An historical evaluation of the Lutheran medical mission services in Southern Africa with special emphasis on four hospitals : 1930s-1978.
Ntsimane, Radikobo Phillip.
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The purpose of this thesis is to show through a chain of events how the Lutheran Mission societies in their quest to provide health care through biomedicine to indigenous people in Southern Africa ended up co-operating with the South African government in the implementation of the policy of apartheid. The question that this thesis will thus seek to answer is the following: If foreign missionaries were motivated to the extent that they left their homes in Europe and North America, why did they allow their hospitals to be subjected to government takeovers without offering much by the way of resistance? Biomedicine was not introduced to supplement the existing traditional health systems but to replace them. Black people had ways and means to attend to their sick through traditional health systems such as izinyanga, izangoma, and izanusi among the Zulu, and dingaka and didupe among the Sotho-Tswana. In Southern Africa, the missionaries saw suffering and great need, and worked as lay medical practitioners to alleviate health problems long before apartheid was formally introduced after the National Party came to power in 1948. Subsequently, they worked with trained medical missionary nurses and doctors. The Lutheran missionaries saw biomedicine as being not far-removed from advancing their mission work of converting the indigenous people to Christianity. In their provision of basic biomedicine from small structures, the Lutheran missionaries developed their health centres into hospitals by means of assistance from home societies before apartheid became the policy of the government. Financial assistance was also received from the South African government especially in the 1960s to combat the tuberculosis epidemic. However dedicated the missionaries were, they were condemned to see their influence gradually reduced because they were forced to rely on government subsidies in the running of the hospitals. In the 1970s, the apartheid government nationalized Lutheran and other mission hospitals. The hospitals were taken over and handed to the newly-established homelands and self-governing states to run. Under this new management, the mission hospitals’ quality of service was compromised. The question is: why did the Lutheran missions allow their hospitals to be nationalized? Overall, one can see that the Lutheran missions were influenced by race when they excluded black people from participating in the running of the mission hospitals, despite Blacks having taken over the running of the former mission churches since the 1960s. In Botswana, nationalization occurred differently. There was no total take-over of mission hospitals and the attendant exodus of white medical missionaries. From the time of independence in 1966, the Botswana government decided to work with mission societies in health care. The government formulated health policies and provided part of the financial needs of the hospitals, while the mission societies provided personnel and ran the hospitals. For example, the Bamalete Lutheran Hospital (BLH) in Ramotswa continues to be run by the Hermannsburg Mission Society. The national Lutheran Church played an important role in the hospital as the Church was part of the governing board. This thesis has attempted to show that, while the Lutheran missionaries were motivated to develop a health care system for the indigenous people through the introduction of biomedicine and the building of hospitals, they were so dependent on the assistance of the apartheid government, especially in the 1960s and the 1970s, that they could not see that their collaboration with the government in the nationalization of mission hospitals was in fact a collaboration with apartheid. Some individual mission doctors and nurses, especially in the Charles Johnson Memorial Hospital in Nquthu, resisted the nationalization programme, but not the Lutherans. These were paralysed in the face of the pseudo-nationalization programme of the apartheid regime. The interpretation of the Lutheran doctrine of the ‘Two Kingdoms’, which dissuades Christians from interfering in the sphere of secular governance, may have had bearing on their reluctance to challenge the apartheid regime to provide better health care.