The Steamer Parish: The Rise and Fall of Missionary Medicine on an African Frontier (review)

Heeding the clarion call of David Livingstone, Anglican missionaries of the new Universities' Mission to Central Africa (umca) laboriously made their way to what are modern Tanzania, Mozambique, Malawi, and Zambia in the nineteenth century. Although intent on evangelizing heathen, umca missionaries soon realized that they were also in the vanguard of an assault of Westernization. They were direct diffusers of technology and British educational notions and standards. They also were responsible for introducing Western medicine to broad areas long reliant on traditional healers, spirits, and local herbs.

This thorough and deeply researched book examines the accomplishments of the umca around the shores of Lake Malawi, including sections of what are now central Malawi and northern Malawi, northwestern Mozambique, and southwestern Tanzania. Good focuses primarily on the medical aspect of the umca endeavor, from the late nineteenth century through about 1965. Given the historic poverty of Malawians, the impecuniousness of the British colonial government of Nyasaland (now Malawi), and the reduced circumstances of the missionary endeavor itself, umca physicians and nurses were more ambitious than successful, more earnest than effective. The umca's medical missions were chronically underfunded and understaffed. They expended too little effort on building local capacities. Further, the umca itself was always less efficient, less organized, and less clear about its medical goals than were the Presbyterian missions elsewhere around Lake Malawi. The Presbyterian missions were practical about what they could and could not do, better supported from home, and far better led.

Good shows exactly how Western medicine was introduced and perceived, and how the umca in Malawi focused for too long on curative rather than preventive efforts. Even in an era when, and in an area where, the practice of medicine was primitive, the treatment available to Africans in umca's hospitals and clinics, short of trained personnel as they always were, was rudimentary.

Good is also obsessed with the geographical and physical barriers to missionary success. Most of the umca's mission stations were situated at or near harbors around the lake or on large islands within it. The original plan was to reach potential converts by steaming around the lake, stopping at villages and settlements, and reinforcing and communicating with hospitals and clinics. Unfortunately, this method of missionary action depended upon the umca's tiny fleet of wood-burning ships, which were often in dry dock, awaiting repairs to their boilers or their hulls. Good knows an enormous amount about the fleet, the mission ships, and the umca's many strategic errors.

The umca was too high-church, too establishment-oriented, and too racist, both consciously and unconsciously, in its relations with Africans—even the indigenous priests whom it had recruited and trained—to have had a major transformative impact on the emerging Malawi. Furthermore, unlike the two Presbyterian mission groups and the competitive Roman Catholics, the umca operated on Malawi's rural periphery. Until too late, it did not follow its own converts to the cities. It never rose above the mediocre in its supply of medical services. As Good shows, it clung to the lake and to its hopeless steamer service.

Yet, as deficient as the umca was at delivering quality medicine to the people of Malawi, it trained a remarkable number of early indigenous preachers. It also fostered the likes of Masauko Chipembere, the son of a umca archdeacon and Malawi's leading nationalist in the 1950s.

Steamer Parish is not explicitly interdisciplinary, despite the author's claim, his technical background, and his careful and well-informed critique of the history of medicine in Malawi and in the mission. Nor does the author's deep knowledge of the lake steamer trade make this book interdisciplinary in method. Nevertheless, Good has made a major contribution to the study of technological transfer by Western missions, to the study of the West's detailed impact on Africa in the...