Across the Wide Zambezi: A Doctor's Life in Africa

by Warren Durrant

  The Aunt does a dance of triumph over the body. Tension builds up in the audience. Little Kwasi explains, breathlessly: 'She tinks it's dee Offen, but it's not. It's dee Dotta.'

  The Aunt pulls back the blanket, and makes Rigoletto's discovery. She shouts, 'Adjei! Adjei!' and beats her cassava bosoms.

  This brings the house down. Women literally roll in the aisles, to the peril of the babies on their backs. Some of these fall out of their cloths and roll in the aisles themselves, crying their protests at this rude awakening.

  Next enter the undertakers, sporting bowler hats and drinking beer out of bottles. 'Dey are drunk,' explains Kwasi.

  There is a good deal of fun with the body, which is tossed and dropped between them and into the audience, which rises enthusiastically to toss it back; the body remaining rigid the whole time.

  The Wicked Aunt is ordered into a corner by the Uncle, and the Orphan reappears, now herself dressed like a Takoradi tart, on the arm of the Doctor. Virtue rewarded!

  All this has been spun out, with a great deal of extemporisation and song and dance, to about two hours. The play concludes with a moral delivered by the Boy.

  'If you do good, you do it to yourself. If you do bad, you do it to yourself.'

  The audience crowds out, and we seek our car. Soft voices plead for a lift back to town. This time I am not so cautious and say, 'Jump in!' Immediately, the car is full of writhing bodies, mostly female, with legs and arms protruding from the windows.

  Some men unceremoniously remove a sufficient number of bodies, and we drive away.

  PART TWO - CENTRAL AFRICA

  1 - Zambia

  I stayed in Ghana for eighteen months and returned to England before Christmas, 1969 - the dead of winter. And of course, I felt as if I had come up from the boiler room. I found a comfortable residential hotel near my native Liverpool, and seeing no reason to follow the example of Captain Oates, I remained within its doors until the slightly kinder weather of March arrived, except for rapid dashes to the motorcars of friends who were kind enough to collect me.

  At that time I still had ideas of going to Australia, and even took a book out of the local library on the country: until after a few months I discovered I had read exactly twenty-four pages, though faithfully renewing it several times. In the same period I had read John Gunther's thousand page Inside Africa for the second time, and several other books on Africa besides. I began to realise this could only mean one thing.

  But a return to Ghana would not do. Samreboi was a lonely place for a bachelor. I was only human (to say nothing of being a male human) and I looked for wider horizons and feminine opportunity. I also looked for a more satisfactory training than a doctor can give himself working alone - which is a most unsatisfactory training.

  So I applied for a post in the large company hospitals of the Copper Belt of Zambia, namely, the Anglo-American Company hospitals at Kitwe, of which there were two: a 300-bed hospital for the workers, and a smaller one for the management. These were covered by a full team of specialists: full, that is, for that type of complex in Africa, which means one consultant in each of the major specialties.

  Zambia has been described as 'a vast, hot, ugly country which wears its human inhabitants, white and black, as an elephant wears its fleas' (Peter Wildeblood: Against the law). Now it is a principle of mine that nothing in nature can be ugly, and since most of Zambia belongs to nature, I cannot join in that epithet; though I concede its monotonous landscape would not be one's first choice in decorating a chocolate box.

  But philosophy apart, I have to admit the writer had a point, which is why I used the quotation to open this section.

  Here was forest again, and as monotonous as the forest of West Africa, but without its enchanting loveliness: or so it seemed to me at first. Nor were the trees tall. The highest trees in Zambia stop at thirty feet: thirty feet of scrubby bush, like the woolly heads of its black natives, except for the exotic gum trees, which were introduced from Australia via South Africa. These were tall - fifty feet or more - with their tall trunks and long branches, sometimes in their blue skins, sometimes in white nakedness, sometimes with skins half shed, like moulting snakes. These trees were brought by the white man and marked his places: the city spaces, the parks, or giving shade to a white farmstead.

