An Assessment of People's Response to British Healthcare Services in Sokoto Metropolis, 1920-1960

Article Citation: Attahiru Ahmad Sifawa (2019). An Assessment of People's Response to British Healthcare Services in Sokoto Metropolis, 1920-1960. DEGEL: The Journal of the Faculty of Arts and Islamic Studies, Vol. 17, No. 1. ISSN 0794-9316

AN ASSESSMENT OF PEOPLE'S RESPONSE TO BRITISH HEALTHCARE SERVICES IN SOKOTO METROPOLIS, 1920-1960

By

Attahiru Ahmad Sifawa

Department of History, Sokoto State University, Sokoto

ahmadasifawa@gmail.com

Abstract

This paper examines the people's response to colonial healthcare services in Sokoto metropolis. The central argument of this paper is that people's rejection of British healthcare services was part of the general hatred and resistance against colonial domination in Sokoto metropolis. There was an interesting paradox in the study of the response of the people of Sokoto to European healthcare services. For instance, when Clapperton first visited Sokoto during the reign of Sultan Muhammad Bello, the Sultan requested for European health expertise. However, after the British conquest of the Caliphate and establishment of colonial rule, the people of Sokoto, led by the Ulama’a, bitterly rejected the British healthcare services when it was introduced in the metropolis. The paper examines these opinions, realizes that; while Sultan Muhammad Bello, a scholar of international standing based his position within Islamic context, and followed the foot- steps of some classical Caliphs. The situation in the 20^fh century Sokoto was more of inter-play between resistance against foreign domination, vis-a-vis ideological and civilizational conflict. Thus, following the failure of all sort of military resistance against the British Christian domination of the Sokoto Caliphate, the resistance metamorphosed into rejecting everything brought by the British, including services of social and material benefits.

Introduction

The provision of healthcare services is an essential pre-requisite for any meaningful human and socio-economic development. From time immemorial, civilizations and governments accorded special priority to safeguarding the welfare of their citizens.The traditional Hausa society develops an elaborate medical institution consisting of spiritual and material-medical practices.¹

An auspicious moment for traditional medical practice came after the establishment of the Sokoto Caliphate. The leadership of the Sokoto caliphate had a keen interest in medical practice. The triumvirate of Sheikh Uthman bin Fodiyo, his brother Abdullahi Fodiyo and his son Sultan Muhammad Bello studied and fashioned the Hausa traditional medicine to suit Islamic Shari'ah. The three of them produced quite a number of works on medicine.² Muhammad Bello alone, wrote over ten books and treatise to answer some medical needs like liver, kidney and related sickness.³ The leaders of pre-colonial Sokoto metropolis were conscious of safeguarding the health of their subjects. It was reported by Last, that Muhammad Bello requested for European health expertise when Clapperton first visited Sokoto⁴ .The Caliphs during the Umayyads and the Abbasids were all believed to have engaged the services of non-Muslim physicians to look after the health of their people⁵. Therefore, the way and manner people of Sokoto metropolis responded to; or resisted the British healthcare services merits a detailed and careful examination. This paper only sets the stage without going in to any detailed examination or venturing into theological discourse.

The Introduction of British Healthcare Services in Sokoto Metropolis

Until 1920, nearly 20 years after the establishment of colonial administration, provision of healthcare services to the native people of Sokoto was not given consideration by the British administration⁶. The colonial medical services during these early years were only given to the few colonial officers.⁷ The Sokoto Native Authority dispensary was opened in 1920 near the Sultan's palace, (presently, WCWC hospital). The establishment of the dispensary was made necessary in order to combat the cases of epidemics and provide basic healthcare services to the people. The introduction of European healthcare services initially recorded little success as the people of Sokoto were not willing to patronize European medicine for many reasons. According to Tibenderana:

There were prejudices against the dispensary on religious grounds. The dispensary was regarded by many Muslims as an improper place to go for treatment because it facilitated the mixing of the sexes which was against Islamic dogma It was also regarded as improper for men to carry out medical examination and treatment on women.⁸

