26O BOOK REVIEWSworld, particularly the developed world, by better nutrition, good watersupplies, adequate refuse and sewage disposal and reasonable shelter.Improvements in these essential needs can be brought about only byimproved social conditions engendered by economic prosperity and thecessation of the present war which has had an adverse effect on thedevelopment of the country.Few would argue with the authors that there must be an increasingdelivery of health services at rural levels; the problem is to encourage peopleto work in such areas. They advocate the training of large numbers ofvillage health workers (V.H.W.s) who would be invaluable, provided theyare willing to remain working in these areas on a part-time basis. Onlytime will tell whether those already trained will be acceptable. In referringto the Advanced Clinical Nurse (A.C.N.) they state (p.43) that 'the A.C.N.is really a doctor in practically everything but name'. I would take issuewith this and say they are highly skilled members of the nursing profession,a nurse practitioner or physician's assistant in modern parlance, but theirbasic training remains far short of that on which one would base the trainingof a medical practitioner. Efforts have been made in the Faculty of Medicineof the University of Rhodesia to expose students throughout their career tothe needs of community medicine, including a three-week attachment in theirfinal year in a rural area. Of recent years, owing to the war situation, thishas had to be curtailed but experience in primary medical health services isgiven in a rapidly developing urban township where many rural people arearriving daily. It is noted that neither of the two medical authors have spentany time working in the rural areas of Rhodesia, where their experiencemight have been broadened and thus brought greater professional relevanceto the text.In this reviewer's opinion the basic structure of the health services ofZimbabwe is sound. Their development depends on peace not war andincreasing economic prosperity. Many of the ideas suggested by the authorsare already incorporated in the programme for the future and others willbe readily adopted when the situation, both economic and military, allows.It is pleasing to see, even if from two authors who appear to be Londonbased, that they are aware of the needs of rural as opposed to urban healthservices. It is to be hoped that they and others will join with those inZimbabwe to help in providing the expertise to develop many of theirproposals in the future.University of Rhodesia W. FRASER ROSSAlternatives to Poverty By R. Riddell. Gwelo, Mambo Press, Rhodesia toZimbabwe No. 1, 20pp., ZR$0,30.This booklet is the first in a series of monographs in which a range of issueslikely to confront policy makers on development in a legally independentZimbabwe are discussed.The work falls into two main sections. One provides an historicalsummary of the process of development which has shaped the economy asit now stands, noting a number of current social and economic problemareas. The other, looks to the future, attempting to address in broad outlineBOOK REVIEWSthe task mapped out in the brief for the series: 'How can the new Govern-ment of Zimbabwe provide for the basic needs of the poorest sectors ofSociety?'.The author begins by identifying three general problem areas Š poverty,unemployment and inequality. Without engaging in the (academically fascinat-ing) definitional intricacies surrounding the three issues, it is, I think, reason-ably fair to say Š and Riddell almost implies this Š that in the particularcontext, the first and second problems affect exclusively the Black sectionof the population, while the third distributional question is at the broadsocial level mostly noted with the White population as the reference point.These problems, Riddell believes, 'the present development strategyis totally incapable of solving'.The 'Present Development Strategy'In this section, Riddell gives an historical sketch of the development ofthe economy. A sketch Š I do not think anything more. The accuracy ofthat sketch is, for those familiar with the details, easy enough to assess bymeans of a ten-minute read through the twelve pages. The usefulness ofthose pages is that they raise the following major issues:Capital, capitalism and growth: Riddell notes the generally unquestionedcentral role of foreign and local capitalistic interests in the growth of themain productive sectors of the economy Š manufacturing, commercialagriculture and mining. Here the explicit conclusion is drawn that growthand expansion have not been negligible in terms of output volume, the exten-sion of external linkages and absolute wage employment, and further, thatŠ and Riddell places accent on this Š the overall economic structureyielding this growth has demonstrably failed to absorb much of the availablelabour force. Moreover, the employment that has been