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PubMed2005

Dietary inferences from dental occlusal microwear at Mission San Luis de Apalachee.

San Luis de Apalachee, one of a chain of Roman Catholic missions established in Spanish Florida (modern states of Georgia and Florida) in the sixteenth and seventeenth centuries, was the principal center of missionization of native populations in the Florida panhandle. Paleoethnobotanical remains yield evidence of production of various kinds of crops at the site, typical of nearly all mission period sites in the area. Stable isotope (carbon and nitrogen) analysis and dental caries evidence suggest that maize was not as important in the diet at San Luis as in other contemporary settings in the region. Ethnohistorical research indicates a heavier reliance on meat consumption compared to other mission settings. This study examines dental microwear of occlusal surfaces of maxillary molars from San Luis and five other Native American mission period sites in Spanish Florida. Epoxy casts of molar crushing facets were photographed under 500x magnification, using a scanning electron microscope. Photomicrographs were digitized using Microware 4.02 (Ungar [2002a]) and statistically evaluated using one-way ANOVA and post hoc Tukey's multiple comparisons tests. These analyses reveal that the frequency of pitting on the San Luis molars is significantly greater than for other mission period sites. Consistent with bioarchaeological, historical, and archaeological documentation, these findings suggest that diets were different in the San Luis natives in comparison with the other native populations in Spanish Florida. Various dietary factors likely came into play, resulting in these differences, and may have included significantly greater meat consumption at San Luis.

Analysis of Variance↗
PubMed2003

Perceptions of science. The anatomical mission to Burma.

Until the 1830s, most Americans were unfamiliar with the images of anatomy. Then a small vanguard of reformers and missionaries began to preach, at home and around the world, that an identification with the images and concepts of anatomy was a crucial part of the civilizing process. In his essay, Sappol charts the changes in the perception of self that resulted from this anatomical evangelism. Today, as anatomical images abound in the arts and the media, we still believe that anatomical images show us our inner reality.

Anatomy↗
PubMed1982

Surgery in an African bush hospital.

A 10-year review of procedures undertaken in the operating theatres of a rural mission hospital in West Africa showed a total of 13819 procedures. Of these, one-third were general surgical, one-third were minor procedures, and one-third were obstetric, gynaecological or orthopaedic. This review is a record of the surgical procedures undertaken in a "typical" rural hospital in the Third World. It also indicates that a doctor contemplating a period of overseas service in such a hospital should have basic training in general surgery, obstetrics, gynaecology and trauma.

Africa, Western↗
PubMed1985

Missionary doctors vs Chinese patients: credibility of missionary health care in early twentieth century China.

This paper deals with the encounter between the Chinese and Western medical missionaries in early twentieth century China. Based on data of two Canadian Protestant missions in China before 1937, this study reveals that medical missionaries were generally ignorant of Chinese medicine, and they regarded Chinese medicine as part of an inferior, heathen culture. Such a 'mission-centric' perspective prevented the missionary doctors from creating an effective doctor-patient relationship with the Chinese patients. To the Chinese, missionary health care provided an additional health care pathway. The functional complementarity of Western medicine to the pluralistic Chinese medical structure enabled missionary medicine to gain increasing credibility from the Chinese, although few Chinese actually understood the basic principles of Western medicine. Implications of this missionary doctor-Chinese patient relationship in China are discussed.

China↗
PubMed2000

The colonial world as mission and mandate: leprosy and empire, 1900-1940.

The history of medicine in twentieth-century empires has been dominated by studies of "imperial tropical medicine" (ITM) and its consequences. Historians have been fascinated by the work of medical scientists and doctors in the age of high imperialism, and there are many studies of medicine as a "tool of empire." This paper reviews work that explores colonial medicine as a broader enterprise than ITM in three spheres: missionary activity, modernization, and protection of the health and welfare of indigenous peoples. To illustrate the themes of mission and mandate, it discusses the development of policies to control leprosy in the tropical African and Asian colonies of Britain in the first half of this century, especially the work of the British Empire Leprosy Relief Association (BELRA). Although BELRA's efforts did little to change imperial medical and health agendas, they had an important impact locally and ideologically, and show how closely interwoven the themes of Christian caring, medical humanism, colonial development, and welfare policy had become by the outbreak of the Second World War.

Africa↗
PubMedDate not supplied

[Surgery of congenital malformations in developing countries: experience in 13 humanitarian missions during 9 years].