He also noted that the existence of indigenous medicine which Bunza describes as Islamically fashioned traditional medicine further made the newly introduced European medicine less popular.⁹ Although an attempt was made in 1923 to reduce local resentment when some private huts were erected for female patients at the dispensary in order to provide some privacy, the people of Sokoto still did not avail themselves of the healthcare services.¹⁰ Resentment against the Europeans medicine persisted , that despite the outbreak of small-pox, relapsing fever and other epidemics as well as the high death rate associated with them, most people in the metropolis were not willing to attend the hospital. Lamenting on the situation, the resident stated that: The mortality of recent years has been disastrous and we have to stand by, practically helpless, because the people did not trust in our help.¹¹

It is important to note that throughout the 1920's it was only the Native Authority (N.A) dispensary that served the whole people of Sokoto metropolis. However, people's boycott and resentment against European medicine remained the most serious challenge against the success of British healthcare services.

The Expansion and Development of British Healthcare Services in Sokoto Metropolis

By the late 1920, the N.A dispensary had grown to full capacity as a result of the increase in population of both the towns' men and southerners living in Sokoto. The population of Sokoto metropolis by 1929 was nearly 20_:000.¹² Eventually, arrangements started in 1929 for the construction of N.A hospital. The work started immediately and was completed In 1932.¹³ Therefore, by May 1932, the people of Sokoto started to enjoy the services of a modern hospital consisting of a:

Combined administrative and out-patient block, male and female wards to accommodate sixty in-patients, an operation theater, laundry and post-mortem theater, all built in permanent materials.¹⁴

The Sokoto N.A hospital is presently the Specialist Hospital Sokoto. Although the separation of males and females was made possible with the construction of a separate female ward, people's response and attendance at the hospital remained unimpressive.¹⁵

Another development in the history of colonial health services in Sokoto metropolis was the construction of another dispensary close to the Sokoto market which was opened in 1936. The dispensary was put under Miss Healing, a nursing sister who assumed duty in September 1936¹⁶. With this development, the number of institutions providing medical services in Sokoto became three that consisted of; the newly built dispensary near the market, the old town dispensary (presently WCWC hospital near the Sultan's Palace) and the N.A hospital (presently, Specialist Hospital Sokoto). The town dispensary continued to act as an annex to the N.A hospital. People requiring long term treatment or those from outlying districts were usually accommodated there. Despite all these developments, people in Sokoto metropolis were not willing to attend modern hospitals. According to Backhouse, the Sokoto Divisional Officer;

Sokoto town's people still do not avail themselves to the hospital facilities and the majority of in-patients were derived from outlying districts in particular, Argungu and Birnin Kebbi¹⁷

However, apart from the erection of a new female ward block at the Hospital in 1939, Child Welfare work and ante-natal clinic were started by Miss Marke, a nursing sister at the town dispensary. However, due to her inability to run the two centers single handedly, she requested and secured the assistance of some European ladies in the metropolis who had no medical training, to assist her in running the clinics. In addition, the nursing sister usually generated some gifts from some enthusiasts of European health services and it were distributed to mothers and babies who attended the hospital in order to encourage attendance.¹⁸

The inability of Miss Clelland after she took over from Miss Marke in 1941, to generate as many materials as possible for distribution to patients at the hospital, as well as her little sympathy with the interest, belief and culture of her clients, combined to diminish the popularity of child welfare and antenatal clinics.¹⁹

One surprising nature of the people's response to British healthcare services was that even the local elites and the N.A officials, such as the staff and headmaster of the middle school, the Sultan, his councilors and his councilors' sons were reluctant to attend the hospital including the ante-natal and child welfare clinics as Miss Clelland herself established. In order to make the welfare work a success, the nursing sister embarked on house to house visitation so as to come into direct contact with the mothers. Unfortunately, even at the Sultan's house, Miss Clelland was not welcomed and as a result of the embarrassment, the medical officer advised her to discontinue with the visit in 1942.²⁰

