By Jedrin Ngungu
Many years ago as a medical student, I was told that there is no such thing as a textbook case. In other words, as a doctor, you will never see a patient with a particular disease who has symptoms as exactly as they are described in textbooks. In fact, every doctor I practiced with knew that if a doctor presented a case which was exactly similar to a ‘textbook case’, then he was without doubt taking liberties with the truth.
And indeed, this was the case once I started my practice at Wusakili hospital in Kitwe. You made a diagnosis of Rheumatic Heart Disease because your patient had enough symptoms to warrant that diagnosis and not because he had all the symptoms of Rheumatic Heart Disease as described in textbooks.
But when I moved to England for my specialist training, I was utterly shocked to discover for the first time that there is such a thing as a textbook case! How could this be? Quite a large number of my patient had more than 90 percent of the symptoms of a particular disease as described in textbooks. In fact two patients had all the symptoms that have ever been described for the particular conditions that they had.
I searched everywhere for an explanations to this strange phenomenon which had caused cracks in my long held belief that there are no textbook cases. I talked to colleagues, discussed with my supervisors the consultants, and searched everywhere without great success. Then one day after months of searching I suddenly found the explanation. And it was as simple as can be.
All the textbooks we use in Zambia are largely from England, written by English scholars for English doctors and describing the typical English patient. No wonder a typical patient seen in England with a particular disease had most, and in few cases, all the symptoms that have been described for that disorder. This is because a child presenting to Mporokoso General Hospital with asthma will be very different from a child who presents to the Queen Elizabeth Hospital in Kings Lynn, a rural English town, also with asthma.
This is why I strongly believe that we should write our own textbooks in Africa which can accurately describe disease as it presents in our region instead of extrapolating what obtains in Europe, or indeed America, to the African situation. And as a Consultant Psychiatrist, I know this is hugely true for psychiatry which is basically defined by cultural norms and practices.
Now, this is not only true for medicine but for most things that Africa copies from the West, be it democracy, education, finance or religion. Africa will only overcome its many challenges if it begins to believe in itself, that it can develop its own original solutions specific for the African situation. Playing copy cat will not do.
That is why we must oppose all those individuals who always want to antagonise fresh ideas and suggestions that are purely African because ‘this is not how it is done in London’. We as a people will shape our own destiny guided not only by what we learn from Europe but by our own traditions, cultures and values. Instead of treating the London School of Economics and Political Science as the worlds shining light whose pronouncements should be obeyed by all, we should be establishing our own Lusaka School of Economics which will be able to produce top notch research papers useful for Zambia and the rest of the continent?
The idea that just because someone was at Harvard or World Bank makes them an expert and an obvious leader on all things African is a complete fallacy. We are the experts when it comes to Africa, whether in politics, medicine or business. No one understands our issues better than we do and we should reject and resist this notion that whatever we suggest can never be as good as what comes from London or Washington.
I am not suggesting that we overlook good advice or indeed genuine overtures of help from our friends in the Western world. There is obviously a lot that works that has been tried and tested. But that we should weigh everything in a balance and not just accept whatever we are being given. The destiny of Africa is in the hands of the Africans. The West has its own agenda and whatever benefit may accrue to us is just a bi-product.
Another reason why Africa must not copy from the West is that not everything we do here in the West works. Having lived in England for 10 years, I realised how often changes are implemented in their education, finance and even worse, health service because the original ideas had failed. Who would have thought that come 2009, the Royal Bank of Scotland, one of the biggest financial houses in the U.K. and the world, would be nationalised and that we would see the collapse of the so-called free-market economy?
In the Nation Health Service (UK), there have been so many changes in the last 20 years such that in some instances, there has been a 360 degrees turn around. Now you can see how this can be very confusing for the copy cat. You may be copying something today which tomorrow will be found unworkable. Africa need not copy everything. We can be original and successful. We started off late but we are pushing forwards. Our ideas are not inferior. Let us become confident in our own ability to shape our destiny and create a better world for our great people.
The author is attempting to merge science and politics. I feel he should stick to what he knows best, in this case psychiatry. Please do more research before publishing your opinions
great article! these are the types of thinkers that will change the face of africa for the better.
Well said Doc, but dont you think its time you returned back to your mother country to assist in developing this nation. For instance instead of you payn taxi to the UK government, you can be contributin to ZRA which will assist to up left the Zambia economy and start producing our original things like books.
Dude where in Zambia is he going to find a job that will pay him as much as he is getting paid in the UK? no disrespect to Zambia but the tax system is almost non-existent reforms have to start from the bottom and am afraid our problems are bigger than just printing our own books.
