The Emergence of Organized Health Care Services

It would seem from available accounts that the earliest form of Western-style health care in Nigeria was provided by doctors brought by explorers and traders to cater for their own well being.^[2] The services were not available to the indigenes.

It was the church missionaries that first established health care services for the people.^[1] In this regard, tribute must be paid to the Roman Catholic mission, the Church Missionary Society (Anglican) and the American Baptist Mission. It is stated that the first health care facility in the county was a dispensary opened in 1880 by the Church Missionary Society in Obosi, followed by others in Onitsha and Ibadan in 1886. However, the first hospital in Nigeria was the Sacred Heart Hospital in Abeokuta, built by the Roman Catholic Mission in 1885.^[1] 
There are several anecdotal reports of practices within these missionary health care facilities to suggest that they were primarily used as tools for winning converts and expanding their followership. Consequently, these facilities were competitive rather than complementary. In spite of this fact, they were of such high quality that, by Independence in 1960, Mission-owned hospitals were more than Government-owned hospitals ( 118: 101). This high quality is also evidenced by the fact that the Seventh Day Adventist Hospital in Ilesha as well as the Wesley Guild Hospital in Ile-Ife became the nucleus of the teaching Hospital complex of a major university in Nigeria. Even today in Nigeria, the Baptist Hospitals in Ogbomsho and Eku function as referral centers in the health care delivery matrix. Because of the evangelical functions of these health care facilities, it was left for the government to organize and develop policies for general health care. It is well known that towards the end of 19^th century, European powers were at war with each other for ownership of the vast rich land of Africa. They established frontiers needed to be secure and so there was a powerful British military presence in Nigeria. For the military, this was located in Lokoja, the British for therefore established medical services there. Under the Governor, Lord Lugard, Lokoja was the military headquarters in 1900. Aside from military health services, civilian services were also established and it is known that the first government hospital for civilians, the St. Margaret's Hospital, was built in Calabar in 1889. At the time World War I (1914- 1918) was ending, present day Nigeria was being born by the amalgamation of the Northern and Southern regions. This war produced a lot of military activities in Nigeria, leading to the establishment of several military health care facilities, some of which were left to function as civilian hospitals after the war. With time, several government-owned health care facilities were established, ranging from rural health centers to general hospitals.