4 - Careers in Health and Healing: Competing Visions of Training and Practice

Summary

The making of the colonial medical profession in Kenya was conditioned by the shifting political, economic, and cultural developments in the country. The usual means toward raising an occupation to professional status, such as standardization of training and claims to a distinct and exclusive body of knowledge, evoked intense debates, which revolved around the type and quality of education for Africans, the nature of medical training for Africans, gender and culture, and the theory and practice of biomedicine as perceived by both the physician and the patient. The colonial medical profession placed its emphasis on hospitals and laboratories. It also objectified the patient, both as host and as victim of disease. It maintained its insensitive posture to the patient's psychotherapeutic needs. What could not be determined through an array of tests on bodily fluids or sensed by stethoscope was considered not germane to the patient's treatment and recovery. The emphasis on specific data and diagnosis, the enormous faith in scientific investigation, and the claim to objectivity denied the subjective and sympathetic understanding of the patient any space in the colonial medical profession. By reducing the patient to an object that had to be acted upon according to established Western biomedical norms, the colonial medical profession in fact helped institutionalize traditional therapeutic practices as a competitive and persistent alternative as well as a supplement to mainstream colonial health care.

This chapter examines the politics that informed the growth and development of the medical profession against the backdrop of the political, economic, and cultural conflicts and compromises that shaped its operational limits in colonial Kenya. The chapter is organized into four sections. The first section examines the basis of the selective issuing of licenses to physicians. In the second section, I discuss the politics of the training and placement of Africans in the colonial medical service. The relationship among patriarchy, state, and gender is examined in the third section. In the final section, I analyze the place of traditional healers and their services, which were based on the principle that the patient was first and foremost a subject and that medicine was both a science and an art. As an art, traditional healing projected the point of view that the practice of medicine required a grasp of the cultural and social ideas that enabled the healer to understand and appreciate the patient as a whole person.