Results and Discussion

Abstract

This chapter unveils the primary outcomes. The study reveals that economic, geographical, and agricultural elements played pivotal roles in shaping the pace of missionary expansion in Zambia. While the progression of missionary education was gradual and unequal between genders during the colonial era. Moreover, medical missionaries notably addressed the healthcare needs of the African populace, leveraging local auxiliaries. Additionally, the evidence underscores that historical exposure to missionaries continues to exert a substantial influence on education and health outcomes in Zambia.

Missionary Expansion

The work of Christian missionaries in the early nineteenth century in Central Africa preceded the Europeans’ colonization. Upon arrival in Central Africa, the missionaries first settled in the coastal areas and, after that, they proceeded to explore inland (Gann, 1968). David Livingstone was the earliest Christian missionary to explore Northern Rhodesia; his mission into Northern Rhodesia began from Cape Town, transitioned into Linyanti, and ultimately penetrated Northern Rhodesia via the Zambezi river (Beck, 2007; Rotberg, 1965). The expeditions of David Livingstone in Central Africa paved the way for missionaries that joined the mission field after him (Gann, 1968). Because missionaries established themselves in coastal areas before moving into the interior, distance to the coastline played a vital role in the early phases of missionary settlement. The evidence from this study corroborates the early historical narratives and recent empirical evidence that in the initial phases of exploration, missionaries established themselves in areas along the African coastline (Alpino & Hammersmark, 2021; Gallup et al., 1999; Gann, 1968). The pattern of settlement along coastal areas is even more pronounced in countries with a coastal line; however, since Zambia is a landlocked country, both the empirical evidence and the early settlement pattern show that missionaries first established themselves in regions that border coastal countries, as can be seen from Fig. 6.1.

Fig. 6.1

Early protestant missionaries in Northern Rhodesia 1883–1898

As missionaries were moving into the interior, navigable rivers and explorer routes paved by early missionaries and others became important. The evidence in this study shows that missionaries had a predilection for regions near rivers. The rivers were important for transportation, and historically, areas near rivers were more populated and, hence, more likely to develop. The Christian missionaries’ evangelistic mission was people-driven; essentially, missionaries sought to establish mission stations in populated regions (Alpino & Hammersmark, 2021; Jedwab et al., 2022; Johnson, 1967).

Additionally, for Northern Rhodesia, before missionaries could establish themselves in any region in Zambia, they needed the approval of the ruling Paramount Chief. The Paramount Chiefs commanded a great influence over the local tribal chiefs; essentially, once the Christian missionaries received the approval of the Paramount Chief, he would then advocate for them to set up mission stations in other chiefdoms under his hegemony (Gann, 1968; Ragsdale, 1986; Snelson, 1974). The findings of this study corroborate this narrative that Chiefs played a pertinent role in facilitating missionary settlement.

Other factors that significantly influenced the settlement of missionaries included the soil fertility and the railway line. Fertile soils made it possible for them to grow various crops for sale and for their livelihood and the railway line enabled missionaries to transport the agricultural produce to the markets. Farming was also used as a proselytization strategy. In 1905, the British South African Company awarded the Jesuit Fathers about 10,000 acres of land in Chikuni among the Tonga people. The land was given to the Jesuits, expecting that the priests would use the land to teach the natives “modern” ploughing methods and make their herds of cattle more productive (Ragsdale, 1986). Essentially, agriculture was therefore an important aspect of the missionaries work in Northern Rhodesia, and many of the missionaries in Northern Rhodesia readily accepted the title “Apostolates of the Plough” (Ragsdale, 1986).

During the period in which this study was conducted, malaria had already been adopted and used in Northern Rhodesia as a prophylactic for malaria. Therefore, the study does not find any evidence that malaria ecology influenced the settlement patterns of missionaries.

Christian Missionaries and Education

The investigation elucidates that gender disparities in Zambia’s educational system were significantly shaped by the government’s dependence on missionary societies for educational provision. This reliance led to limited advancements in girls’ education within government schools, where females constituted less than one-third of the student body. Instead, the majority of girls received their education through missionary societies, which, initially, aimed at providing separate education for girls and boys with a focus on nurturing Christian wives. However, the scarcity of female missionaries posed a substantial hindrance, contributing to the existing gender gap in education, with girls primarily receiving a domesticity-focused curriculum, contrasting with boys who were prepared for colonial economic participation (Snelson, 1974).

Additionally, the findings reveal that educational endeavors during the colonial era predominantly favored boys. In 1925, two-thirds of enrolled students were boys, a trend that continued until the 1940s before gradually reversing (Annual Educational Reports, 1924–1953). This initial gender gap expansion aligns with global patterns of formal education’s initial expansion, typically led by boys (Baten et al., 2021). Nevertheless, other studies argue that this bias was intentional, with missionaries directing education toward males, often in collaboration with indigenous elites (Becker & Woessmann, 2008; Boserup, 1970; De Haas & Frankema, 2018). Notably, the study indicates denomination-specific variations in gender access, with Protestant missionary schools in Northern Rhodesia displaying a relatively more equitable distribution than their Catholic counterparts, although the overall gender gap persisted until the end of the colonial period, with 40 percent of girls compared to 60 percent of boys attending school (Annual Educational Report, 1963).