generated for theBlacks has been at unacceptably low wage levels (with reference to PovertyDatum Line desiderata). The implicit critique therefore essentially collapsesinto the 'growth' without adequate, sufficiently paying employment' thesis.On the 'dual economy: Here the conclusion reached is that in historicalterms, the Black peasant economy has been, and been made, subserviently,disadvantageous^, and debilitatingly functional to the accumulation require-ments of capital in the 'modern' sectors Š in three ways. First, the Reserveeconomy supplies labour to the capitalist sectors Š and cheaply. There issome ambiguity in RiddelPs presentation here as to the relative status,historically and currently, of structural determinants (e.g. at p.8) anddeliberate State labour policies (e.g. p.7) in this process of internal migration.Second, the Reserves supply 'an accommodating mechanism' to the modernsector, by subsidizing the incomes of the wage workers, who 'are not paidanything like the full amount necessary to provide for the basic minimumneeds of their families'. Third, the existence of Reserves has allowed theŁ State to pursue discriminatory policies in the provision and distribution ofinfrastructural support and assets (especially land), biasing these in favourof the 'modern' sectors.The net effect of all this has been that 'the development of the modernsector is ... built upon the underdevelopment of the reserve economy'.The conclusion amounts to an (again) implicit sectoral dependency thesis,supplementing a pronounced unbalance growth hypothesis: accumulationŁ and growth in the 'modern' sector finds its polar opposite in the involutionof the Black rural economy. lBOOK REVIEWSRiddell takes the position that, particularly with the advent of a newpolitical dispensation in Zimbabwe, the need for solutions to the problemsof Black rural and urban poverty and unemployment, and of inequality inthe distribution of assets and income, takes on added urgency. And sincethese problems are a result of policy biases contained in past strategiesinteracting with the structural processes summarized above, the solutions'require ... a very different alternative from the present approach'.The Basic Needs Approach to DevelopmentRiddell proposes that what is needed is a re-orientation of developmentphilosophy and policy so that the satisfaction of the basic needs of 'thepoorest sectors of the population' occupies a central position. Basic needsare defined as consisting of three elements: adequate private consumption,access to social services, and mass participatory democracy.Unless adequately balanced with accurate portrayal, coherent thinkingand clear expression, brevity in socio-economic discussion, particularly ofpolicy issues, always carries the grave danger on the part of the presenterof misrepresentation of ideas Š and of misinterpretation on the part of therecipients. I fear that this could be the result of the way that the BasicNeeds Approach has been introduce'd to the context of Zimbabwe.In so far as addresses the question of incorporating considerationsof poverty, deprivation and distribution into the public policy decision matrix,the Basic Needs Approach says nothing shatteringly novel to the study ofsocial problems. But in so far as it simply focuses on a (hopefully non-ephemeral) shift in emphasis in the thinking of world professional analystsand agencies about the purposes (and only secondarily strategies) of growthand development, the Basic Needs Approach only gives a new label to anuniversally important issue: humanity must struggle to alleviate povertyand its consequences.Riddell's discussion of this shift is, I think, too brief. It also appearsrather, haphazardly and hurriedly assembled. Summarizing the Basic NeedsApproach and juxtaposing that summary with comments on general macro-economic sectoral policy options, urbanization and industrialization, the roleof foreign capital, technology and know-how, Research and Development,participatory democracy and self-reliance, the problem of the influence ofEast - West geopolitics on the evolution of strategic development options, etc.,and presenting all this in a 13-page section, results in the likelihood thatthe meaning and implication of the Basic Needs Approach itself will be lost.Superficiality becomes almost inevitable.Riddell raises many important and relevant issues in this pamphlet.Those issues are not new to this country and economy. That lack of noveltydoes not make them any less valid, or urgent. His presentation of theseissues leaves much to be desired, for example, detail, rigour and, for otheranalysts theoretical explicitness. The over-riding point, in my view, however,is that the issues are being raised. The country can only benefit from morethorough efforts.University of Rhodesia M_ KADHANITraditional Healers and the Shooa Patient By G. Chavunduka. Gweto,Mambo Press, Zsmbeziana No. 3, 1976, 139pp., ZR$5,90.