Pule, the Doc is making a contribution. Appreciate and make use of contribution instead of seeking fault and missing the point that is intact very beneficial.
Ooops
You are spot on, many times i talk to Zambians about such things people tend to criticise me. And yet i dont stop and still working on it, this is the kind of thinking that will make Zambia the Best place on earth for everything. SPOT ON!
Imwe Ba Jedrin. Clinical medicine is an applied science, meaning your clinical diagnosis is an intelligent guess made from an assessment of the weight of evidence (signs and symptoms). The only medical sub-specialties that are pure sciences involving no guess work are pathology (including microbiology, parasitology, chemical pathology, histopathology). It is from the laboratory sciences that clinical differential diagnoses are either validated or thrown out, that the shadows you chase are given substance. Your seven years plus of training are worthless without the backing of the lab sciences.
And have you even bothered to mention this fact in your alleged great article? Predictably, no. You are the typical clinician, taking all the credit. Thank you – from the real scientists.
GOOD article and great picture which points to what we should be doing. However, instead of copying pleasure equipment such as a pool table. The village boys sould be copying and making their own Zambian village solar water pump that can be used to water crops in the garden or draw water from a well for cattle to quench their thirst.. As an example; Zambians in the Diaspora, get hold of solar pump technology it will do more good than a mud pool table which obviously goes with tujilijili
Clinical medicine is an applied science, meaning your clinical diagnosis is an intelligent guess made from an assessment of the weight of evidence (signs and symptoms). The only medical sub-specialties that are pure sciences involving no guess work are pathology (including microbiology, parasitology, chemical pathology, histopathology). It is from the laboratory sciences that clinical differential diagnoses are either validated or thrown out, that the shadows you chase are given substance. Your seven years plus of training are worthless without the backing of the lab sciences.
And have you even bothered to mention this fact in your alleged great article? Predictably, no. You are the typical clinician, taking all the credit. Thank you – from the real scientists.
Don’t get personal brother. If there’s something you can contribute just as Dr Ngungu has, please feel free to share with us. Taking his article with a pinch of salt is just going to retard us. If you have also got something worthy while to share with us, then please go ahead. This was a good article and it was not entirely medicine.Â
I couldn’t agree with you more. Industrialization in the West occurred because of their resilience to solve their unique problems in their own unique way. The problems we have in Africa, and  in particular Zambia, is the failure to recognize a problem when its there, doing nothing about a problem when we recognize it, and the unpatriotic lot who would rather frown on anything local, coupled with the defeatist extreme left wing African who just criticizes others’ ideas and believe that the black man is inferior to other races and can never solve a problem even of his own. We need to change this mentality. Government may help by implementing the depression and war time era type of propaganda that America and Europe implemented to effect action in their citizens. China did the same.
TRY TELLING THAT TO THE CHINESE!
Bravo. Good thot but what r we doing about it. Brazil. R doing and china too n beating the west
Bwana Ngungu, please stick to your stethoscope and stop ascribing race to ailments. Medical Practiitionares who see politics in human diseases can be very dangerous.
Dear Reflector, clearly you missed the plot. Where has race come from? Are you assuming that all English scholars who’ve written books are one race? Or are you assuming that a typical patient is one race?
Jedrin this is what I have been telling people even about the constitution. Lets not copy the american one but come up with one that will answer to our challenges. I like the RSA constitution at least its a bit original.
I am against the total or indiscriminate transfer of models regardless of whether they are from the east, west or else where. We should be able to pick up the good points about functional successful systems.
The industrial revolution was successful because of (1.) mass production from mechanisation powered by steam then electricity power (2.) a recognition of the importance of teamwork and systems.
We are in the computer revolution which we will not benefit from because our leadership is not encouraging education in this direction. We can learn from the South Korean model of economic success and computer assisted industrialisation. South Korea today lends to the IMF and World Bank after being one of the poorest countries in the world.
Walasa Doctor, such are the kind of articles we need ba Lt not HH with his rubish all the time.
“Our Humanism is different from that of the West. Ours, takes into consideration the African culture as well as the belief in the existence of God.”
I never knew that ONE PLUS ONE is not TWO in Africa.
Suntwe u r rt
I Quote “You may be copying something today which tomorrow will be found unworkable” end of quote, now I add…..”You may be copying something today from an economics text book at UNZA (written in UK) which has already been found unworkable” ….What a good piece of work !!! keep it up doc.
