This project subjects three Swiss mission hospitals in Ghana, South Africa and Tanzania to an examination using the tools of History and Anthropology. The hospitals provide us with a means of entering into both the transnational history of different Christian missions and their influence on, and encounter with, diverse health systems in the continent. This allows for a comparative approach that highlights differences and commonalities and that raises new questions. By choosing an inter-disciplinary approach the study challenges the meaning created by dichotomies such as Christian-heathen, universal-local, European-African, professional-amateur and modern-traditional. Our approach destabilizes the fixity of these labels and underlines the dynamics of change in institutions and practices related to health in Africa.

Our study underlines the importance of financial structures to the ways in which hospitals fulfil their role in society. As mission hospitals attempted to serve a wider rural public, they had to turn to the state and secular officials for help. This undermined their spiritual and evangelical nature and confirmed the importance of the state and donor agencies in their development. During this time the hospitals became important rural sites for medical training and ‘decolonisation’. Outside influences and local needs pushed them to become important laboratories in the construction of ‘hospitals without walls’. This study particularly recognises the vital contribution of these rural hospitals to wider health systems.