  Otherwise the Bushveld, as it is called, was so monotonous it was said when people skidded in their cars on its endless roads in the wet season, did a turn or two and then resumed their journey, they sometimes travelled a hundred miles or more before a previous petrol station informed them they were retracing their steps: unless they ran out of petrol first.

  Zambia must be the last part of the old Empire to be significantly occupied and developed by the white man. I have met men younger than myself who came up in the Forties in ox waggons, whose first homes were rondavels (thatched roundhouses). These were Afrikaners, of course; and this must represent the last trek of that indefatigable people, who penetrated as far as Angola and Kenya.

  Kitwe itself seems to have been mostly built since the Second World War. It is the largest of the group of mining towns on what is known as the Copper Belt, which runs indeed like a belt across the waist of the large body of Zambia. It runs up into the southern Congo (Zaire), into the famous province then known as Katanga, where there is another group of copper mines, which belonged to the old Union Minière of Belgium. Two companies divided the Zambian mines between them: Anglo-American (which was neither Anglo nor American, but South African), and Roan Antelope.

  Kitwe was a pretty town, which certainly looked like no mining town in Britain. It was a typical Central African town (in fact, a city), consisting of a central grid of wide streets. The streets of all these towns seemed to follow the example of Bulawayo, where the streets were made wide enough to turn a span of oxen, which consists of eight pair of beasts. The buildings were all modern, no more than three storeys high, giving the city an intimate feel. There were at least two good hotels, large shops, banks, and other commercial buildings, cinemas, clubs, restaurants, and handsome public buildings. The traffic was light, and the pavements wide: a pleasant place to walk about; though more walking was done by Africans than Europeans. The main grid was based on a wide central square, known as Kaunda Square, after the first president, who was still in the early days of his long reign. There were many trees: blue gums, already mentioned; the flamboyants, which were a blaze of fire in season; frangipanis, with their fleshy, ivory-coloured blossoms; and the delicate jacarandas, which flowered in clouds of mauve. The flowery season for all was September and October, before the rains began in November. For we are now south of the equator: the rain in the tropics follows the sun, and the rainy season in the south fills the other half of the year from the north. Winter is July, and December is high summer. In fact, winter in Zambia was little more than a few cold nights in June and July: the rest of the year was summer. The hottest month is actually October, panting for the rains, which was called the 'suicide month'.

  The best suburbs were built nearest to the city centre, in the usual Central African fashion. Large houses, almost always single storey, lay in large gardens. These houses were not called 'bungalows', a term unused in Central Africa. A double-storeyed house was exceptional and referred to as such: so in future, in this narrative, a 'house' means a single-storey house, unless otherwise designated.

  British people will see a reversal of conditions in their own country, where the best suburbs are the farthest out and the city centre consequently dies at night (or did in the sixties). In Victorian times it seems to have been otherwise, to judge by the decayed magnificence of the old central suburbs of Liverpool and Manchester: and Central Africa was simply following an older tradition. The city centre consequently lived at night in its clubs, cafes, hotels, etc.

  The better suburbs were very spacious: Kitwe must have been at least five miles across, though the total population was 100,000. You needed a motorcar, unless you lived within a mile of the city centr
e (as I did). The great arc of Second Avenue was the main artery of the suburbs, and that was about two miles long.

  These good suburbs, which were originally built for the Europeans, lay all to the north-west of the city centre. To the south-east lay the mine and all its works, and beyond them the vast workers' townships, where the prevailing winds and uncontrolled effluvia of the mine blew over them, in the correct direction: a universal principle in Central African industrial towns.

  These weather conditions were reversed for a month or two when the south-easter blew in the winter, but you can't have everything in life, and at least it brought coolness.

  By the sixties many Africans were rising in the world and entering the posher suburbs. But some were less posh than others. These were the older suburbs, which were actually more central than the others. Junior white managers lived among the Africans here, and in my new (and reduced) status of general duties medical officer (GDMO), I was one of them.

