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Special Articles

MEDICINE VERSUS POLITICS IN RHODESIA

ON April 5 a large and distinguished audience sat inthe hot Salisbury sunshine, to watch the laying of thefoundation stone of the new medical school and teachinghospital at the University College of Rhodesia and

Nyasaland. The Federation is about to come apart.The multiracial College, now with over 500 students,does not know where its annual income will come fromin a year’s time. Nyasaland and Northern Rhodesia areboth crying out for their own university institutions. If

anyone ever thought that a shared university would helpto promote or to cement political federation, this example,added to those of Singapore-Malaya and the West Indies,must have completed his disillusionment. The futureof Southern Rhodesia now looks bafflingly obscure. Itseemed a most inopportune moment to found so expen-sive and delicate a thing as a multiracial medical schoolin Salisbury.The project dates from 1956 when the College set up

a planning committee, under the chairmanship of theDirector of the Nuffield Foundation, which financed aclassic study of the educational philosophy of a medicalschool appropriate to Central Africa: in a word, of thecurriculum. On the basis of the report and recommenda-tions of the planning committee,1 the University of

Birmingham agreed to affiliate the new school, to sharethe responsibility for its physical and academic planning,its appointments and its examinations, and to award

Birmingham degrees to its successful students. Themedical school building is being financed by the College,with help from the Nuffield Foundation and other sources,the teaching hospital (initially of 300 beds) by the Federa-tion Ministry of Health. The two are being designed asone complex. The first 26 students, 5 of whom areAfrican, were admitted to their premedical year in March.Professors of preclinical sciences and of medicine havebeen appointed, and appointments to other chairs aredue to be made this year.There was no hint of hesitation in the speeches made

at the foundation-stone ceremony. The Federation hadchosen Lord Salisbury to lay the stone. This was taken

by some of the arts and science students to be politicallyprovocative, and they carried placards alongside the

approach road quoting his lordship’s past derogatoryremarks about the savage Africans; others carried counterplacards. It is remarkable how students of a 6-year-oldcollege, in a country devoid of university tradition,behave exactly in the manner of students elsewhere.The medical students were awkwardly caught betweentheir desire to join the protest, and the obligation ofgood manners on what was peculiarly their occasion.

They solved their problem by politely attending the

ceremony but absenting themselves from the socialobservances that followed it. Lord Salisbury eschewedpresent-day politics, and devoted his speech to his familyassociation with the earlier history of Rhodesia and tothe theme that medicine, being above politics, can

command the united support of those who politicallydiffer. The Federation Minister of Health spoke of theimportance of the new medical school to the develop-ment of medical services in the country. The Principalof the University College and the Vice-Chancellor of theUniversity of Birmingham re-affirmed the commitment

1, Central African Medical Journal, June, 1958, and March, 1959.

of their respective institutions to the joint undertaking.To the reader of English newspapers it all sounded

a little unreal. Were these people refusing to face thefacts, free-wheeling along unaware of the failure of theirengine ? Or were they confidently showing their faithin the rightness of their course, despite the politicalstorms ? The latter is the impression they give,

" they "meaning the European Rhodesians and a proportion(no-one quite knows how large) of the African ones. Theiraim has been to develop an efficient multiracial society.Their belief is that this can be achieved only gradually,with the progressive extension of the franchise and theadvantages of social equality to the African as his economicand educational standing improves. Whether they havemoved too slowly in this direction can be a matter fordiscussion, with the benefit of hindsight; but theycertainly have moved, and they wish to continue on theircourse in spite of the impatient pressures of Africannationalism and what they regard as the unsympatheticattitude of the British Government. They know thatthe financial unscrambling of the Federation will bedifficult and painful, but they cannot believe that in theprocess of it resources will be denied to the newly foundedmultiracial medical school, itself so necessary and so

right. They put their faith in the logic of the situation,and in the value of medicine. This is courage ratherthan foolhardiness, and deserves every support.

ROBERT AITKEN

Public Health

Mortality in 1962THE Registrar General has issued provisional figures

for death-rates from cancer and tuberculosis and formaternal and neonatal mortality in England and Wales in1962.1

Deaths from cancer.-The provisional death-rates for allforms of cancer in 1962 were 2416 per 1,000,000 populationfor males and 1951 for females. The rate for males includesan increase from 871 per 1,000,000 population in 1961 to 895in 1962 for deaths assigned to cancer of the lung, the rate forother forms of cancer having remained the same at 1521. Therate for cancer of the lung for women increased from 141 per1,000,000 population in 1961 to 146 to 1962; for other formsof cancer it decreased from 1810 in 1961 to 1805.

Deaths from tuberculosis.-The provisional death-rate fromrespiratory tuberculosis in 1962 was 59 per 1,000,000 persons.This is a decrease of just over 9% compared with the previousyear.

Deaths from maternal causes.-The provisional rate for mater-nal mortality (including abortion) per 1000 live and still birthswas 0-35.

Neonatal mortality.-The neonatal mortality-rate was 15.1

per 1000 live births, the lowest on record.

Population ForecastAccording to the Registrar General,2 the population of

England and Wales may increase from the mid-1962 figure of46,768,000 to 63,774,000 by 2002. In 1955 the official popu-lation projection implied that there would be 645,000 livebirths in England and Wales in 1975, but each year since thenthe estimate has been increased. This latest projection, takinginto account the sustained rise in births since 1955, impliesthat in 1975 there will be 891,000 live births-almost a quarterof a million more than were expected seven years ago.1. The Registrar General’s weekly return no. 14, 1963. H.M. Stationery

Office. 2s.2. The Registrar General’s quarterly return no. 456. H.M. Stationery

Office. Pp. 24. 2s. 6d.