One of our alumni, Wayne Cooper, MD, MSB, (2007) recently returned from Hope Africa University in Bujumbura in the Republic of Burundi a small East African landlocked country of 8½ million people bordering on Lake Tanganyika, which is considered one of the poorest countries in the world. He sent his notes about this unique experience to Professor Baker and with his permission we are posting them here on our Website.

Dr. Cooper’s Notes:

I was asked to teach "Christian Philosophy of Medicine." I was recommended because of a course on Philosophy of Medicine I taught at the University of Texas, Dallas. Since Hope Africa University is affiliated with the Free Methodist Church I was concerned that some in the administration might pressure me on how I should teach the course…but I never received any question, commentary or critique of how I should teach the course….Their library was actually well stocked in books on general philosophy and philosophy of religion.

On Autonomy and Western Bioethics Having read your [i.e. Baker’s] articles and Tris Englehardt's, I didn't know what might be their experience and view on the principle of autonomy. There is no history of bioethics in the community, no notion of informed consent. But I found that they were in general quite comfortable with the concepts. They were not conversant with the lingo, but the concepts were familiar to them. The medical system in the country is modeled on the French model…. my impression is that it is still very paternalistic. I cannot say how well they assimilated the concepts or how they might incorporate them in their practice, but I can say that they made high grades on the exams.

Regarding the history of bioethics, the students had little knowledge of it. They were not familiar with the history of the Holocaust or the Nuremburg Doctors' Trial.

On Teaching Students I had no preconceptions about these students, so I just started teaching the course the same way I had taught it at UTD. However, there were some real pedagogical challenges: No slides, no PowerPoint, just what books might be available in the library (I subsequently investigated and found that the library has a good supply of philosophy and philosophy of religion books). There was no possibility of photo-copying notes or articles. The only method of teaching was chalk and the blackboard. An additional challenge was that English is the 3rd language of the students (First – Kirundi; Second – French).

I found that there were 51 students in the class. They did not appear in class promptly, but instead drifted in over the first 20 minutes. Despite that, I would start on time. Over time, the best students came to appear at the beginning, but I naturally used the first few minutes to review what we had already covered. I would list on the left side of the board the topics to be covered in the next 1 ½ hours. Then I would put the title of the topic on the top middle of the board, then give cryptic sentences covering the major propositions of that topic, much as one might do by taking class notes. Since there was a language problem and no possibility of [photo]copying I was concerned that I would rapidly lose the students, so I spent some time writing these notes on the board. This gave the students time to copy my notes. Then I would talk 10-20 minutes about each proposition, filling in the details. They seemed to be following me.

At the end of the first day, the student representative came to me with an idea – it turned out to be brilliant. They would choose the student in the class who made the best notes of my lectures, then bring those notes to me at the end of the day. I would correct them and make additions. Then, OVERNIGHT the students would share the notes and make each other copies! By the next morning all of us were on the same page. This showed me real quickly how serious these students were. By the end of the first week, it was clear to me that I was dealing with a class of very serious students. When anyone did not understand a concept or a discussion, they would ask questions – even from the back of the class. After I’d give an explanation the student who understood the concept would explain it to the others (in French or Kirundi). This process of course energized me into working on and improving my lectures between classes.

It was clear to me by the beginning of the second week that these students would have no problem grasping the tough abstract concepts of philosophy. I gave the first quiz near the end of the first week. It was a multiple choice exam in which I wanted to see how well the facts and concepts had been grasped. It was basically the same exam I have given to UTD and UTT students, where the average grade is usually about 75. The average at HAU was 95! The key here was that the students had explained the material to each other

By the end of the second week, after a second exam with another average of 95, the students were participating aggressively in discussions of some complex concepts from some very abstract philosophers (Hegel, Schleiermacher, Feuerbach, Kant, Levinas, Buber….)

 I also took pictures of the students washing their own clothes in the wash trough behind the dorm – after 6 or more hours of classes a day. They often would be singing as well. In short, as a teacher it was a thoroughly enjoyable and challenging experience. I would recommend this experience to any American teacher who has the opportunity. 

By the way the accommodations here were excellent, comfortable and clean. The meals (“3 squares a day”) were very good and healthy (rice, beef, zuchinni and pineapple with an orange drink was typical). The administration was overwhelmingly accommodating and gracious. Bishop Elie is a very impressive gracious host, and…we attended the Sunday service at her church. You have never seen the Gospel sung and danced like it was done there! Unforgettable.

One’s heart goes out to these people who have suffered so much tragedy in the recent past [violent Hutu-Tutsi conflict]. Everywhere one sees industrious activity and building. Despite the abject poverty, there is singing, dancing, bustling everywhere, and an atmosphere of hope. Incredible! A thoroughly enjoyable and encouraging experience!  

Wayne Cooper