On the whole, both Carrow and Leonard, the two successive Residents reported in 1942 and 1944 respectively, that, it was mostly the southerners living in Sokoto who patronized and enjoyed the services of British medical institutions.²¹ For instance McCabe reported in 1946 that, of the 66 deliveries at the N. A hospital, only 17 were Hausa women who were not only within the metropolis but from outlying districts.²². The way and manner at which the people of Sokoto negatively responded to European medical services will most likely engage the attention of anybody studying colonial health services in Sokoto metropolis. Unlike electricity, radio and other social services which were provided towards the end of colonial administration, when the level of resistance against the British had waned down, and not necessarily as a result of the wonders of those services which might have caused the admiration by the local people, British healthcare services were introduced at the early stage of the administration when resistance against the British was higher. Little wonder therefore, they were widely resented and boycotted by the people of Sokoto. And again, the existence of an elaborate traditional medical practice, in some instances religiously fashioned, might have served as convenient alternative to modern healthcare services.

Ideological Basis of Resistance to Colonial Health Services

Reasons will suggest that with the house to house medical services, the people of Sokoto who previously complained of the intimacy and lack of privacy for their women at the hospital would whole heartedly accept and patronized the European medicine. Unfortunately, that did not happen.²³

According to Sambo Waliyi, the people of Sokoto were more antagonistic with the British healthcare services than the western school system. This explain why even members of the aristocrats who patronized the western school system in order to maintained their positions and perpetuate their dynasties, were reluctant to patronize European medicine, particularly at a period when such an action was tantamount to renouncing one's faith.²⁴

A clear understanding of the circumstances behind the surrender and subordination of the Caliph’s administration and the people of Sokoto in particular, to the British colonial administration, is necessary before any meaningful comprehension of the nature of the interrelationship between the people of Sokoto and the British colonial administration can be achieved. On this note, some Insiders account from Risalah ilal Mu'asirin by Qadi Abdallah and Risalatul Wazir iIa Ahl – al ilmi wal Tadabbur by Wazir Al-Bukhari is very essential. The two works were compiled to offer the people of Sokoto with an alternative way of resisting British colonial administration within Islamic Shariah.

Qadi Abdullah compiled the Risalah ilal Mu'asirin at the eve of the British conquest of Sokoto city. In the book he maintained that the only condition under which Muslims can negotiate peace with unbelievers is when they are weak and incapable of confronting the un-believers, until such a time when they are stronger and capable of defeating them. In this case they can accept their over lordship. But even that defends on the condition that Muslims will not be under the total control of the unbelievers Therefore since after the British conquest, the Muslims of Sokoto will remain under their total control, negotiating peace with them cannot be lawful under Islamic Shariah. Therefore, the only alternative according to him was for the Muslims to emigrate out of the city not to subject them-selves under the British administration.²⁵

On his part, Wazir, Al Bukhari was the vizier of Sultan Attahiru 1 during the British conquest. Himself a scholar of distinction, he maintained that, since even if the Muslims emigrate out of the Sokoto city, they had no better place to go, the only alternative was to negotiate peace with the British, and submit to their rule pending the time when they could mobilize enough strength to push the British out. It was this opinion that Wazir AI-Bukhari compiled in his book after the British conquest of the Sokoto Caliphate²⁶ Thus after the battle of Giginya in March 1903 and the eventual defeat of the caliphate forces, Sultan Attahiru I. Qadi Abdallah and their followers emigrated eastward. On his part_, Wazir AI-Bukhari and his followers, including Attahiru who later became the Sultan, returned and negotiated peace with the British.²⁷ But their submission to British rule according to AI-Bukhari was temporary as permitted by Islam, pending the time when they could be able to mobilize enough strength to repulse the British out. This strategy they adopted was of Taqiyya dissembling, outward friendship with the Europeans.²⁸

The Wazir was later disturbed when he started to realize that the British had come to stay. It was this state of contemplation and unsettled mind that informed his decision to seek the opinions of other scholars and compiled his earlier opinion in a book form. The decision according to Maishanu was nothing but an apologia against his conduct after the British conquest of Sokoto.²⁹

Therefore, the Wazir and other people that stayed in Sokoto after the British conquest adopted Taqiyya. They only befriend the British outwardly, but internally, they believed that a whole-hearted acceptance of the British rule and policies meant renouncing their faith. This explains in part the essence of their skepticism and prolonged resistance against British policies and programmes including those with social and material benefits.

