Medical activities under adverse conditions. Memisa Medicus Mundi]

The largest medical missionary organization in the Netherlands is Memisa Medicus Mundi. It has been in operation since 1984 when the organization Memisa, founded in 1925 by 2 doctors from Rotterdam and a priest, merged with Medicus Mundi Nederland. 130 of its doctors work in 80 programs mostly in English-speaking Third World countries. The regional representative for East Africa, worst affected by AIDS, related that a number of doctors work in hospitals where more than 1/2 of patients suffer from AIDS. Many doctors do not want to go to Africa because of the AIDS stigma and the lack of professional challenge of caring mainly for victims of 1 disease. Yet increasingly more foreign doctors are needed, as native doctors are often infected themselves. 1992 World Health Organizations data indicate that 1 out of 40 adult Africans is infected with the human immunodeficiency virus (HIV). In major East African cities the proportion reaches 30% of the adult population. A 1991 visit to Uganda, Tanzania, and Malawi revealed the spectacle of empty villages or inhabited only by children and old people. In Malawi there is 1 doctor for 40,000 people and 1 bed for 600 inhabitants whose average age is 49.3 years for men and 57.2 years for women. The doctors working there stressed prevention, and 1 of them got embroiled in a conflict with the Catholic archbishop because of handing out condoms. Nonetheless, sensitive topics such as sterilization, caesarean section, abortion, euthanasia, and contraception have been addressed to educate the people, since prevention takes precedence over treatment.