Good article Dr.Ngungu.Don’t listen to jealous people like #2 Pule…if Ngungu was in zambia right now he would be facing a zesco blackout and have no water due to that major burst pipe.No water ,no electricity and fighting for on call allowance -he wouldn’t have had the mind to think progressively like this and write an inspiring article.You don’t have to be in Zambia to develop Zambia.Lets join hands -whether you are home or abroad and make Zambia a better place.We need Zambian textbooks- someone started with Jelita and Mulenga and stopped there….let Zambian entrepreneurs,educators,engineers,doctors,economists continue striving to better our country.Politicians won’t do it as its become obvious.
Good evening
I was about to post a similar article to LT, now that Jedrin has written this enlightening one, I don’t even need to.
“None but ourselves can free our minds” said Marcus Garvey, and he went on to challenge Black skinned people by saying “Rise up, ye mighty race! For ye are born to rule and not to serve! Ye are a nation of great Kings and Queens scientists, architects, philosophers… ye can achieve what ye will… and ye shall!”
There is need for Africans to rid themselves of the instruments of oppression in their many forms. Rewriting textbooks from an African perspective is just one of them. Learning about the REAL History of Africa prior to the Slave Trade and Colonialism is another. African native languages be taught side by side with English/French… etc.
contd.
In short, what we need are African solutions to African problems.
This does not necessarily mean that all Africans in the west should now physically relocate to Africa. In this age of advanced communication, I see no reason why an African doctor based in the UK cannot be in contact with doctors and hospitals in Africa, creating networks and passing on technical skills, or exchanging knowledge/developments. It’s not only medicine/science, this applies to all professions and businesses.
Zoona
Unfortunately, all the educational system in Zambia and elsewhere in Africa is based on Western Civilization. We use a foreign language. The textbooks we use in our universities and colleges are mostly writen by an American or a European. We dress, talk and eat western. We are born copysts and are copysts by default. Modern technology is based on Western civilization. The Chinese, the Japanese, the Koreans, and the Indians have made it simply by copying. You are saying that Africans and Zambians in particular must not copy. You are yourself, your success and everything a product of copying. Why don’t you lead by example and try to re-invent the wheel?
It is not re-inveting its making the wheel using your own materials and a far better quality, suiting the environment it is meant for.
Thats a great picture showing people playing pool,although i would have loved if someone gave me an idea of what those balls are made of.Great explaination by doc ,children in zambia get sick and all we get at the clinic is panado why why why.I know in england that if a black doc is good they dont send them back to africa and i kw this doc will not come to africa no matter what.british pounds are alot of cash in zambia and the medical equipment is always latest.unlike in zambia we find the same old tables,beds even beddings at hospitals very old.bad toilets no water etc..improve you zambians..employ more nurses docs and build more hospitals with latest medical equipment.
Unfortunately, this is not an original thought or idea. The University of Zambia was founded in 1965 on the mantra, in the Lockwood Commission report, to produce educated manpower that would be “responsive to the real needs of the country”. The so-called educated elites have betrayed the people of this country by their failure to prescribe solutions to the many problems facing the people – poverty, HIV/Aids, governance, unemployment, hunger, ignorance, injustice, etc, etc, … etc. We have, instead, educated people who are up todate on issues of global economy and finance than the squalidness in Shangombo. Shame!!!!
 Everything in Africa has been touched by the visitors and you cannot find even an authentic African, not even in the remote rural areas. The African way of life is a thing of the past and it will never be easy going back. Good point doc, but yr ideas are not doable.Â
There is a correlation between the sudden inventiveness of Europe and its exposure to other peoples. Those who don’t get it should take the time to consider that if other cultures had creations, intellectual property or traditional knowledge to begin with then those who wanted to own the world would not have taken the time to exclude ‘slaves’ and ‘colonial natives’ from legally owning IP amongst other ‘rights’.On a lighter note I recall being in a certain UK army museum reading a framed poster that states – Gun Powder was reinvented by the British. The Chinese could cry foul but it is more amusing to RE INVENT right back. It must be enshrined in the constitution that one has the right to own one’s creations or we will keep watching others make a profit while we are in an IP coma :)
Well put doc. All who have read your article have had their neurons firing at high frequency. It is a wake up call. You dont need to be based in Zambia to contribute positively to the development of Zambia. In fact it is easier to support relatives back home when you are abroad than joining them in that crashing economy.
Dr Ngungu, you are one very wise Zambian and I wholeheartedly thank you for your insight. Rightly as you put it, there must be a balance with what we can learn from the west and that which only we as africans know best. Not everything western is good or can work in our african setup, hence the need to choose wisely. Very well articulated and thoughtful article I must say.