Thus, following the failure of all forms of military resistance and the subsequent consolidation of colonial rule, the Ulama'a embarked on total condemnation of British administration and everything associated with it. The Ulama'a as Adeleye and Usman rightly argued were the ‘think tank’ of the caliphal society and had been serving as the conscience of the Muslim community. They embarked on what Usman further considered as the intellectual warfare against British domination. To actualize this course;

The writing of poems was subsequently employed to mobilize and enlighten the Muslim on what the Malams (Ulama'a) considered the evils of the infidel system introduced by the British.³⁰

Of the leading scholars that championed this course, were; 'Malam Maikaturu, Malam Ibrahim Khalil and Malam Maharazu. Maikaturu was the most widely known scholar who traveled to many outlying districts and propagated his ideas. Maikaturu condemned the European ways in its totality, including language, dressing, and pastime activities such as games among others. He went to the extent of concluding that anybody that wore European type of clothes and prayed, his prayer was null and void, even if he prayed a thousand times. In fact any slight acceptance of the British or using anything theirs, was according to Maikaratu, an act of disbelief that will lead someone to the hell fire ³¹

Another notable scholar was Malam Ibrahim Khalil He condemned all British policies and programmes such as medicine, taxation, conscriptions, edicts and ordinances as well as seeking employment or working under the Europeans.³² On European medicine, Malam Ibrahim Khalil said in one of his poems:

i.              Zaidu kak Kasha Kabsu  -Zaidu do not take drugs (European tablets)

   Kwaya halakata  -Drugs are dangerous

ii. Wanda duk Kason Allah -He who loveth Allah,

Bai Fara Rikata  -will never take it (Drugs).³³

For 'Malam^’ Maharazu, policies and programmes a part, a Muslim is not permitted to use anything associated with the Europeans including their type of food such as cake, sweets, sugar, biscuits and bread.³⁴

A careful examination of the activities of these scholars reveals a higher level of counter colonial moralist and propaganda than an orthodox Islamic teaching. For instance, Mallam Maharazu came to admit the permissibility of using some European products such as public address system to call for prayer, tape recorder for audio presentation of religious poems_: coins (British currency) for business transaction, soap for bathing and kerosene and lamps for illumination in his later years.³⁵

But in any case, the activities of these scholars played a decisive role in injecting hatred and discontent against the British administration in the people of Sokoto metropolis. Therefore, the people of Sokoto considered it as a religious obligation to shun British policies and programmes, and that any slight acceptance of the British or using anything theirs’ would tantamount to loosing ones’ faith. According to Ikime,

In discussing the Caliphate's resistance to British conquest, a prominent place is usually given to the role played by Islam. There is good reason for doing so. Islam forbade Muslims from willingly submitting themselves to infidel rule. Because of this injunction the Muslims of the Sokoto Caliphate felt they had a duty to resist the British push³⁶

Therefore, there was a great deal of ideological basis in the people's response to British healthcare services in particular and overall relationship between the people of Sokoto and the British colonial administration.