  I lived on Eleventh Avenue, within walking distance of the city centre, across the railway line (the famous 'line of rail' which linked the country with the south and ended, not at Cairo, as Rhodes originally hoped, but at the heads of the great river system of the Congo). On my right lived a white Rhodesian family, and on my left a black Zambian one, and I could not say who made the most noise, as our kith and kin in those parts are not the shrinking violets of the old country, any more than the blacker Africans. Mercifully, there is plenty of space between such houses in Africa, so I was not much disturbed. On the black side of the fence, the quaint obligations of old Africa were observed, and a large extended family accommodated by the official occupant; the cooking fires of whose relatives dotted the large garden at supper time. As if inspired by this, the white family would throw a braaivleis (barbecue) for their friends about once a month, at which much beef and beer were consumed and noise produced around the smoking fire, while the house became a rowdy sound box with music (or something).

  My white neighbours were the Millers. Jem was a bearded jovial giant, of Celtic appearance: Sylvia was a petite, spirited blonde, with something of the Dutch in her - in fact, she came from the Eastern Cape. They had splendid family rows, which they no more disdained to share with the rest of the avenue than the Africans did on my other side. I may say that the rest of the avenue was British, and silent. Otherwise, the Millers were charming and cultured people, who soon became my warm friends (which is more than can be said for the rest of the avenue, for reasons I had better not go into).

  And they were liberals.

  Yes, reader, such creatures existed in that part of the world. They were not the dangerous revolutionaries which South Africa can produce: Rhodesia was more British, and kinder (or politer, anyway), than that. But they gave me much sound information on the region.

  Jem produced the best aperçu I have heard on his own country. 'Imagine UK ruled by the Jews. They would probably make a better job of it than the Anglo-Saxons; but the Anglo-Saxons wouldn't like it.'

  Sylvia could be very spirited. One afternoon I heard her shrill tones, not in her own house, but in the street outside. A large black man in council overalls was half-way up a ladder, doing something with a chain saw to a tree, which had nothing to do with the Millers, except in the aesthetic way. Sylvia was half way up the rest of the ladder, punching the astonished man in the kidneys with her tiny fists, without appearing to disturb him much, and screaming about 'beauty' and 'conservation' and such-like. The man kept repeating the formula, 'Mistah Cummings, madam', who, I guessed was the city engineer, rather in the spirit of 'acting under orders', which I understand has lost force since Nuremberg. Failure of communication, as they say, was mutual and complete. Sylvia only left off to take another line of attack - via the telephone on Mr Cummings. I seem to remember the tree, or most of it, was spared.

  One night I got a telephone call from Sylvia at 3 am. She had had a burglar. Jem was away, and she was in the house alone with the children. I slipped on a dressing gown. She had rung the police, and as I went round, they arrived. Prompt! Several of them jumped out of the Land Rover and ran about the garden with revolvers. If the cook had emerged for any reason, he wouldn't have stood a chance.

  Sylvia was soon with us in her house coat. And she had some evidence for the police. She had woken up in the night and seen the man in her room. From whatever complicated motives - fear, rage, maternal - she went for him like a leopardess and tore the shirt off his back. I even think there was blood on it.

  Well, they never caught the burglar, of course; but when I returned to my house I discovered my late father's watch was missing from my bedside. The man must have got into my house before Sylvia's and never disturbed me. I think the front door lock was broken.

  Jem told me he was an admirer of Liverpool humour, at least ever since one famous experience. After one of their parties, he and Ted were the only ones left, slumped in armchairs at six o' clock in the morning; apart from Sylvia who had got a few hours in her bed, who then appeared in her nightdress and surveyed the usual wreckage of such feasts with bleary eyes. It was Sunday and they had given their servants the day off. There was going to be a lot of cleaning up to do, and the ladies take these things more seriously than we men do. My fellow citizen tried to cheer her up (or something).

  'Give us a song!'

  As I said, the mine ran hospitals for management and workers. To begin with, I was assigned to the workers' hospital.