Correction….if other cultures had no creations…
The Doc has touched on many issues but in the case of textbooks I don’t think you can put the blame on the origin of knowledge. The blame should be put on Zambian intellectuals, most of them are too lazy to publish their research or publish text books on their speciality. We have many people with Masters but we don’t have any secondary book written by a Zambian been used in schools or sold in bookshops. The Zambian intellectuals should publish their research and show how symptoms will differ compared to a patient in UK, USA and Asia.
It’s also a matter of perspective. St Paul’s cathedral looks like a mosque to me :)Â
Western ideas did not come from thin air and if you want to control the trade then control the language of trade. English is quite clever in that we are speaking many combined languages in one and the additions to the Oxford dictionary continue to grow.Â
It’s not the language or identity of authors that lets us down. It is our failure to convert our academics in to providers of an educational option. Case in point this debate was had after Alex Chikwanda article on feeling dissed over Zambia’s placement in SA history. Prior to that the conversation has popped up in numerous blogs. Some engage. Others do not. When we debate without the insults, we create a better platform for potential solutions.
@SK – you beat me to it! Except I’m not sure about the laziness as there are intellectuals publishing globally. It is bringing them to the table which is now down to the weakness of our educational publishing industry. In fact our general weakness is marketing ourselves but I believe toughening our IP and controlling our traditional knowledge will provide support for the improvements to come.
I love the construction of the pool table. That’s reverse-engineering at its best. Nothing like a game of snooker after a day’s work, and I bet one needs more skill to play on this table with those balls. And good article by the way.
Ninga iyo ni pool or zilibwanji guys. Good innovation ni sangwapo zoona pa pool the African way. The bazungu think they are clever we can do it our way also. I end here!
Good article, but actually, over the years UN-WHO has made very profound inroads into Tropical Disease Research in sub-Sahara Africa, like the Centre at Ndola Central Hospital (on the 5th or 6th floor? I can’t remember. I saw some hard working people of many nationalities, including Zambians on that floor). And I would like to believe that the research findings, whether in paper form or book form, does reach our institutions of learning in the region, including the school of medicine in Lusaka.
What cripples Africa and African thinking is not this so-called ‘transfer of Western ideals’. Rather, it is an education system that does not allow for in-depth analysis. This article is shallow at best, starting with an observation long understood in Medicine not to have much to do with where books are written but perhaps by whom and when. A book today detailing the signs and symptoms of a heart attack will detail the different presentations in people from different demographic backgrounds. Further, this notion that Africans copy to a detriment omits to mention we criticize copying only for selfish reasons and endorse it when it fits us. A scientist needs to make a scientific argument not this kind of argument. In medicine we merit on strength of research not writer’s skin color.
I really like this author, we shall meet soon … I don’t know how but we shall. I almost lost hope thinking there aren’t many of such smart people among the Zambian Enterprise clansmen left but today my spirit has been renewed.
As for the picture above, I think we can find a way for making sure none of our people live without electricity and in mad houses ever again. I believe it is a possibility.Â
Thanks a trillion, Doc.
well written article we always copy the west in almost everything when are we going to be real and original?
We must disabuse ourselves of the notion that the west got to where they are today thru pinpoint planning & execution.The west industrialised thru fits & starts and became developed and as recently as the 1950’s many homes didn’t have indoor plumbing,a phone and even many left battered Europe for USA.To think that zed won’t stumble along the way or indeed that there’s one formular for fit for zed is to lie to ourselves.Even the multinationals all over africa know to treat each country according to its unique set of circumstances.In short we can neither mirror the west nor another african country and we won’t get to the promised land without setbacks.
Excellent article doc! You have just described what i would term the “African curse”, copying almost everything from the west. In so doing, we have ended up copying even the bad things. And its no wonder Africa lags behind in innovation.Â
We are not final because we are infallible, but we are infallible only because we are final …
Awe mwe, kuli akantu.. what is that naimwe ba @38 B.R
Ba Nostradamus: Ba Doc, rekindled a lot of hope with his article in that we can really be masters of our own destiny if we collectively start to believe in ourselves, as we do that we should not be afraid to make mistakes, but we should be ready to correct our own mistakes should we discover that what we believed to work there and then may not work here and now.
At that point we self-actualize, we realize that we are not final because we are infallible, but we become infallible only because we are final. In other words, by becoming skeptics of anything and everything around us, we evolve beyond relativity and pragmatism.
