Over 135 years after work began on a dispensary for the people of Zanzibar, the iconic Stone Town building has reopened as the Aga Khan Polyclinic.
The building’s foundation stone was laid in 1887, when Indian merchant Tharia Topan commissioned it to commemorate the 50th anniversary of Queen Victoria’s reign. Prominently situated on the waterfront, it incorporated African, Arabic, Indian and European features. It opened in 1900 as “The Khoja Haji Nasser Nurmohamed Charitable Dispensary”, where a single doctor and his assistants provided Western-style health services.
Zanzibar was then a British Protectorate, with clove production as its main economic output. With slavery abolished in 1897, and a consequent shortage of field workers, the rulers turned their attention to the health of the labour force. They established a locally financed Department of Sanitation and a Department of Hospitals and Medicine, and opened a public hospital in 1896.
However, Western medicine was not widely accepted in the country, with residents preferring a blend of Islamic, Hindu-Ayurvedic and African treatments, and women unwilling to be attended by male doctors. Breakthroughs like germ theory and vaccination did not find favour in Zanzibar. Meanwhile Christian health facilities were often linked with attempts at religious conversion. These institutions therefore mainly served Europeans and the Arab and Indian elite rather than Swahilis.
It took until the 1930s for Zanzibari women to begin training in Western medicine in Egypt, India, Britain and Uganda, and for fees to be eliminated for the poorest, but women remained reluctant to attend healthcare facilities.
By the end of the British colonial period in 1963, health facilities offering fee-based Western medical services included the General Hospital, 17 clinics, 10 government and private dispensaries and several health posts. In 1964, the Revolutionary Government replaced these with a public health system open to everyone, and the Old Dispensary stood vacant.
The Aga Khan Trust for Culture leased and restored the building in the 1990s, converting it into an Outreach Health Centre in 2022-23. The Centre, operated by Aga Khan Health Services (AKHS) with finance from the Agence Française de Développement, aims to enhance and maintain the health of all Zanzibaris.