  It had a number of specialised departments, each under a consultant specialist, and the GDMOs like myself were rotated between them every six months. I was placed first in the surgical department, under a benign and highly competent surgeon, Mr Hunt, a man then in his fifties.

  Mr Hunt did rather more than a general surgeon would do in England: or rather, he covered a wider field, for he also did orthopaedic surgery. I do not mean he did hip replacements, which had not then been invented; nor would he have attempted anything so ambitious if they had. But he nailed femurs and screwed ankles, etc, which a general surgeon certainly does not do in England; nor does he need to.

  Mr Hunt also covered traumatic surgery - accident and emergency - which is also a specialty in Europe.

  And, of course, he was a general surgeon who did such things as hernias and bowel resections. In other words, as even specialists are in Africa, he was an all-rounder, but worked within the limits of his own competence and the resources available to him.

  And so it was throughout the other departments: obstetrics and gynae, internal medicine - all of which stretched to include sub-specialties such as ear, nose and throat, eyes and so on, at a basic level.

  There were a specialist anaesthetist and pathologist. We did not run to psychiatry; and children came under the specialist physician and surgeon.

  This is the usual thing in Africa - breadth and simplicity, rather than specialisation - at hospitals up to this size.

  There was little formal training for the GDMOs (or general doctors), and the hospital was not very busy. The general public went to the large government hospital, which was a very different affair.

  There was nothing wrong with this. The mine hospital was designed to serve the mine people, and this it did well, with ample resources, both professional and material. And it was a place where a general doctor could learn much if he was prepared to push the specialists. In a formal training establishment the teachers push the pupils - and chase them. But formal training was not within the remit of the mine hospital, nor did it need to be.

  At night the GDMOs were on call for all departments together, and could summon the appropriate specialist, and so maintained their broader experience. All in all, although it was not geared for training, a person who wanted to learn could learn much through observation and some extended practice.

  My contract here was for two years, and they were not years wasted.

  At week-ends we helped out with the flying doctor service: the government doctors were too busy for that. I think it was some kind of pri
vate charity, and was run for the benefit of outlying mission hospitals, where there was no doctor. We made weekly trips in a Cessna with a volunteer pilot. Emergencies at these places were sent to the government hospital by ambulance, and sometimes by air. Of course, our services were also voluntary, and it was great fun and instructive too.

  Flying in a Cessna is like flying in a Mini car - a pretty nervous experience for the first time, which one quickly got used to. And the broad expanse of Africa was an exhilarating sight from the air. We looked down onto the large houses, with the blue squares of their swimming pools: we crossed the bleaker areas of the townships, and were soon over the open country - like a map painted grey-green and yellow (for my first trip was in winter and the dry season), with a few straight-ruled lines of roads running across it.

  That first trip, we came after an hour to a hill, rising like some beast from the ocean of the Bushveld, the hard earth shining through its crop of shrubby trees like the scalp of a Bushman. Then, over the hill, was the landing strip, which looked like a six-inch ruler placed on the ground. How on earth were we going to land on that?

  The plane smashed down with a hard bang, and then hammered across the earth as if it had lost its wheels. A reception committee of brothers or nuns would be waiting, together with the usual crowd of children.

  The different missions - Anglican, Catholic, etc, - rather merge together in my memory. At one Italian mission we would be met by Sister Ilaria, in a large American car: a delightful lady who would never make her living as a taxi driver in her own country, or anywhere else where there was other traffic, or anything except fresh air. Even Africa was not big enough for her. She had several square miles of it to move around in, not another vehicle in sight (except the plane, which give her her due, she never hit in my experience), but as soon as we were in ('we' being myself and the pilot), she backed into a tree - bang! - then lurched forward, in and out of a ditch, and finally, after using the dirt road as a rough guide to the mission, deposited us there, probably having been instructed to apply the brakes within twenty yards of a building; talking and waving her hands and her white habit about all the time, in the happiest spirit in the world: a spirit not always caught by her passengers.