The authors report their surgical experience concerning seriously impaired children due to congenital malformations or other non-congenital anomalies such as burns and traumas. All the patients were operated in one of 13 humanitarian missions undertaken in four developing countries. Throughout the "Third World" the demand for reconstructive surgery is extremely high due to the high birth rate and consequently large number of patients, as well as the shortage of both medical staff and supplies. In developing countries Primary Health Care has always been considered a priority and so hospitals, which are used mainly for emergency operations, are usually few in number and badly equipped; elective surgery is considered a luxury. Children with congenital diseases and/or other non-congenital anomalies who are fortunate enough to reach a hospital will often be treated by general surgeons lacking specific training; those children suffering from disabling conditions are often neglected and left to live with their anomalies for the rest of their lives. Our surgical missions have always been undertaken at the request of Catholic missionaries and/or secular organizations which contribute to the individual health schemes of each country. Highly experienced volunteer staff took part in the missions; medical teams are made up of 2 surgeons, one or two anaesthetists and two scrub nurses. The assistance and cooperation of local medical staff was essential in the preselection of cases to be operated while each single medical team provided all the necessary supplies for surgery, which took place in small but well-equipped missionary hospitals provided by the local authorities. A total of 1140 children were operated on during the 13 missions: 32% of these had routine procedures performed in day surgery and 54% underwent major plastic and reconstructive surgery for facial, uro-genital and anorectal malformations or for serious consequences of burns or traumas. The proportion of emergencies was only 3% as these were normally excluded because of the short duration of the missions. 26 patients had to be reoperated as a result of complications or surgical failure and long-term follow-up provided by either the local staff or as a part of later missions was given in over 70% of the major surgery performed. On the whole, the surgical results were highly satisfactory even if a final evaluation should be made taking the cultural factors and the socio-environmental conditions of each individual country into consideration. Such an evaluation should most importantly be made on the basis of the well-being of the patient, general satisfaction of the families involved and improved quality of life of these children.

Adolescent↗
PubMed1995

Radiological services in rural mission hospitals in Ghana.

The provision of basic radiological services in rural, first-referral hospitals is an essential component of any country's attempt to achieve health for all. We report the results of a review of examination frequency trends, operator training background, and machine operational and safety status in the X-ray facilities in rural mission hospitals in Ghana in 1991-92. The radiological workload at the reporting hospitals was low and declined by more than 50% over the study period. Although most of the X-ray operators had little or no formal training, they produced adequate imaging results. Most of the X-ray machines seen were over 20 years old, yet remained functional, but less than 25% had standard radiation safety (beam limitation) devices. These results suggest that many rural, first-referral hospitals in developing countries could benefit from a careful review of their services and adoption of the WHO Basic Radiological System (WHO-BRS).

Ghana↗
PubMed1990

Pediatric HIV-1 disease in a Kampala Hospital.

Data of pediatric patients screened for HIV-1 infection between 1985 and 1989 were studied retrospectively in one of the major mission hospitals of Kampala (Uganda). Symptomatic HIV-1 infection was mainly acquired perinatally and was diagnosed in 87 per cent in children under 2 years of age. The mortality rate was 40 per cent in pediatric in-patients with symptomatic HIV-1 infection as compared to 12 per cent in overall pediatric inpatients. Symptoms included in the WHO clinical case definition for pediatric AIDS were mainly insensitive, unspecific and demonstrated a low positive predictive value. There was no difference in the prevalence of malaria and measles between HIV-1 positive and HIV-1 negative children.

Child↗
PubMed1975

Surveillance of Lassa fever in missionaries stationed in West Africa.

To determine the distribution of Lassa virus in West Africa, a serological survey was undertaken. A number of mission hospital supplied sera from patients admitted with a history of fever and specimens were also collected in New York from missionaries who had experienced an unusual febrile illness while working in Africa. More cases of Lassa fever were detected among missionaries than among Africans, possibly because many African patients had left hospital before the complement fixation tests had become positive. Although most adults had fairly high fever and some were prostrated, fever was less severe in the children examined. In general the findings confirm that not all Lassa fever patients have the severe syndrome described in the original reports.

Adult↗
PubMed1996

Perinatal mortality in an institution where nurse aides conduct deliveries, Nkayi District, Zimbabwe.

OBJECTIVE: To evaluate the perinatal mortality and describe the effects of nurse aide conducted deliveries on it at Mbuma hospital, Nkayi District, an institution where nurse aides conduct deliveries. DESIGN: Retrospective descriptive study based on review of maternal records from January 1992 to December 1994. SETTING: Mission hospital situated in a rural area. MAIN OUTCOME MEASURES: The training which the health worker who conducted the delivery had and the pregnancy outcomes. RESULTS: 1459 deliveries were conducted and of these 824 (57pc) were conducted by nurse aides. The perinatal mortality of the nurse aide conducted deliveries was five per 1000 births and that of the trained staff was 57 per 1000 births. CONCLUSIONS: Nurse aides conducted more than half the total deliveries at the hospital. The hospital referral system, where normal deliveries are conducted by nurse aides while primigravidas and complicated cases are conducted by trained staff is working well as supported by the low perinatal mortality of the nurse aide conducted deliveries.

