Organization and work of the Gold Coast Medical Field Units

(1) The Medical Field Units of the Gold Coast were created by a change of name of the Trypanosomiasis Campaign at the beginning of 1951. Their directive was to expand and to tackle rural endemic disease as widely as possible, but they had no increase in medical staff. An account is given of how this was accomplished. (2) Organization, training and progress are described in detail, and a short section is given on each of the principal endemic diseases, illustrating the possibilities and weaknesses of an organization doing a wide range of medical work with too few doctors. (3) Throughout the paper, it is stressed that the achievements were made possible only by regarding the morale of the junior staff as being of the greatest importance, by developing their initiative, and demanding responsibility from them at all stages of their careers. (4) The field medical organizations of French West Africa and Nigeria are briefly compared with the Medical Field Units. It is noted that all West African field medicine is derived from the pioneer work of Jamot. (5) Although between 1951 and 1955 much valuable field work was done by the Medical Field Units, it is considered that the greatest achievements of the period were creation of a truly efficient organization and obtaining official recognition of its usefulness, with every hope of its permanent survival. (6) In considering the future, the view is expressed that priority in tackling rural diseases should be given to conditions which affect farming efficiency and, consequently, nutrition.The most important of these are yaws, guinea worm and onchocerciasis. Yaws and guinea worm are already under attack.Onchocerciasis, for which so far only palliative treatment has been possible, should be the next object of all-out attack. (7) Rural dispensaries are complementary to field medicine. It is considered that both should be under the same command, and that as the pattern of rural endemic disease becomes known there should be an increasing tendency to deal with it from strategically placed, suitably staffed and regularly inspected static centres.