A GENERAL ACCOUNT OF THE EVOLUTION OF COLONIAL HOSPITALS
When military operations are being undertaken, the sick and the seriously-injured are admitted into basic and makeshift installations : first-aid posts and ambulant hospitals in the countryside.
In times of peace, the hospital is a source of confidence for the indigenous people while it welcomes and looks after the European population as well as native soldiers and civil servants. Permanent installations, better and better equipped, are called ambulances, health centres and finally hospitals.
This last stage is attained when two conditions are fulfilled : on the one hand, the admission of patients into well fitted-out shelters; on the other hand, high-quality medicine all the more efficacious when it is dispensed by specialists capable of handling more sophisticated techniques.
Evolution is progressive. The beginnings are modest : two physicians, one in charge of medicine, the other of surgery (the chief physician of the establishment has the highest rank), a chemist, an administrator, some members of the staff, besides whom are native workers, more and more numerous as time goes on and better and better trained. The hospital necessarily contains an operating theatre, a maternity ward, a laboratory, a ward for the mentally unwell... but also the kitchen, the linen room, the garage...
The advent of electricity revolutionizes working conditions : surgical operations take place under bright lights, the autoclaves and the sterilizers are modernised. Later on, x-rays, refrigeration, cold chains and air-conditioning transform the practice of medicine.
At the beginning, only military personnel are in the services : in the fever and contagion sections as far as medicine is concerned and in the section for the wounded in surgery. The qualifications of these workers are made more explicit.
After the Second World War, most of the hospitals are renovated, others are built. Special branches of medicine begin to appear : Paediatrics, Respirology, Gynaecology...
Non-military public employees are recruited. They are few and occupy such posts as that of chief midwife or dentist.
Special attention is given to the needs of poor indigenous people, who have been receiving free medical attention accorded to the natives. Very often, as in Bamako, in Conakry..., they are admitted into particular quarters or wards. In the big capitals, a second general hospital is built for them, for example in Dakar, in Antananarivo, in Pnom-Penh, in Saigon. These hospitals are also directed by the Colonial Health Service.