Most helpful critical review
188 of 245 people found the following review helpful
Wannabe practitioner beware
on March 1, 2008
I will admit that while I lived in West Africa, I had a copy of Where There Is No Doctor on my shelf, and that I consulted it on a frequent basis. As a public health worker, it was an invaluable resource at the time. However, this was not the only book I had on hand, and I certainly didn't view it as the Medical Bible that so many cavalier explorers think it is. The simple fact is, unless you have adequate training to perform any sort of diagnosis or treatment, YOU SHOULD NOT DO SO, and you will probably do more harm than good. This book DOES NOT make you a medical professional to any degree whatsoever. It is also filled with horrible ideas that "might work" (that is a direct quote). Teaching people to rinse out condoms (as the French Language version suggests) or using bisected lemons as impromptu cervical caps is dangerous and totally irresponsible. There is no way in hell anyone who has simply leafed through this book is ready to deliver a baby. That is ridiculous. Sure, most of the time a mother will pretty much deliver her baby herself, but if something goes wrong, and you don't have the experience, you little tour into obstetrics is likely to kill the mother and/or the child.
There is enough misinformation in the rural areas of the developing world already, and this book has the potential to take lives. Even in the most dire of situations, untrained yahoos should not be tempted into thinking that they can diagnose even the simplest of bacterial infections and prescribe the proper antibiotic.
Another thing that this book does is take cultural health information that has evolved amongst native peoples, and it simplifies it so that other people can "try" it. There is a scarily simple illustration of a technique for circumcision in this book that has the potential to lead to the loss of a little boy's penis. In cultures where circumcision is practiced there is (almost) always a dedicated practitioner who performs such rites, and either has done hundreds (or thousands) of them, or has studied under the previous practitioner as an apprentice. i.e. this person is practiced, and has experience. This person is NEVER some wiseguy who got a copy of Where There is No Doctor from a friend, along with a rusty pair of scissors. Trying to circumcise a boy with the helpful sketch provided by this book would be ludicrous. God forbid some charlatan gets ahold of this book and comes to the great idea that he should be his village's "doctor." Many of the techniques in this book must be performed in an aseptic manner to reduce the chance of infection, but they are not done in such a manner in the book.
That being said, the book can be a powerful tool for public health workers who do not have a strong background in clinical medicine. But it must be used cautiously, with supplemental information. There are innumerable fallacies in this book, and the author has taken little care to edit it. I'm sure the man means well, but really what he's done is reassure people who've watched too much ER that they can be doctors too.
Honestly, the book should be re-edited, and many of the techniques should be removed, as they have the potential to cause more harm than good. If you want to help the developing world, support the local Ministry of Health, and empower them to either place trained nurses in the area, or to sponsor traditional healers and midwives to get the vital bits of training they need, training that can bridge the gaps in their significant knowledge base. Proper health networks are not built by medical tourists and short-stay medical missionaries who want to play doctor. They are constructed from the inside by countries who have people working to distribute resources and fight against corruption. If you want to help, pick up a few bags of cement and build a village health center that can be kept clean, but don't pick up a syringe and act like you know what you're doing.