However, studies in colonial infrastructure and social services in Sokoto metropolis reveal that the people of Sokoto were more antagonistic of European medicine than other services introduced by the British such as educational system, pipe-borne water, electricity, radio and others.³⁷ It will be very interesting to find out why European medicine was hated far and above all other services introduced by the British, despite its efficacy demonstrated in curing various illness among the native people that attended the hospital. It should also be recalled that some of the earlier accusations against the British healthcare services were of intimacy and lack of privacy for Muslim women as well as men carrying out medical examination and treatment on women.³⁸ In line with the above, a separate ward for female at the N.A hospital, and private huts at the dispensaries were provided. In addition, a female nurse, nursing sister was most of the time available at the metropolis, yet the average people failed to attend the hospital.³⁹ In fact, it reached a period when people were dying of sickness and epidemics, including the Sultan, yet they failed to patronize European medicine.⁴⁰ Far and above all, house to house medical services were introduced by the nursing sister in order to come into direct contact with the mothers, yet she was sadly disappointed.⁴¹

Similarly, in the 1940s up to the end of colonial administration, people who attended the hospital were dashed with gifts and clothes A land rover vehicle was provided by the NA to serve as an ambulance that usually goes round the city to chase out and carry sick people to the hospital, but some of the affected people used to be crying.⁴² Therefore, it could not only be the strength of anti-British scholar's sermons and propagandas that succeeded in creating this special enmity to European medicine. Other forces must be at work. Otherwise it was contradicting when some native people attended British schools and accepted appointments and served under the British administration, but still found no genuine reason in using European medicine. At the same time many people agreed to use pipe-borne water, electricity, cloths and other related services but refused British healthcare services. It will take much detailed future research to find out other responsible factors why people in Sokoto metropolis seriously resisted and failed to positively embrace the British healthcare services. However, the role of Hausa traditional medical practitioners needs to be examined.

 By the time of British conquest of Sokoto metropolis, the Hausa traditional medical institutions have reached certain level of acceptance. The defunct Caliphate administration had also succeeded in the incorporation of Hausa traditional medicine into broader Islamic conception of disease and therapy. The bulk of medical literature bequeathed by the Caliphate also contained many scientific approaches to disease investigation, cure and use of various materials for preparation of medicine.⁴³

One critical area of the pre-colonial medical practice in Sokoto metropolis in particular and Hausa land in general was its strong relation with the various crafts and industries as well as socio-cultural groups. Every (head of a) particular group specializes in curing certain forms of disease. Bunza enumerated ten (10) of such groups viz: Black Smith, Bone setters. Hunters, Fishermen, Yan-Bori, Diviners, Boka, Medicine man and Magori.⁴⁴ In addition however, Islamic scholars too were involved in various medical practices including antenatal and maternal health Issues. As at the time of the British conquest of Sokoto metropolis, these socio-cultural groups constituted almost half of its population. Consequently, the introduction of British health institutions did not mean progress in the eyes of these socio-cultural groups, but a radical attempt to supplant the role of their institutions. Therefore, the serious and persistent antagonism against the British health care services could also be understood by how the pre-colonial Hausa traditional medical institutions struggled to sustain their interest in a radically changing society.

Conclusion

This paper examines how the general hatred and resistance against British colonial domination led to people's rejection of colonial health services in Sokoto metropolis. Although not a theological work, the paper discovered a lot of contradictions between the attitude of average men in Sokoto in the 20^lh century, with those of; the founders of the Sokoto caliphate and, some orthodox caliphs, as it relates to engaging the services of non-Muslim physicians. In any case, the attitude of Sokoto people during the early days of colonial administration demonstrated a high level of resistance against colonial domination. And again, it entails a clear demonstration of the force of religion and the influence wielded by the Ulama'a in a Muslim community.

Resistance against the British domination of the Sokoto city did not end with the battle of Giginya in March, 1903 or the Satiru revolt of 1906. The resistance metamorphosed in outward boy-cot and rejection of the British policies and progammes including services of social and material benefits throughout the colonial period.

The implantation of British values and civilization in the Sokoto metropolis lead to a very serious struggle between British imperial forces and different indigenous socio-cultural, political and economic groups trying to sustain their interest in a radically changing society In other words, there was a civilizational conflict between the existing traditional institutions and British values and civilization.

The success of government policies and programme depends on the extent to which the interest, beliefs and culture of the affected community are taken into account.

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