Practicing Biomedicine at the Albert Schweitzer Hospital 1913-1965

Ideas and Improvisations

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Author: Tizian Zumthurm
Tizian Zumthurm uses the extraordinary hospital of an extraordinary man to produce novel insights into the ordinary practice of biomedicine in colonial Central Africa. His investigation of therapeutic routines in surgery, maternity care, psychiatry, and the treatment of dysentery and leprosy reveals the incoherent nature of biomedicine and not just in Africa. Reading rich archival sources against and along the grain, the author combines concepts that appeal to those interested in the history of medicine and colonialism. Through the microcosm of the hospital, Zumthurm brings to light the social worlds of Gabonese patients as well as European staff. By refusing to easily categorize colonial medical encounters, the book challenges our understanding of biomedicine as solely domineering or interactive.
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Tizian Zumthurm has defended his Ph.D in February 2018 at the Institute for the History of Medicine at the University of Bern. He is a historian of medicine and Africa, interested in the everyday tensions and connections between theories and practices, between ideas and improvisations.
Acknowledgements
List of Illustrations

Introduction
 1 Utilizing a Colonial Archive in Gunsbach, Alsace
 2 Theorizing Hospitals in Africa and the Practice of Biomedicine
 3 The Context: Trade, Politics, and Health in Colonial Lambaréné
 4 Albert Schweitzer and His Hospital in Lambaréné: a Short Historiography

1 Between Pragmatism and Order: Medical Organization and Daily Routine
 1 The Hospital Prior to 1927: Establishment and Adaptation
 2 Patient Numbers: Reflecting Global and Local Events in Orderly Records
 3 Patients and Their Stay: Strict Conditions, Varied Degrees of Enforcement
 4 Patient Motivation: Conceptions of Health and Other Treatments
 5 Staff from Europe: Clear Guidelines and Flexible Duties
 6 African Staff: Versatile Training and Reliable Service
 7 Staff in Comparison
 8 Infrastructure: Necessity and Maintenance
 9 Conclusion

2 In and Out of Control: Technologies and Patients in Surgery
 1 Surgery, Technology, and Control
 2 Surgery at the Albert Schweitzer Hospital: Context and Development
 3 Controlling the Surgical Arena: Actors and Organization
 4 Technologies of Control: the Example of Lamps
 5 Controlling Bacteria: Asepsis and Manual Labor
 6 Controlling Patients via Technology: The Example of Anesthesia
 7 Beyond the Operating Theater: Limits and Implications of Control
 8 Conclusion

3 Dimensions of Ignorance: Discourses and Practices of Obstetrics
 1 Depopulation, Domesticity, Ignorance: Framing Maternity Care in Colonial Africa
 2 Maternity Services in Colonial Gabon and at the Albert Schweitzer Hospital
 3 Ignoring Training: Recruitment Priorities
 4 Giving Birth at and Outside the Hospital
 5 Ignoring Context: Maternity Care as a Medical Service
 6 Key Areas of Ignorance: Medication and Feeding
 7 Conclusion

4 Trial and Error: Drugs and the Treatment of Infectious Diseases
 1 Experiments in a Laboratory? The Treatment of Leprosy in Colonial Africa
 2 Leprosy in Lambaréné
 3 Dysentery in Africa and Lambaréné
 4 Trials and Errors: the Use of Pharmaceuticals at the Albert Schweitzer Hospital
 5 Conclusion

5 Healing and ‘Civilizing’: Community and Safety in Psychiatric Care
 1 Psychiatric Services and Ideology in Colonial Africa and at the Hospital
 2 The Mentally Ill in Colonial Gabon and at the Albert Schweitzer Hospital
 3 Treating the Mentally Ill at the Albert Schweitzer Hospital: Drugs and Community
 4 Accommodating the Mentally Ill at the Hospital: Perspectives on Safety
 5 Conclusion
6 Conclusions
 1 Connecting Concepts: the Incoherence of Biomedical Practices
 2 The Practice of Global Biomedicine: Schweitzer and the Value of the Local
 3 Taxonomies of Global Health and the Albert Schweitzer Hospital

Bibliography
Archival Sources
 Interviews
 Published References

Index
People interested in the history of medicine, especially in the colonies. Practitioners of Global Health. Students of Medical History. Historians of Africa. People interested in the work of Albert Schweitzer.