Medical school teaches us that patients should be part of the decision-making process regarding their health. They should give an informed consent and be aware of the risks and benefits of the treatments they are contemplating. This idea seems to disappear when we go practice medicine in the so-called developing world. Trying to uphold them can open a new perspective on the perception of Western Medicine in the non-Westernized world. The idea for this presentation was born during elective in Niger. This elective took place during the “measles season” and also saw a resurgence of polio. Efforts were made to put in place an immunization campaign. Many drawbacks were soon discovered: the cost of the syringes and the needles, difficulties to reach the rural villages, but the most important issues was a socio-cultural one: media and word-of-mouth in neighboring Nigeria had the vaccination syringes filled with bad things. Some religious authorities accused the WHO to pretend to help the children but to really inject long-term contraceptives or sterilizing components for population control. Other rumors heard in villages where that AIDS originated from vaccination. But the most intriguing case of cultural appropriation of scientific facts is the frequently heard story was that the “white doctors” actually put the “spirit” of measles in the injection to fight the disease. This presentation will review and analyze some information campaigns targeted to West Africa as well as draw from interviews done during vaccinations campaigns to outline the (west) African perceptions of “modern” medical care. We will also discuss the fact that “informed consent” is almost never sough by physicians –foreign or not- and explore the impact it has on the care provided and the so called “paternalistic attitude” of health care providers. We will sketch a comparison between the North American patient-doctor relationship and the same relationship as seen in West African “modern” medicine. Finally, we will attempt to sketch how those issues have an impact on the quality of medical care provided in West Africa.