Horton R
The Lancet, 84 Theobald's Road, WC1X 8RR, London, UK.
Lancet. 2001;358(9299):2141-9. doi: 10.1016/S0140-6736(01)07221-X.
In 1957, Ghana became the first African nation to achieve independence from its colonial ruler. But since then Ghana has suffered mixed political and economic fortunes. The health of Ghana's people and the country's progress in modernising its health-care system have fluctuated according to peaks and troughs in West African history. Some critics see Ghana's course since independence as a promise unfulfilled. Others view Ghana as a model for North-South cooperation, which could be rolled out across the whole of Africa. In November, 2001, I visited hospitals and health centres in both rural and urban settings to investigate the present state of Ghanaian medicine. The picture I saw was one of a country clear about what it wants to do but divided about how it should achieve its goals. If Ghana is to be a model for Africa, it is more a model of problems to be faced than solutions discovered.
1957年,加纳成为首个摆脱殖民统治获得独立的非洲国家。但自那时起,加纳的政治和经济命运便起伏不定。加纳人民的健康状况以及该国在医疗体系现代化方面的进展,都随着西非历史的兴衰而波动。一些批评者认为,加纳自独立以来的发展历程是一个未兑现的承诺。另一些人则将加纳视为南北合作的典范,认为这种模式可以推广到整个非洲。2001年11月,我走访了加纳城乡的医院和健康中心,以调查该国医学的现状。我所看到的景象是,这个国家清楚自己想要做什么,但在如何实现目标上存在分歧。如果加纳要成为非洲的典范,那它更多的是一个面临诸多问题的典范,而非已找到解决方案的典范。