The Mission Station was on the top of a steep rise, overlooking the river.

All that the Mission Society had offered the Schweitzers was a house and a piece of land on which to build their hospital. But when they arrived they found that all the available African workers were working for the timber trade, which was flourishing at the time.

There were already hundreds of patients awaiting them, most with multiple diseases. So at first they worked in the open, constantly interrupted by thunderstorms. Then they were offered a former chicken house. It had to be scrubbed and disinfected, but it was better than nothing.

Schweitzer managed to collect a few workers, to build shelters for the patients, doing most of the work himself, while, as he wrote “the black foreman lay in the shade of a tree and occasionally threw us an encouraging word.” One well-dressed African watched sympathetically while Schweitzer dragged great balks of timber up the hill, and Schweitzer asked him to lend a hand. “I can’t do that”, said the African; “I’m an intellectual”. “I always wanted to be one of those,” said Schweitzer, toiling on, “but I never made it.”

So time was divided between building and medical work. After dark Schweitzer played on the special piano with organ pedals, protected against termites, which he had been given by the Paris Bach Society.

Gradually the “hospital” grew. Practically every disease under the sun was treated – not only the specifically tropical diseases but European ones as well, from pleurisy and whooping-cough to nicotine poisoning and venereal diseases.

Schweitzer listed the commonest as "skin diseases of various sorts, malaria, sleeping sickness, leprosy, elephantiasis, heart complaints, suppurating injuries to the bones (osteomyelitis) and tropical dysentery.” Hernias were also very frequent, often becoming strangulated and causing intense pain followed by death.

After eight months, however, he was able to record a success rate for his operations of 100%.

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