Furthermore, the study identifies a lasting impact of missionary education on educational attainment and the gender gap post-independence. Proximity to a missionary station correlates positively with increased years of education, both for cohorts born during colonial rule and those born post-independence. Despite an overall rise in educational attainment, females consistently lag behind. Girls born in the pre-independence era, on average, received two years less schooling than their male counterparts, though this gap significantly reduced for girls born after independence to half a year on average. While a broader cross-continental study suggests a smaller gender gap in regions intensely exposed to early missionary education (Baten et al., 2021), this study highlights that access to missionary education initially exacerbated the gender gap during the colonial period, possibly due to the educational expansion’s strong male bias. Conversely, access to missionary education is associated with a reduced gender gap for cohorts born in Zambia after independence, reflecting increased educational opportunities for girls in the later phases of schooling development.

Christian Missionaries and Health

Establishment of Health Care in Colonial Zambia

As shown in Fig. 6.2, the colonial government operated 12 African hospitals that were mostly situated along the rail line and at their main administrative centers throughout the colonial period. In contrast, in Fig. 6.3 it is noted that missionaries established a larger network of 89 mission hospitals strategically located in rural areas where the majority of Africans lived. This distribution of healthcare facilities reflects the missionaries’ focus on establishing hospitals in isolated rural areas, while the state’s healthcare provision centered around urban areas. This pattern of missionary dominance in rural healthcare provision, with the state primarily serving urban populations, is not unique to Northern Rhodesia. Similar patterns have been observed in other parts of Africa, such as Malawi (Hokkanen, 2019), Tanganyika (Jennings, 2008; Crozier, 2005), Kenya, and Uganda (Crozier, 2005), particularly in the early years of colonial public health establishment.

Fig. 6.2

Spatial distribution of government hospitals in Northern Rhodesia 1924–1953. (Source: Drawn by Author)

Fig. 6.3

Spatial distribution of missionary hospitals in Northern Rhodesia 1953. (Source: Drawn by Author)

The missionaries did not only focus on quantity when establishing healthcare facilities, but rather, the evidence at hand suggests that the majority of missionary hospitals were well-established institutions staffed by qualified medical professionals, enabling them to provide treatment for a wide range of prevalent ailments among the African population. The trust established by the missionaries led to increased visits to missionary healthcare facilities, and the expansion of their services during the colonial period (Gelfand, 1961; Rotberg, 1965). Moreover, the financial support received from the colonial administration and donations from private entities and churches back home played a significant role in facilitating the expansion of missionary medical services.

Figure 6.4 provides a visual representation of the proportion of outpatients who sought medical care at African colonial and missionary hospitals in relation to the total population. According to the data presented in Fig. 6.4, the number of outpatient attendances at missionary hospitals in 1932 initially lagged behind those at African state hospitals. However, this difference can be attributed to incomplete statistics reported by the missionaries regarding outpatient attendances during that year, as indicated in the colonial medical reports. The evidence presented in Fig. 6.4 suggests that, overall, there were more outpatient attendances at missionary hospitals compared to African state hospitals. Specifically, starting from the 1940s, over 40 percent of the African population sought medical care at missionary hospitals, while less than 20 percent attended African state hospitals as outpatients throughout the colonial period. Missionaries had established themselves as the primary healthcare providers in Northern Rhodesia, with a wide reach, particularly in rural areas. For many Africans residing in rural Northern Rhodesia, missionary healthcare was not only the primary option but often the only available one.

Fig. 6.4

Number of outpatients in government and missionary hospitals as a percentage of the population 1929–1953

Figure 6.5 illustrates the number of patients who were admitted to government and missionary hospitals in Africa. However, it is important to acknowledge that not all missionary hospitals were consistently included in the records of inpatient admissions, and the reporting of these records varied over time, as indicated in the colonial medical reports (Northern Rhodesia Medical Report, 1934, 1939, 1946). Consequently, the data presented in Fig. 6.5 does not offer a comprehensive representation of inpatient admissions in missionary hospitals. Based on the data available in Fig. 6.5, it is evident that there were more inpatient admissions in African government hospitals compared to missionary hospitals. Nevertheless, there is a gradual increase in inpatient admissions in missionary hospitals towards the late 1940s. The sudden surge in inpatient admissions around 1952 could suggest an improvement in the reporting of inpatient admissions from missionary hospitals or a discrepancy in reporting by the colonial government. Throughout the colonial era, the admission rate for Africans in state hospitals remained below 2 percent.

