AFRICA

"Ex Africa veni sempre aliquid novi."
Herodotus

You should first be forewarned: I am an Africanist.

My senior medical school elective was dedicated to just such an experience as I would like to help you achieve, now 30 years ago, and I have never stopped going back. As your experience will be unique, mine certainly was, in some ways I hope you do not have to repeat. I was in a remote rural Nigerian mission hospital during the breakout of the active Biafran civil war, in which I was privileged to be at one of the only remaining health facilities for a population of over 9 million people. I hope to help you avoid a shooting war, and I have no intention of sending you into one; but anyone working in poor and unstable areas of the world must lose any hypersensitivity they may have preformed to automatic weapons being brandished by ill-trained youths who are often hungry and ambitious. You will have many more thoughts about what constitutes security as you live as an outsider in conflicts you may have not even heard of let alone understand. A short string of relatively recent venues for my own experience may help you appreciate what I mean when I speak of doing one's best in areas of instability: within the last few years I have worked many times in Eastern Zaire, along the Rwanda, Burundi refugee overflow area, Cyprus, Kuwait, Lebanon, El Salvador, Romania, Kazakastan, Uganda, Sri Lanca, South Africa, Pakistan, Mozambique--in each of them very needy people with problems of security exacerbating the delivery of services.

There are three principle European languages useful in Africa, whereas there are many areas that use Arabic or its Eastern and Western African derivatives as well.

ANGLOPHONE AFRICA:

In West, East and South Africa, where vestiges of the British Empire were present, and all over where quite general American influence persists, English is the lingua franca. These areas of Africa are even more extensive in the use of English when almost all medical and communications and transportation media use English as the first language--lucky you! But remember, the goal of the undertaking is to get you out of the big centers and into the areas of greatest need where the English that is claimed by some is not recognizable by most who were born with this mother tongue.

FRANCOPHONE AFRICA:

French is a very great help in many parts of Central Africa, and nearly indispensable in parts of French West Africa. It may not be Parisian, but it is French. This is the language of diplomacy and sometimes the government official language by which one relates to officialdom--which it has usually been my intent to avoid, dealing directly with the people. Some of those people, those who have been to school, carry on a good conversation in French, but would often prefer not to, and many have a smattering of English if they have had any contact with media.

LUSOPHONE AFRICA:

The former Portuguese colonies of Mozambique and Angola use Portuguese officially. I have also found they do well if you can carry on a conversation in Spanish, which has been requested of me for lectures in the single medical school in Mozambique, Universidade Eduardo Mondelane. As beautiful as Angola is and as great an opportunity it might be to work there, it is too unstable and far too dangerous at this time to have me endorse an opportunity in this other principle Lusophone african nation.

LOCAL LANGUAGES:

Go ahead; take the plunge! You will not need to become an orator, but it is a giant step across the gulf separating people to learn the greetings, pleasantries, and some of the standard medical phrases in their own language. Regional languages are useful--two are Arabic-based: Ki-Swahili on the East Coast and Hausa on the West Coast, and some Bantu market languages like Bangala in Central Africa. They are more than happy to help in, for example, Zulu, which you would expect in any nation with more than 13 official languages--as South Africa has!

ORGANIZATIONS TO CONTACT IN AFRICA: