A Brief History of Missionary Medicine in Aburi

On the grounds of the Presbyterian Women’s College of Education in Aburi lay the ruins of Dr. Rudolf Fisch’s “Hospitälchen” (small hospital). Dispatched in 1885, Dr. Fisch was among the first missionary doctors the Basel Mission (BM) sent to the Gold Coast. “Missionary doctor” in this context means that Dr. Fisch was supposed to save lives as well as souls. During our trip to Aburi, we got to explore the ruins of the hospital, which inspired me to look further into the history of medicine in Aburi. In this essay, I aim to sketch the development of medicinal work carried out by the missionary doctors.

The Sanatorium in Aburi. Basel Mission Archives (BMA), BMA D-30.10.002. https://www.bmarchives.org/items/show/56399 (retrieved 19 August 2024).
The Sanatorium in Aburi. Basel Mission Archives (BMA), BMA D-30.10.002. https://www.bmarchives.org/items/show/56399 (retrieved 19 August 2024).

Medical Work before the Sanatorium was Built, 1832-1887

Over the course of 100 years, the BM sent multiple doctors to the Gold Coast. The first one was Dr. Christian Heinze, who arrived on the Gold Coast together with Andreas Riis and Peter Petersen Jäger in 1832.[1] Shortly after their arrival, they learned that all their predecessors who had arrived in 1828 had died of tropical fevers – a fact that had not yet been known to the BM leadership when it dispatched the next crew of missionaries. The same fate met Dr. Heinze, who died after only seven weeks on the Gold Coast. Riis opted to get treated by an African healer, after deeming the British governmental doctors to be incompetent.[2] Riis survived and set up a mission station in Akropong.

Dr. Fisch’s Arrival and Planning of the Sanatorium, 1885-1887

It took the BM 50 years before they decided to send out another doctor; this time they tasked him to also do missionary work such as preaching. Dr. Rudolf Fisch arrived on the Gold Coast in 1885 and set up in the mission station in Aburi to conduct simple check-ups on both locals and Europeans. In addition, he undertook frequent trips to other mission stations.[3] At first, he only had two rooms in the mission station house, as the sanatorium was still in the planning stage. In 1886 the construction of the sanatorium started, supervised by Dr. Fisch himself, who was a learned craftsman as well as a doctor. Dr. Fisch nearly died of complications of dysentery and was sent back to Europe to recover. Dr. Eckhardt was sent to replace him. When Dr. Eckhardt arrived, the first two rooms of the sanatorium were already finished and ready to be used for medical work.[4]  However, since the existing apothecary was left vacant for a long time, much of the medication was spoiled, due to the tropical conditions. Dr. Eckhardt was busy reorganizing the apothecary as well as treating the missionaries in surrounding stations, which in turn meant the local population fell short of medical help. This led to dismay with the locals, as they saw no point in going to the European doctor, since he was always away.[5] Although it cannot be said with certainty based on the available sources in the BM archives and the literature, I am quite certain that the sanatorium was not intended for Africans but rather the missionaries. A sanatorium in its broadest sense is a place to rest during or after an illness, with emphasis on resting. It comes from a European tradition of healing not only the body, but the mind also, usually by resting for a couple of weeks while undergoing medicinal or herbal treatment. Emphasis is put on breathing in clean air, which was thought to be very important for the treatment of tuberculosis, for which many sanatoriums were build.[6]

Dr. Rudolf Fisch in 1885, just before setting off to the Gold Coast. BMA QS-30.001.0755.01. https://www.bmarchives.org/items/show/100207547 (retrieved 19 August 2024).
Dr. Rudolf Fisch in 1885, just before setting off to the Gold Coast. BMA QS-30.001.0755.01. https://www.bmarchives.org/items/show/100207547 (retrieved 19 August 2024).

Work in the Sanatorium, 1888-1895

With Dr. Fisch’s return to Aburi in 1888, Dr. Eckhardt set up a doctor’s office in the mission station in Christiansborg near Accra, where he treated missionaries as well as locals. Dr. Eckhardt, like Dr. Fisch, was very committed, and paid the ultimate price. In 1893, Dr. Eckhardt died of liver failure, reportedly the first death to occur in the sanatorium.[7] Although Dr. Fisch was not a trained surgeon, smaller surgeries like treating cataracts were conducted in the sanatorium. For patients recovering from a surgery, a small clay hut was constructed. Since Dr. Fisch was always short of help, patients were ordered to assist, for example for the dressing of wounds or to administer medicine.[8] It was a clear intention of the medical mission to recruit African caretakers for the hospital; however, the early results were not satisfactory to Dr. Fisch.[9]

Hospital or Sanatorium? 1888-1903

Before making the trip to Ghana in early 2024, I expected that we would be visiting the ruins of the sanatorium; however, it is certain that the ruins on the grounds of the college today are from the “Hospitälchen” (small hospital), which finished in the year 1900. The hospital was to be made of stone, including the floor, unlike in the sanatorium, which had a wooden floor.[10] This, and the fact that 4 rooms were planned (an operating theatre, a treatment room and two rooms for stationary patients) points towards the ruins being from the hospital. Comparing the ruins (see Figure 2) to a photograph by Dr. Fisch (Figure 3) of the so called “Krankenhof” (courtyard of the hospital), strengthens this impression further.

Ruins of the hospital (my own photograph).
Ruins of the hospital (my own photograph).
The Hospital. BMA D-30.10.029. https://www.bmarchives.org/items/show/56425 (retrieved 19 August 2024).
The Hospital. BMA D-30.10.029. https://www.bmarchives.org/items/show/56425 (retrieved 19 August 2024).

When you visit the “Hospitälchen” today, nothing indicates that this dilapidated stone structure was the first hospital in the area. Its height and massive structure are a testament to the robust construction and so it stubbornly stands in the courtyard of the Girl’s College today. This thoroughly impressed me, as I imagined the lively atmosphere in around the hospital that Dr. Fisch described in his reports and diaries.

Working and Living in the Hospital, 1904-1911

Dr. Fisch was often out and about and needed assistance in taking care of the stationary patients. He applied to the BM committee for a deaconess. A deaconess in our context is an evangelical nurse, who, in the interest of the medical mission, healed both body and soul. Sophia Hertlein, also trained in anaesthesiology, arrived in 1905. In 1906, an extension of the hospital was built. An important part of Dr. Fisch’s work was prevention of common diseases, such as malaria and various venereal diseases. At this point in time, it was known that mosquitos were transmitting many of the tropical sicknesses, and early preventive measures included window nets made from wire.[11]

The patients were often accompanied by their families who helped out by preparing food or caring for their family members when Dr. Fisch or Ms. Hertlein were away. This led to a very lively hospital situation, which – following Fisch’s reports – could get chaotic as the number of patients steadily increased.[12]

As mentioned, the saving of the soul was just as important as the saving of the body. Conversions often happened on the hospital bed. Even dying on a hospital bed meant that the soul was saved by the “Great Physician”.[13] This is not specific to the Aburi hospital, for which I did not find sources about conversions of patients.

In 1911, Dr. Fisch left the Gold Coast good. He was replaced by Dr. Müller, who was better trained in surgery than Dr. Fisch, so that more complicated surgeries could now be conducted in the missionary hospital.[14] In 1912, the hospital treated more than 20,000 patients and plans were made to build a modern hospital in Aburi. With the Basel missionaries’ deportation in 1918, in conjunction with suspicions against the mission’s German connections during the First World War, the project was stopped.[15]

After the Basel missionaries left, the BM institutions were subsequently led by evangelists of the Edinburgh Missionary Society and the small hospital in Aburi was soon abandoned and replaced by a bigger and more modern hospital, which today is the Tetteh Quarshie Memorial Hospital in Mampong.

Generally, medical work in tropical conditions was a young field of medicine when Dr. Fisch and his co-workers were in Africa. Treatments to common sicknesses changed over time, as well as malaria prevention. For the missionary doctors, it was a challenging, but also fulfilling time, as especially Dr. Fisch grew very fond of the African people. He had a lot of empathy for the less fortunate and elderly patients.[16] The medical mission did not last for a very long time, but it surely influenced the early healthcare system on the Gold Coast and later Ghana.

Portrait Fabian Herzog
About the author:Fabian Herzog

I study history in my Masters at the University of Basel. In the last few semesters, my focus of study has shifted towards African history, generally I am interested in medical history. Aside from being a student, I work as a bike courier. I like to read, listen to music and to travel.