06. Ethiopia’s Historic Quest for Medicine

Medical Developments at the Time of Menilek

We saw last week how rivalry between the European powers in Addis Ababa led, during the reign of Emperor Menilek, to the establishment of clinics, at the Italian, French and British legation. They competed with the Russian hospital, a truly pioneering institution which had been established a few years earlier. Now read on!

Ras Makonnen’s Leprosarium

Foreign medicine also began to make its appearance in the provinces at about the same time. In Harar, to the East, Ras Makonnen was keen on establishing modern medical institutions. In 1901 he gave the French Capuchin missionary Monseigneur Jarosseau land on which to establish Ethiopia’s first modern-style leprosarium.

This institution, which was run entirely by French missionaries, consisted of one large building, made of stone and mud, and 49 traditional style huts. There some twenty-five families, for the most part Oromos, were housed, fed and treated free of charge. Treatment was based largely on the use of choulmoogra oil. Ras Makonnen is said to have taken a keen interest in the institution, and Menilek, on learning about it, expressed a wish to establish a leprosarium like it in Addis Ababa. The idea did not however materialize until long after the Emperor’s death.

The First Harar Hospital

Makonnen also wanted to establish a modern-style hospital in Addis Ababa. He hoped at first to do so with British help. On attending the coronation of King Edward VII in 1901 he travelled to Edinburgh, with a view to introducing British medical activity in Harar, similar to that then being carried out in Aden. A British physician, Dr John Young, duly visited Harar to explore possibilities, but the idea of British assistance was for one reason or another soon abandoned.

Undeterred by this difficulty, the Ras proceeded to establish a hospital, at his own expense. It was run for a short time by Dr Vitalien, a physician from the French island of Guadeloupe, who had been appointed as medico to the Franco-Ethiopian railway company. He was referred to by Ethiopians as the “tekwur hakim”, or “black doctor”, and in racist European circles as a “coloured native” or “nigger”. The hospital was built of stone. Jennings, a British traveller who visited shortly after its establishment, vividly recalls:

“It consists of six wards on the ground floor facing the front, and three double wards on the first floor facing the back. The floors are concrete, and the walls are white-washed on the inside. The ordinary spring-wire and hair mattresses, sheets, blankets, iron bedsteads and bedside tables are in use. The latrines and urinals are in a separate out-building in the back, with a modified cesspool; on the left side is the dispensary; on the right are the operating theatre and offices, while the cook-house is at the back to the left. Utensils and drugs are supplied to the patients, but with the exception of milk they find their own food; and the laundry work is done outside.”

Enter the French Government

Once established, the hospital attracted the attention of the French Government, which was interested in having access to a medical establishment on the cool plateau inland from the torrid port of Djibouti. The French accordingly agreed to purchase the hospital for 50,000 francs, and to run it as a French institution open to the local Ethiopian population, as well as to patients from the nearby coastal French Protectorate. The Harar hospital was later supplemented, in 1911, by a much smaller institution in Dire Dawa, run by the railway company.

This was Ethiopia’s second provincial hospital.

Closure of the Russian Hospital

Medical progress in Addis Ababa meanwhile suffered a major set-back, in 1906, when the Russian Red Cross mission was withdrawn from the capital. The exact reasons for the closure are not precisely known to the present writer. Russia was then suffering from the revolutionary turmoil associated with the abortive Russian Revolution of that year. There seems, however, to have been friction between the Russians and the Ethiopian Government. The latter’s customs authorities, we are told, insisted on taxing the annual supply of Russian medicines, valued at 6,000 roubles, which the Russians regarded as a gift to Ethiopia. The enraged Russian Ambassador, General Lichine, refused to pay, and telegraphed the authorities in St. Petersburg. Three days later he received instructions from them to close the hospital.

A Medical Influx

Though the closure of the Russian hospital was a serious blow to medicine, a number of European doctors, and one dentist, shortly afterwards arrived, to practice in the capital. The first such foreigner to come was the country’s first foreign dentist. He was a Greek, Dr Caracatsanis, who had received his training in Athens, and, having practiced in Egypt, was brought to Addis Ababa by Empress Taytu, as early as 1907.