Delivery, Obstetric↗
PubMed1992

Gastric and colorectal cancer in the rural Indian subcontinent: a survey of patients attending mission hospitals.

37 missionaries working in India, Nepal, Pakistan, Bangladesh and Bhutan completed questionnaires regarding their clinical practice during the year 1980. Information was collected on the frequency of both gastric and colorectal cancers. More than 500,000 out-patients were reviewed and over 100,000 inpatients treated. A total of 291 gastric tumours and 169 colorectal carcinomas were diagnosed. Surgery was performed in 82% of the hospitals but only 36% had a histology service. In India and Pakistan there was no significant difference between the incidence of gastric and colorectal neoplasms. The relative risk of developing gastric rather than colorectal cancer in Bangladesh was 8 (95% confidence limits 4.5-14.2) and in Nepal the relative risk was 4 (95% confidence limits 2.0-7.0). A significant variation in the occurrence of cancer was observed between countries. Nepal had the highest and Pakistan the lowest numbers of both gastric and colorectal tumours. It seems likely that local environmental factors, such as diet, play a significant role in the development of these tumours.

Bangladesh↗
PubMed1996

Soul sisters: the St. John and Raynard nurses in nineteenth century London.

This paper uses the archives of the St John's training institution for nurses and the Raynard Mission to determine the extent to which cultural images and specialised space defined and drove the nursing profession in nineteenth and early twentieth century London. Emphasis is placed upon image and rhetoric, both sacred and secular, and the way the two combined to define the 'ideal' Victorian woman and nursing in the nineteenth and early twentieth centuries, and the understanding and treatment of illness. Research to date suggests that through a process of rationalisation of biblical and socio-cultural rhetoric, a specialisation of space, symbolic and literal, abstract and real was created; this enabled women to work in a gendered enclave, the organisational structure and rhetoric of which paralleled that of nunneries or convents. And even as the 'secular' became dominant in medical attitudes and treatment, the 'sacred'aspect of nursing and the emphasis placed upon it as being a vocation remained strong.

History, 19th Century↗
PubMed1990

[Albert Schweitzer's East Africa plans and the Berlin mission. According to, thus far, unpublished correspondence of the years 1929-1936].

In 1928 Albert Schweitzer planned to found a second private hospital comparable to that in Lambaréné (Gabon), this time in Somalia, the former German colony Deutsch-Ostafrika. At Lambaréné there were French missionaries nearby whereas in Somalia Schweitzer intended to cooperate with protestant missionaries from Berlin. For that reason informative talks with responsible members of the Berliner Missionsgesellschaft and negotiations about basic conditions started in 1928 continuing until 1936. As the correspondence is still preserved in the society's archives at East Berlin an ample documentation about the whole procedure can be published here for the first time. It demonstrates different aspects of Schweitzer's unique personality, his social aims, contrary and corresponding views of his German partners, flashlights on the organizing support by intimate friends, the way of collecting financial support, etc. Collaboration was assuming its concrete form, when, all of a sudden, the growing monetary inflation and deteriorating economic situation forced Schweitzer to desist of realizing his East-African dream in order to save Lambaréné.

Correspondence as Topic↗
PubMed1994

[Analysis of services of medical missionaries during the late Yi-Dynasty and the era of the Japanese occupation of Korea].

Authors investigated the services of medical missionaries during the late Yi-Dynasty and the era of the Japanese Occupation in Korea. The information and materials were got from the following primary sources: The Searching Report on the European and American Residents in Korea (1907-1942); The Korean Mission Field, Vol 1 (1905.11)-Vol 37 (1941.11); Christian Newspapers, No 1 (1915.2)-No 1128 (1937.7). Through this study we found that 280 medical missionaries came to Korea to do the medical services during the period from 1884 to 1941. Among them were 133 medical doctors, 5 dentists, 6 pharmacists and 136 nurses. And it was found that 71 medical missionaries (25%) belonged to US Northern Presbyterian Church, 50 (18%) to US Northern Methodist Church, 38 (14%) to US Southern Presbyterian Church, each 32 (11%) to US Southern Methodist Church and Society for the Proppagation of the Gospel (Anglican Church), 20 (7%) to Canadian Presbyterian Church, each 12 (4%) to Australian Presbyterian Church and Catholic Church, 9 (3%) to Seventh Day Adventist Church, and 31 Western medical personnels without connection to any missionary society. ...

Christianity↗
PubMed1993

Gastric and colorectal cancer in patients attending mission hospitals in rural areas of South-east Asia.

