NSIKU – NZOLA – BISALU as an Afro-Clinical Ethics Framework: Repairing Medical Neglect in Africa and the Diaspora under Neo-Colonial Psycho-Pathologie

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This foundational report establishes the Afro-Clinical Ethics Triad — Nsiku (duty clarity), Nzola (relational empathy), and Bisalu (inventive remediation) — as enforceable clinical governance categories for health systems in Africa and the diaspora. Medical neglect toward African populations is reframed not as underdevelopment, but as a predictable phenotype of neo-colonial psychological architectures. Building on prior diagnosis of Dark Tetrad selection pressures in post-colonial governance (Nsiangani 2014, 2016, 2022), the document demonstrates how narcissism, Machiavellianism, psychopathy and sadism manifest as bedside neglect, procedural fetishism, humiliation of poor patients, and technical indifference. The paper introduces Nsiku, Nzola and Bisalu as normative axes for national clinical licensing, bedside auditing, psychometric screening, disciplinary authority, and diaspora hospital accountability. Annexes define measurable indicators for these ethics constructs and provide calibration instructions for ministries and quality agencies. Additionally, a probabilistic harm model is presented — a logistic predictive transformation linking Dark Tetrad scores, institutional impunity signals, and Nsiku/Nzola/Bisalu operational audits to expected risk of preventable harm. Thresholds (Green / Amber / Red) are defined to support decision triggers for intervention. This is a regulatory architecture — not only ethical theory. Clinical sovereignty is defined as an operational capacity of African nations to select, screen, discipline and promote clinicians who protect life as a sovereign function. This report positions ethics as infrastructure, not decoration. It establishes a governance pathway to collapse Dark Tetrad selection pressure and restore care as civilizational identity. The Nsiku–Nzola–Bisalu triad is therefore proposed as the normative backbone of sovereign Afro-Clinical Ethics for the next phase of African medical systems.