| The need for a community health approach on the part of African medical missions is discussed. The author points out the positive danger in providing people with a type of medicine that is too costly and does not get to the heart of the problem. Examples of a community approach to medicine, taken from government programmes for smallpox eradication and measles immunization, and steps toward establishing community medicine in mission hospitals are outlined. These include: taking a case history of the community; doing a physical examination, not only of the people, but also of the resources and environmental conditions present in the community; deciding what laboratory analyses are required; setting up a surveillance system to provide feedback on births, deaths, disease, and malnutrition incidence, etc.; cooperating with governmental and other project efforts; and setting up a system of periodic evaluation. Further general practical suggestions concerning nutrition, tuberculosis, education, etc., are given. |