25 missionaries working in Taiwan, Thailand, Indonesia and the Philippines completed questionnaires regarding their clinical practice during the year 1980. Data were collected on the numbers of both gastric and colorectal cancers diagnosed. More than 90,000 out-patients were reviewed, and over 25,000 in-patients treated. In total, 76 gastric and 118 colorectal carcinomas were seen. Surgery and radiology were available at 88% of hospitals, but histology at only 53%. In both Indonesia and the Philippines, the relative risk of developing colorectal compared with gastric cancer was 3.3 (95% confidence limits 1.8-6.2 and 1.4-8.5, respectively). In Thailand and Taiwan, these tumours occurred with similar frequencies. Thailand, Indonesia and the Philippines had similar numbers of gastric neoplasms, but Taiwan a significantly higher number than the other countries (z > or = 4.4, p < 0.0001). Thailand had lower numbers of colorectal tumours than the Philippines, (z = 2.2, p < 0.05), Taiwan (z = 3.4, p < 0.001) and Indonesia (p = 5.0, p < 0.0001). Local dietary factors probably play an important role in the development of these tumours.

Christianity↗
PubMed2002

Volunteering in Africa: an orthopaedic surgeon-pilot flies to Africa to volunteer.

I lived a dream. After 45 years service as an orthopaedic surgeon, a career military officer, private practice, and an appointment to the faculty at Duke University, I retired to begin another career--volunteerism. Specifically, I volunteered to serve at Tenwek Hospital in Africa. Tenwek, a World Medical Mission Hospital, is a 4-hour drive west of Nairobi, Kenya. The hospital serves 400,000 Kenyans. Tenwek is a wonderful hospital, modern by African standards, well-equipped and staffed. The average daily orthopaedic case load is five to nine cases. Fractures, sepsis, and deformity are the usual surgical challenges. An essential part of the dream was to commute to serve-to fly myself across the Atlantic, through Europe, and on to Africa in a manner reminiscent of aviation pioneers long past. This portion of the dream was not realized completely, but was sufficiently achieved to appreciate the accomplishments and difficulties of those who went before. For me, my dream was realized. Volunteer service brings heartache and joy but adds a special dimension to our profession. The motto "We make a living by what we earn, we make a life by what we give" was reinforced each day.

Developing Countries↗
PubMed1998

[The fate of the old Jejoong Won following the establishment of the new Jejoong Won (Severance Hospital)].

Dr. Allen, the first Protestant missionary in Korea, had an opportunity of saving the life of the queen's nephew shortly after his arrival in Korea in 1884. In gratitude the King established the Royal Korean Hospital (Jejoong Won), the first hospital in Korea, and appointed Dr. Allen in charge of the medical affairs of the hospital. After Dr. Allen's resignation from the mission, the work was successively carried on by Drs. JW Heron, RA Hardie, CC Vinton and OR Avison, the last of whom arrived in 1893. In 1894 the connection of the Hospital with the Korean Government was severed and the work taken over by the Northern Presbyterian Mission. Since then, it has been a distinctly mission institute. In 1900, while attending the Ecumenical Conference of Foreign Missions in Carnegie Hall, New York, Dr. Avison made the acquaintance of a philanthropist LH Severance, who made a gift of $10,000 for a new hospital. This building, the first modern hospital in Korea, was opened and dedicated in 1904. It was named the Severance Hospital. As the new hospital was built, the old hospital building was to be returned to the Korean Government according to the agreement made in 1894. On retaking the old hospital, the Korean Government paid $30,289.99 won for the renovation of the original building and new buildings established in the site during the period of Avison's entire charge of Jejoong Won. The old hospital building was used as an official residence for a diplomatic adviser Stevens, who was assassinated for his pro-Japan activities, and as a social club for Japanese officials.

Christianity↗
PubMedDate not supplied

Missionary health: the great omission.

North American mission boards were surveyed to identify and prioritize missionary medical problems and determine initiatives for improving health. Malaria was the most common nontrivial medical complaint, and viral hepatitis the most serious. Nevertheless, only 72 percent of boards recommend malaria prophylaxis, 57 percent ascribe to regular immune globulin use, and 31 percent advocate hepatitis B immunization. Sub-Saharan Africa was considered the region of the world where missionary health was most in peril. Besides strategies to minimize the risks of malaria and hepatitis, recommendations for improving missionary health include greater use of rabies and typhoid vaccines; increased attention to mental health concerns and accident prevention, particularly seat belt use; increased health education regarding both clinical issues and public health principles; improved scheduling for relaxation and family time; and greater availability of comprehensive health services before departing, while abroad, and upon returning from an overseas assignment.

Christianity↗