# Rudolf Fisch

Samuel Rudolf Fisch (November 18, 1856 – December 2, 1946) was a Swiss-born physician, preacher, and medical missionary to Ghana. Fisch built the Basel Mission Hospital in Aburi, Ghana in 1885. In Ghana, Fisch pioneered the application of prophylaxis for Malaria and founded the Blue Cross (originally named “Anidaho Fekuw” translated as “The Temperance Movement”) with a core mission of fighting against alcoholism and other substances.
In addition, Fisch was a well known author contributing to Archiv für Schiffs- und Tropenhygiene, a German medical journal focused on tropical medicine, maritime health, and hygiene. He published a well read guide to health in the tropics: Tropische Krankheiten: Anleitung zu ihrer Verhütung und Behandlung which translates to "Tropical Diseases: Guide to their Prevention and Treatment".

## Early life and education

Born in the Aargau canton of Switzerland, Fisch initially trained as a saddler before joining the Basel Mission in early adulthood.
Fisch's medical training began in 1880, where he studied medicine at the University of Basel, earning a Doctor of Medicine degree with a dissertation in ophthalmology.

## Mission and legacy

Rudolf Fisch began his missionary work in 1885 when he arrived at Aburi on the Gold Coast, then a British Colony (now Ghana), with two chests of medical instruments and drugs. He had been sent by the mission to be based at Aburi, a town in the Akuapim South Municipal District from 1885 to 1911. He was the first member of the mission with scientific training. He was to serve as both the medic and a religious missionary.
Aburi, located about 25 miles inland from Accra and elevated 1,450 feet above sea level, was strategically chosen as the headquarters of the Basel Mission medical activities due to its central location and healthy environment. A two-story sanatorium for European missionaries and an outpatient clinic for Africans were constructed at Aburi, forming the first European medical facility away from coastal towns in the Gold Coast. Fisch began daily consultation hours from 2 to 5 pm, treating a wide range of cases, from leprosy and mental illness to injuries and tropical diseases. His work was widely attended by all social classes, with some patients traveling up to 20 hours to seek his care. In his first year, Fisch reported treating over 600 African patients. By 1902, the outpatient count had increased to 4,002, alongside 36 inpatients, reflecting the growing demand for medical care. (Hauns in Africa; Basel Mission Archives) He faced skepticism of his practices by his colleagues, diverging from the traditional local medicine or homeopathic approaches which had been common at the mission.
Fisch oversaw the construction of a mission hospital in 1900, which included four patient rooms, a surgery, and an additional clay house for overflow patients and their families. His commitment to delivering accessible healthcare extended beyond the hospital. By cycling over 3,000 kilometers on 30 medical tours in 1902 alone, he reached mission stations throughout the Gold Coast. As the patient load continued to grow—surpassing 7,800 outpatients and 62 inpatients by 1906—Fisch appealed to the Basel Mission Committee for expanded facilities and additional staff. Broader economic and social changes, including the expansion of cacao farming, gold mining, and infrastructure developments like roads and railways influenced the success of the mission hospital. (Basel Mission Archives)
Fisch played a pivotal role in training African medical assistants, many of whom were recruited from former patients or graduates of Basel Mission schools. These assistants, who handled duties including wound care, medicine preparation, and dispensary operations, were crucial to the goal. Additionally, they contributed to the introduction of mission medicine to their local communities, thereby expanding its acceptability and reach. At the hospital in Aburi, African pastors and educators got rudimentary medical training so they could treat patients in local villages. The mission guaranteed the sustainability and cultural integration of its medical services by hiring local personnel.
In 1909, the medical team in Aburi expanded with the arrival of surgeon Theodor Müller, who, alongside Dr. Fisch, increased the hospital's surgical capacity to over 400 operations annually. By this time, the hospital handled approximately 24,000 outpatient treatments each year. Despite these advancements, overcrowding remained a significant issue, leading to plans for a new, modern hospital with expanded facilities, including X-ray equipment. This project was supported by a donation of 250,000 Swiss Francs from the Basel Mission Trading Company, although its completion was delayed until 1928 due to the outbreak of World War I. Dr. Fisch's work exemplified the Basel Mission's belief in combining medical care with evangelical outreach, positioning medicine as a vital tool for community engagement and spiritual transformation. (Basel Mission Archives; Hauns in Africa)

## Legacy
### Bethel Mission Hospital

Fisch built the Bethel Mission Hospital in Aburi in 1885. The hospital was the location of the first surgery performed in Ghana. The hospital and Basel Mission were turned over to the Scottish Mission in 1918 which now operates as part of the Presbyterian Church of Ghana with 55 health care facilities including four hospitals.

