Contemporary history Child health in Nigeria : past , present , and future *

I looked at the list of former Windermere lecturers and realised the great honour conferred on me by being invited to give this lecture. It is also a tribute to the vigour of Nigerian paediatrics and paediatricians, whose frustrations and achievements form the major part of this lecture, and to those paediatricians, mostly your members, who set us on our path-Dick Jelliffe, the late Bob Collis, Arthur Tompkins, Ralph Hendrickse, David Morley, Hugh Jolly, the late Bruno Ganz, the late Richard Dobbs, and Bob Prosser, to name a few-and to those of you in this country who have inspired, taught, and supported us in our gigantic struggle to improve the health of our children. Before the arrival of paediatrics in Nigeria in 1952, children were given scant attention. The earliest health services were provided for sailors and slaves. Malaria took a heavy toll of the lives of explorers and missionaries who ventured inland, but the latter were the most persistent and dedicated to providing services for the indigenes. The government services were developed mainly to care for European civil servants and army personnel and were also preoccupied with eradicating malaria and improving sanitation. From 1900 onwards small hospitals and dispensaries were in evidence in towns with no medical missionary establishments. By 1925 Lord Lugard wrote: 'The diseases of tropical Africa are comparatively few; blackwater fever, malaria, dysentry and anaemia are the principal ones. Lung diseases, enteritis and cholera are rare or uncommon among Europeans. We have now, in the African Tropics, a most efficient medical service, and generally speaking, excellent hospitals with an adequate nursing staff. To the skill of the doctors and the improvements they have effected in sanitation etc, it is due that the returns of deaths and invalidings now show such a wonderful decrease."