Relativity causes frivolity and pragmatism leads to flaccidity both enemies of creativity, thanks a trillion for asking …Â you are the best,
Ba Nostradamus: Ba Doc, rekindled a lot of hope with his article in that we can really be masters of our own destiny if we collectively start to believe in ourselves, as we do that we should not be afraid to make mistakes, but we should be ready to correct our own mistakes should we discover that what we believed to work there and then may not work here and now.
At that point we self-actualize, we realize that we are not final because we are infallible, but we become infallible only because we are final. In other words, by becoming skeptics of anything and everything around us, we evolve beyond relativity and pragmatism.
Relativity causes frivolity and pragmatism leads to flaccidity both enemies of creativity, you are the best.
If this guy doesn’t believe in COPYING THE WEST, WHAT ON EARTH IS HE DOING IN LONDON??????????????????
Seems a lot of his supporters above are stuck in a microcosm just as he is!!! Open your eyes,
CHINA is a good example, THEY COPY IDEAS & MASS PRODUCE, they are NOW THE WORLD’S FACTORY!!!!!
Going by his assertions, lets abandon the “wheel” & just walk!!! LOL!!
Dare I say more?
#40, you really need to sign up to his patient list!!!!
#37 – Enka Rasha: With the quantity of knowledge and experiences of the early developers, late developers have the advantage of charting near-straight tragectories to meet their needs. All that is required is to adapt the fabled wheel to roll smoothly on our potholed roads!!!
well said doctor but what contribution have you made towards what you have talked. Point out concrete things that will make us believe in what you have said. The first step must be taken by you.
Great piece of article. I have a good friend of mine(zambian) working for the word bank and thinks we  can only achieve succes rlying on the west.
THIS PSYCHIATRIST MAY BE A PSYCHIATRY CASE AS HE HAS WRITTEN WHAT HE DOES NOT PRACTISE. HE SHOULD HAVE BEEN IN ZAMBIA, OR ANYWHERE ELSE IN AFRICA IF HE BELIEVED IN AFRICA. I SUGGEST HE VISITS A PSYCHOLOGIST FOR COUNSELING SO THAT HE STOPS BEING FAKE. HOW IS HE GOING TO WRITE MEDICAL BOOKS “THE AFRICAN WAY” IF HE IS NOT SEE AFRICAN PATIENTS IN AFRICA? I HOPE THE PSYCHIATRIST DID NOT JUST WANT TO INFORM ZAMBIA HE IS IN ENGLAND AND A CONSULTANT PSYCHIATRIST. SHAME!
Very good article Doc.our generation is spoiled with western type of life.If we start teaching our children the african culture today!! then some coming generation might change.We have gone too much into western than ever before.e.g….Today if my child is not speaking English language among his/her friend will be seen to be ignorant and you will find nowadays that a child doent even know any other (Local) language apart from English.We are the ones to blame for all this.If we dont change our mind sets,i can assure you that western has come to stay!
Good ideas and suggestion,i wish we could follow it. But Africans are naturally copy cats and it will take decades before we can be masters of our destiny.
Very good article
Can’t agree more with Doctor Nungu’s observations, not everything from the West is good but there’s still a lot of good things that we ought to copy from our friends, pride aside.For example Whenever you decide to come back Dr please advice your collegues at the Ministry that where you’ve been it’s not normal for a big hospital like Kitwe Central Hospital not to have an Ambulance nor an emergency generator.
Those who think that Africans are copying from the west are entirely mistaken. The west copied from Africa. It was the black Egyptians who led the civilisation we know now. It is the Nile valley that is the craddle of civilisation and modern man from Adam did not live in the Middle nowhere but right here in Africa. So, it is you Jedrin who is harbouring an inferiority complex. We are just taking back what we deposited, while we went away on a harzadous journey to conquer and inhabit the most dangerous continent on earth. We were just sidetracked.
One year ago there was another academic on Lusaka Times: Ngoma something, who told us to copy everything from Europe. He should read this article.
Erika Rasha you are right the west didn’t have a comprehensive prototype for development. They actually usurped and copied from other Civilisations and from each other innovated and came up with a new product/s.
This is what we are failing to do in Africa. We have been led to think we can only import science or technology. We can’t make our own. A leader who will change this thinking will be the saviour we have been waiting for. Ngungu ignore the negatives here and you could start the inward looking revolution. Continue writing my bro
SPOT ON ! NOW, START ACTING LIKE SOME OF US ARE ALREADY DOING ! NOT JUST TALKING ! IN MY FIELD I AM DEVELOPING SOLUTIONS FOR AFRICA ! DO THE SAME IN YOUR MEDICAL FIELD ! IT TAKES A SINGLE STEP FOR A MILE JOURNEY ! UH !
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