One of the first resident physicians of this period was the French-educated Dr Vitalien, from Guadeloupe, who served for a number of years as Menilek’s personal physician.

Menilek’s Fatal Illness

The coming of foreign medicine, and foreign medical practitioners, was encouraged at this time by Menilek’s deteriorating health. The Emperor was anxious to receive, and welcome, any physician who might cure him of his ills. More than that, the European powers wanted, as De Castro says, the glory of having the aged monarch cured by one of their nationals.

Among the foreign doctors arriving at this time were two Germans, Dr Steinkuhler and later Dr Zintgraff. They treated the ailing monarch, but, perhaps for that reason, made powerful enemies. They were accused of poisoning, or attempting to poison, their royal patient, and were accordingly thanked for their services, and sent home.

Other foreign physicians arriving at around this time included a Greek, Dr J. Zervos, who later treated the youthful Tafari Makonnen (the future Emperor Haile Sellassie); a Frenchman, Dr Antoine de Taillas, who had earlier served as medico to the railway company; and an Armenian, Dr E. Terzian, who started a private practice, about which, unfortunately, little seems to be known.

The First Pharmacy

The first foreign pharmacist to establish himself in Addis Ababa was a young Georgian, Dr Merab, who held French nationality. He had formerly practiced in Constantinople, where he had treated a visiting Ethiopian delegation, led by Ras Mangesha Warqe. The latter interested him in travelling to Addis Ababa, where he became, among other things, one the small band of Menilek’s personal physicians.

Merab, whose grave can be seen to this day in Addis Ababa’s Gulele cemetery, duly founded the city’s first pharmacy. This, as a good patriot, he named the Pharmacie la Georgie. A man of considerable literary merit, he was also the author of “Medicines et Medicine en Ethiopia”, the first important account of traditional Ethiopian medicine.

Though Merab enjoyed something of a pharmaceutical monopoly he nevertheless encountered some competition. Most European, and Indian, groceries at this time stocked popular medicines. These included iodide of potassium, Ricord’s pills, quinine, castor oil, Epsom salts, laudenum, phenic acid and antiseptic cotton.

The Menilek Hospital

The first Ethiopian government hospital, the Menilek II Hospital, was meanwhile founded, in 1910. Situated on the site of the old Russian hospital, it was run at its inception by the afore-mentioned Dr Vitalien, from Guadeloupe, and later by a succession of French physicians: Dr Rousseau, Dr Garnier, and Dr L’Herminier. Its staff also included two young Ethiopians, Ato Gizaw and Ato Dagne, who had earlier been sent to study medicine in Russia.

Medicine, as in the old Russian hospital, was at this time for the most part entirely free.

Foreign Travellers

Despite the establishment of the above medical institutions, many Ethiopians, particularly in the provinces, still relied on medical help received from visiting European travellers. One of them, Dr Arthur Hayes, an Englishman resident in Egypt, recalls that on visiting the Lake Tana area, he was besieged by Ethiopians wishing to be treated. Most were suffering from syphilis, leprosy, ophthalmia, malaria, itch, or tapeworm. He writes:

For the first time in my life I found my reputation embarrassing. Patients poured in, and it occurred to me that if they had any money and I wished to establish myself in practice in Abyssinia, I should have done very well by the lakeside.”

The visiting British big-game hunter, and ethnographer, Powell-Cotton tells a similar tale. Describing how he passed his time in Gojjam, he writes: “Besides shooting for a few hours every day, I filled up my time looking after and labelling my trophies, writing up my journey, and in doctoring the natives, who, I found, came in ever increasing numbers as my name as a great `medicine man’ spread. Still my little stock of drugs was being rapidly exhausted, and I was reduced to all sorts of expedients in order to give them something that would do no harm, and, by the exercise of faith, might even do some good.”