Togo

This West African country was ruled by the Germans as a protectorate from 1884 until 1914, as the German colony of Togoland. In 1914, at the start of World War I, it was taken by a joint Anglo-French force and the territory was split with the western part becoming part of the Gold Coast (now Ghana), and the remainder becoming the French colony of Togo. It gained its independence on April 27, 1960 as the Republic of Togo, and has a population of 6,100,000 (2005), and has 7.6 doctors and 30 nurses per 100,000 people.

During the period of German colonial rule, health-care services in Togo were extremely rudimentary, even for the European population. The doctors in the health service all reported directly to the governor, working independently of each other. As the Germans wanted Togo to be a “showcase” example of colonialism, they had built four hospitals, at Anecho, Misahohe, Palime and Lomé – the latter having been only just completed when World War I broke out. In addition there was a mobile dispensary run by a doctor who worked from Sokode. The Germans had also made a large impact on reducing the prevalence of sleeping sickness.

In 1938 the hospital at Lomé was the main one for the whole of Togo, with nine minor hospitals, 32 medical posts and six maternity clinics. The medical staff included 16 Europeans, of whom 13 were qualified doctors; and also 13 African doctors who had been trained at Dakar, Senegal, and 310 subordinate personnel, which included nurses and midwives. Statistics for 1938 showed that they had treated 54 European and 6,004 African inpatients, and 989 European and 685,071 African outpatients.

Although the Germans had done much to try to eliminate sleeping sickness, the French had to continue the program, using mobile teams. By 1939 leprosy was still a major problem with about 14,000 lepers in the country, sufferers being limited, by an order of 25 January 1939, to live in particular areas.

After independence, there was an increase in money spent on the entire health system in the country, with attempts to train more local doctors. Of the many medical complaints treated by doctors in Togo, malaria, liver cancer and skin cancer for male patients, are all relatively common. Goiter is also common in some parts of the country. To try to reduce the cost of medicines, pharmacies in the country were nationalized. However the national pharmaceutical company went bankrupt, putting pharmacies back into the private sector.

There are now doctors trained in Togo, mainly at the Faculty of Medical and Biological Sciences at the Université du Benin. The Institut National de Recherche Scientifique (I.N.R.S.: National Institute for Scientific Research), Lomé, is affiliated with the Ministry of Education and is the official medical research center in the country.