### Missionary wages and families

Fisch broadly influenced missionary training and management as well as colonial administration by advocating for higher wages and the support of families relocating to the mission. He believed this would reduce alcohol use and prostitution.

### The Blue Cross

In 1906 Fisch founded Akan “Anidaho Fekuw” translated as “The Temperance Movement” which later turned into The Ghana Blue Cross Society. The group is affiliated with the International Blue Cross Society, a Switzerland-based international Christian organization whose mission is to fight against alcoholism and other substance abuse. Akan was the first non-European Blue Cross organization.

### Publications
#### Tropical Diseases: “Tropische Krankheitend”

Rudolf Fisch released four versions of his published book Tropische Krankheiten (Tropical Diseases) between 1891 and 1912. The book focused on exploring the causes, progression, prevention, and treatment of "the four most prevalent diseases in Africa," which included malaria, dysentery, and conditions affecting the liver and spleen. The publication of the book made significant contributions to the evolving ideology of tropical medicine at the time, a shift within medicine from miasma theories, linking disease to “bad air", to germ theory of Robert Koch, suggesting microorganisms to be the cause of disease. Fisch’s work bridged these evolving ideologies, combining emerging bacteriological findings with longstanding environmental theories of disease. Within the book, Fisch proposed that malaria was caused by parasitic protozoa, as identified by Charles Louis Alphonse Laveran in 1880, and simultaneously emphasized the role of environmental factors like soil, humidity, and human activity in its proliferation.
Tropische Krankheiten also provided practical advice rooted within the discipline of tropical hygiene. Fisch urged European settlers and travelers to adhere to strict health precautions to mitigate the risks of tropical diseases and of the adversarial tropical climate. Tropische Krankheiten functioned not only as a medical guide but also as evidence of how emerging bacteriological theories were intertwined with established ideas about the role of climate and environment in disease prevention.

#### Archive for Ship and Tropical Hygiene: “Archiv für Schiffs- und Tropenhygiene”

Rudolf Fisch contributed significantly to a leading German medical journal Archiv für Schiffs- und Tropenhygiene (Archive for Ship and Tropical Hygiene) in the late 19th and early 20th centuries. The journal influenced much of tropical medicine and colonial health strategies. One article published by Albert Plehn, a German physician who worked in Cameroon, in the archive in 1900 highlighted Fisch’s research findings on quinine prophylaxis to promote its widespread use among European settlers in tropical colonies. Plehn drew extensively on Fisch's findings on quinine prophylaxis to promote its widespread use among Europeans in tropical colonies, particularly in Cameroon. The effectiveness of regular small doses of quinine reducing mortality rates from malaria and black water fever was particularly highlighted in his work. This methodology eventually became a cornerstone of tropical medicine.

##### Quinine and Black Water Fever

Fisch also engaged in prominent medical debates within the Archiv, notably challenging Robert Koch’s theory that black water fever resulted from "quinine poisoning." In a response article, Fisch argued that most cases of black water fever occurred in individuals who rarely used quinine, thus defending the drug's use as an essential preventive measure. His contributions to the Archiv not only shaped the discourse on quinine but also informed broader health policies in German colonies, particularly by advocating systematic quinine prophylaxis. This approach, adopted by figures like Plehn, demonstrated Fisch’s enduring impact on colonial medical practices and the advancement of tropical hygiene.

## Late life and death

At the beginning of 1914 Fisch was offered a permanent preacher position in service of the Protestant Society of the Canton of Zurich in Wädenswil. Prior to this Fisch had recommended the mission leadership send him as a missionary and doctor to the Moba in the northernmost region of Togo. This recommendation was rejected and he later accepted the position of a Preacher in Wadenswil where he worked until 1920. Later he moved to Horgen where he worked for the remainder of his career until his retirement in 1931 at the age of 75. Fisch died in Wädenswil on December 2, 1946, two weeks after his 90th birthday.