Reclaiming the essentials of Akufo

Herbert Gilles' study of disease and environment at Akufo in Nigeria around 1960 was an early example of an integrated and detailed approach to understanding the health of a small group of people. Subsequent studies on a larger scale have focused on particular diseases or on the provision of medical care. The primary-health-care movement has tended in practice to neglect the material environment. Medical anthropological work has returned to detailed studies of processes in small communities. There is a need to return to looking at the overall health and disease pattern of small communities, together with their environment and human behaviour, to get a coherent understanding. The formulation of interventions appropriate to this understanding will be more difficult.