Fig. 6.5

Number of inpatients in government and missionary hospitals as a percentage of the population 1929–1953. (Source: Annual Colonial Medical Reports)

This relatively low rate of admission can be attributed to the limited number of beds available in African state hospitals. For example, according to the colonial blue books, a total of 46 beds were available in six African state hospitals combined in 1925. In 1948, the number of beds in the African state hospitals of Northern Rhodesia had increased to 163, which was spread across seven hospitals out of the total twelve. However, the provision of public healthcare in Northern Rhodesia was deemed insufficient when compared to some other countries in the region. For instance, during the same year, Tanganyika had a significantly higher bed capacity of approximately 3563 beds, which were distributed among 61 African state hospitals, as stated in the Tanganyika Colonial Blue Book of 1948. According to Jennings (2008), by 1963, Tanganyika had further expanded its healthcare infrastructure and boasted over 7000 beds in various state African hospitals.

The African auxiliaries played a central role in the expansion of health care during the era of missionary and colonial rule. These Africans were trained by missionaries in basic medical procedures and were then deployed to work in missionary and colonial state hospitals. Both the colonial state and the missionaries heavily relied on these trained Africans to extend medical services to the Indigenous population. In order to make Western medical practices more acceptable, the trained African medics adapted the medical knowledge they acquired from the missionaries to align with existing Indigenous medical practices. As a result, the trained Africans played a significant role in the expansion and dissemination of missionary medicine.

Figure 6.6 presents a breakdown of the African staff employed in the health sector in Northern Rhodesia. Notably, between 1932 and 1939, the majority of Africans were employed as orderlies, malaria control boys, and laborers. Unfortunately, the medical reports do not provide specific details about the occupations falling under the category of “other servants.” However, it is evident from the reports that a significant number of Africans were employed in missionary hospitals. In 1932, there were 287 Africans employed in government hospitals, and by 1953, this number had increased to 1056, representing a remarkable 267.94 percent increase in African workers in government hospitals alone (Northern Rhodesia Medical Report, 1932, 1953). Africans also constituted the majority of medical staff employed in healthcare in other African countries. For instance, in Kenya, Chaiken (1998) reports that by 1932, approximately one thousand competent African medical staff members were employed in the colonial health sector. Following World War II, Africans held a significant number of mid-level positions.

Fig. 6.6

Total number of African and European Staff in Colonial Health Sector Northern Rhodesia 1932–1953. (Source: Annual Colonial Medical Reports)

Christian Missionaries and HIV

This study also delves into the enduring impact of Christian missionaries on HIV prevalence and associated sexual behaviors. The examination of the influence of proximity to historical missionary churches and health centers on HIV infection yields intriguing insights. Notably, regions in close proximity to historical missionary churches exhibit higher HIV infection rates, while the proximity to missionary health centers does not yield a significant impact. This discrepancy in impact can be attributed to the central role of weekly gatherings in missionary churches for inculcating Christian ethos, which potentially explains the pronounced effect observed in relation to missionary churches compared to health centers, many of which continue to serve as places of worship today.

Within the context of HIV prevention, faith-based organizations (FBOs) have actively engaged in combating the disease by advocating Christian doctrines surrounding sexuality. Inspired by the legacy of early missionaries, FBOs promote abstinence before marriage and a lifelong commitment to a single partner. However, it is noteworthy that Christian missionaries generally discourage condom use within their congregations, expressing concerns that discussing condom usage in a church setting might inadvertently encourage sexual promiscuity.

Utilizing proxies for sexual behavior, such as the number of lifetime sex partners, pre-marital abstinence, age at first sex, and condom use at first intercourse, the study scrutinizes individuals residing near missionary churches or health centers. The results unveil a nuanced pattern concerning the impact of proximity to historical missionary churches and health centers on the number of lifetime sex partners. Those residing near historical missionary stations tend to report a higher number of lifetime sex partners compared to their counterparts living at a greater distance, with proximity to a missionary health center showing no significant effect. Further analysis distinguishing between Protestant and Catholic churches indicates that proximity to a Protestant church alone does not significantly influence the number of lifetime sex partners, while proximity to a Catholic church is associated with a higher number of lifetime sex partners, primarily driven by proximity to a Catholic church.

Regarding pre-marital abstinence, individuals living in closer proximity to a historical missionary church are less likely to engage in pre-marital abstinence compared to those residing at a greater distance, with proximity to a missionary health center exhibiting no significant effect. Subsequent analysis based on proximity to Protestant and Catholic churches reveals that this effect is primarily attributed to proximity to a Protestant church, with no significant impact observed for distance to a Catholic church. Individuals residing near a Protestant church are found to be less inclined to practice pre-marital abstinence compared to those living farther away, while no significant impact is detected in proximity to a missionary health center.

The findings further indicate that individuals residing near a historical church tend to initiate sexual activity at an earlier age than those living farther away, primarily driven by proximity to a Protestant church, while no significant impact is detected for distance to a Catholic church. Proximity to a missionary health center does not significantly influence age at first sex. The study does not find any significant impact of proximity to a mission station or health centers on condom usage.