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Today Lambaréné is inhabited mainly by Bantu ethnic groups such as the Fang, Bapounou, Eshira, and Myéné; these displaced the Pygmies to the east and north of Gabon. The main economic activity in the town is the fishery and a new port is under construction.

Even in his study of medicine, and through his clinical course, Schweitzer pursued the ideal of the philosopher-scientist. By extreme application and hard work, he completed his studies successfully at the end of 1911. His medical degree dissertation was another work on the historical Jesus, The Psychiatric Study of Jesus. He defended Jesus' mental health in it. In June 1912, he married Helene Bresslau, municipal inspector for orphans and daughter of the Jewish pan-Germanist historian Harry Bresslau.

In 1912, now armed with a medical degree, Schweitzer made a definite proposal to go as a physician to work at his own expense in the Paris Missionary Society's mission at Lambaréné on the Ogooué river, in what is now Gabon, in Africa (then a French colony). He refused to attend a committee to inquire into his doctrine, but met each committee member personally and was at last accepted. Through concerts and other fund-raising, he was ready to equip a small hospital.In early 1913, he and his wife set off to establish a hospital (Albert Schweitzer Hospital) near an existing mission post. The site was nearly 200 miles (14 days by raft) upstream from the mouth of the Ogooué at Port Gentil (Cape Lopez) (and so accessible to external communications), but downstream of most tributaries, so that internal communications within Gabon converged towards Lambaréné.

In the first nine months, he and his wife had about 2,000 patients to examine, some travelling many days and hundreds of kilometres to reach him. In addition to injuries, he was often treating severe sandflea and crawcraw sores, framboesia (yaws), tropical eating sores, heart disease, tropical dysentery, tropical malaria, sleeping sickness, leprosy, fevers, strangulated hernias, necrosis, abdominal tumours and chronic constipation and nicotine poisoning, while also attempting to deal with deliberate poisonings, fetishism and fear of cannibalism among the Mbahouin.

Schweitzer's wife, Helene Schweitzer, was an anaesthetist for surgical operations. After briefly occupying a shed formerly used as a chicken hut, in late 1913 they built their first hospital of corrugated iron, with two 13-foot rooms (consulting room and operating theatre) and with a dispensary and sterilising room in spaces below the broad eaves. The waiting room and dormitory (42 by 20 feet) were built, like native huts, of unhewn logs along a 30-yard path leading from the hospital to the landing-place. The Schweitzers had their own bungalow and employed as their assistant Joseph, a French-speaking Galoa (Mpongwe) who first came as a patient.

After World War I broke out in July 1914, Schweitzer and his wife, German citizens in a French colony when the countries were at war, were put under supervision by the French military at Lambaréné, where Schweitzer continued his work. In 1917, exhausted by over four years' work and by tropical anaemia, they were taken to Bordeaux and interned first in Garaison and then from March 1918 in Saint-Rémy-de-Provence. In July 1918, after being transferred to his home in Alsace, he was a free man again. At this time Schweitzer, born a German citizen, had his parents' former (pre-1871) French citizenship reinstated and became a French citizen. Then, working as medical assistant and assistant-pastor in Strasbourg, he advanced his project on the philosophy of civilization, which had occupied his mind since 1900. By 1920, his health recovering, he was giving organ recitals and doing other fund-raising work to repay borrowings and raise funds for returning to Gabon. In 1922, he delivered the Dale Memorial Lectures in the University of Oxford, and from these in the following year appeared Volumes I and II of his great work, The Decay and Restoration of Civilization and Civilization and Ethics. The two remaining volumes, on The World-View of Reverence for Life and a fourth on the Civilized State, were never completed.

In 1924, Schweitzer returned without his wife, with an Oxford undergraduate Noel Gillespie as his assistant. Everything was heavily decayed, and building and doctoring progressed together for months. He now had salvarsan for treating syphilitic ulcers and framboesia. Additional medical staff, nurse (Miss) Kottmann and Dr. Victor Nessmann, joined him in 1924, and Dr. Mark Lauterberg in 1925; the growing hospital was manned by native orderlies. Later Dr. Trensz replaced Nessmann, and Martha Lauterberg and Hans Muggenstorm joined them. Joseph also returned. In 1925–6, new hospital buildings were constructed, and also a ward for white patients, so that the site became like a village. The onset of famine and a dysentery epidemic created fresh problems. Much of the building work was carried out with the help of local people and patients. Drug advances for sleeping sickness included Germanin and tryparsamide. Trensz conducted experiments showing that the non-amoebic strain of dysentery was caused by a paracholera vibrion (facultative anaerobic bacteria). With the new hospital built and the medical team established, Schweitzer returned to Europe in 1927, this time leaving a functioning hospital at work.

He was there again from 1929 to 1932. Gradually his opinions and concepts became acknowledged, not only in Europe, but worldwide. There was a further period of work in 1935. In January 1937, he returned again to Lambaréné and continued working there throughout World War II.

Dr Schweizer was a man of his time. "Woke" followers today might even make out a case for him being "racist":

The journalist James Cameron visited Lambaréné in 1953 (when Schweitzer was 78) and found significant flaws in the practices and attitudes of Schweitzer and his staff. The hospital suffered from squalor and was without modern amenities, and Schweitzer had little contact with the local people. Cameron did not make public what he had seen at the time: according to a BBC dramatisation, he made the unusual journalistic decision to withhold the story, and resisted the expressed wish of his employers to publish an exposé.

The poor conditions of the hospital in Lambaréné were also famously criticized by Nigerian professor and novelist Chinua Achebe in his essay on Joseph Conrad's novel Heart of Darkness: "In a comment which has often been quoted Schweitzer says: 'The African is indeed my brother but my junior brother.' And so he proceeded to build a hospital appropriate to the needs of junior brothers with standards of hygiene reminiscent of medical practice in the days before the germ theory of disease came into being." (WIKI)