927, 26.
Trensz, ‘Le médecin’, 209.
Cousins, Dr. Schweitzer of Lambaréné, 71.
Carleton Paget, ‘Albert Schweitzer and Africa’, 293; Harris, ‘The Allure of Albert Schweitzer’, 813.
Fernandez, ‘The Sound of Bells in a Christian Country’, 543.
Balsiger, ‘Ein helles Band und ein Sonntag’, 148; Stocker, ‘Diary 1961–63’, 16.
Emane, Docteur Schweitzer: une icône africaine, 92–98. Although Emane provides an intriguing and useful study, his methodology lacks a degree of transparency. He frequently does not support his claims with references, he does not provide details of his informants, and repeatedly cites the same four to five interviewees.
Fernandez, ‘The Sound of Bells in a Christian Country’, 544. Italics in the original.
‘Statistiques de l’Hôpital 1966’, L – A – S3, ams.
Munz, Albert Schweitzer im Gedächtnis der Afrikaner und in meiner Erinnerung, 117.
Interview Daudette Azizet Mburu; Interview Léontine Nsowe; Interview Anne-Marie Padje-Poabalou.
Group Interview Port-Gentil; Interview Marie-Joséphine Ndiaye-Boucah.
Emane, Docteur Schweitzer: une icône africaine, 272.
Boundzanga and Ndombet, Le Malentendu Schweitzer.
Naipaul, The Masque of Africa,, 204–5; See also: Achebe, The Education of a British-Protected Child, 80, 158; or the film by the Cameroonian director Bassek ba Kobhio, Le grand blanc de Lambaréné (1995).
Balandier, Afrique ambiguë, 225.