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

by Warren Durrant

  At Umvuma I first met Gareth, who has remained my good friend to this day. He was a Welshman, who farmed a thousand acres (a small-holding in Rhodesia), twenty miles out of town. He supplied vegetables to the hospital and would arrive once a week in his pick-up: a short, sturdy, dark man with a florid face and heavy moustache, rather like an Italian peasant. In his youth he had been compared to Anton Walbrook, and in later life to Joseph Stalin. I thought he looked like Cecil Rhodes. He finally expanded to Sir John Falstaff.

  He had gone to earth in more ways than one in Rhodesia, having left his second wife spitting venom at him in a Canadian divorce court. His opinions on the unfair sex were a legend. Over the years he had polished a number of sardonic aphorisms on the subject, which I called the Maxims of the Duc de Baker, and even tried my hand at rendering some of them into French, in which language they seemed to find a natural home. 'If God ever made anything dirty, it was a woman,' was one; and another, more subtle: 'The only thing a woman cannot forgive a man is the thought that he can live without her.' 'Si le bon Dieu a jamais fait une chose sale, c'était une femme,' and: 'La seule chose qu'une femme ne peut pardonner un homme c'est la pensée qu'il peut vivre sans elle,' were the best I could do for the French edition. But he refused to be described as a woman-hater, and indeed, retained his eye for a pretty face. He simply said, he wanted nothing more to do with them.

  Gareth had been in Bomber Command during the war, and had survived sixty missions over Germany (nearly half with the Pathfinders): the average survived being fifteen out of thirty. After his first tour of thirty, Gareth was awarded the DFM and commissioned by a grateful sovereign. He volunteered for a second tour, in what he described as the madness of youth, and was duly awarded the DFC, having shown both classes of courage. After that little lot, he put his name down for the Dam Busters, but was wisely turned down by the medical officer, who evidently thought that Gareth had done enough, and duly reported to his CO.

  He seems to have been an enlightened doctor for his time. Lord Moran's theory about the quantitative nature of courage - it is like capital: it can be depleted and must be replenished - was unknown then. It would probably have mystified Gareth's CO as much as it did Winston Churchill when he refused to write a preface to Moran's book. Gareth's CO obviously did not know how to break the dreadful news to Gareth: the terrible letters, L-M-F (lack of moral fibre), no doubt hovering in his mind. His attitude therefore puzzled Gareth. He accused him of 'trying to hog all the glory to himself' and 'not letting the other fellows have a go', and more in the same strain, as if they were talking about children's motorboats. It was not till years after, with a little help from me, that Gareth was able to understand what was going on.

  Gareth came fishing with us but never caught anything. We used to say his pessimism communicated itself down the line to the fish and put them off. He played golf at the club and was a regular Friday-nighter at the Falcon, but not a member of the Diners' Club, having, no doubt, a more accurate idea of his age than I did of mine.

  Gareth had a most mellifluous voice - officerly, with a touch of Welsh - but assured me he could not sing.

  Besides his accomplished fourteen-year-old daughter, Ted, the stationmaster, had a younger son, David; and one day Ted and I and Gareth took David and one of his little school friends for a week-end's fishing at the Zimbabwe Ruins Hotel.

  The boys came half-price, which, I suppose, was meant to accommodate family custom. What it did for the hotel's profits is another question, as the boys ate twice as much as we did.

  In the late afternoon, after our arrival, we strolled beside the Kyle dam, our fishing venue of the morrow. The two boys accosted Gareth. 'Can you take us fishing at four o' clock tomorrow morning, Uncle Gareth?' We did not know that they had already failed with Ted.

  In the warm glow of the end of a tranquil day, with the comfortable prospect of his sundowner and supper before him, Gareth said, 'Yes, my boys,' and probably meant it at the time.

  At four o' clock in the small hours, a telephone rang in the room next to the one I shared with Gareth, boring through the thin wall like a dentist's drill, waking both of us. It stopped. A woman's angry voice bawled: 'Get lost!'

  A few seconds later, the telephone rang in our room. Gareth wearily picked it up and a piping little voice asked: 'Are you ready to go fishing, Uncle Gareth?'

  I had not been long at Umvuma before I received a visit from David Taylor, the physician at Gwelo. He told me it was his custom to visit the district hospitals once a month, something which became a regular policy later, but was then a matter of individual enthusiasm. And very welcome such visits are, and very helpful and instructive: just as important as the DMO's visits to the rural stations. And one day, he arrived in the nick of time.

  I had a middle-aged female patient who had been puzzling me. For a week she had had general pains and a low-grade fever (blood smear was negative for malaria), and now she was developing weakness in the legs. Already she was confined to bed. Just as we entered the ward on David's monthly visit, she stopped breathing.

  Quick as a flash, David diagnosed Guillain-Barré syndrome: ascending paralysis of unknown origin, probably infectious - the first time I had heard of it. I have seen several cases since, and have been able to take pre-emptive action in time, thanks to David's most opportune visit: otherwise, I would have had a very mysterious death on my hands and would probably have called it polio.

  We had no mechanical respirator in the hospital. We wheeled the patient quickly to theatre, me pumping her midriff on the way, got her onto the table and a tube down her windpipe, connecting it to the Boyle's anaesthetic machine, which, of course, can deliver oxygen. Then we loaded patient and machine onto the ambulance and drove the fifty miles to Gwelo with me sitting in the back, pumping the bag. At the hospital, they got her connected to a Manley machine, and I left.

  Next day, I heard on the telephone that she had already recovered respiration and was off the machine. The paralysis disappears in reverse order to its onset, from the head downwards. She left hospital fully recovered, a month later.

  I was on the bowling green one Saturday afternoon when a car stopped in the road beyond the hedge. Two young white men got out and then helped a friend, whom they brought up to the hedge in a four-handed lift. There were calls for the doctor, so I went over to have a look.

  I recognised Jan van der Merwe, a young local farmer, who had fallen off his horse, playing polocrosse, and had an injured ankle. They had removed his riding boot and the ankle was very swollen.

  I scribbled some instructions to the nurses at the hospital on a cigarette packet - morphine, X-ray - and asked his friends to take Jannie down there, telling them I would follow shortly. Then, like Sir Francis, I went on with the game.

  When I got to the hospital, I found Jannie, more comfortable after his morphine, sitting on the X-ray table. I studied the plates, looking hard at the malleoli - the knobs of the ankle, where most fractures occur - and could see no fracture. (The degree of swelling and pain in an obviously stoical patient should have made me more suspicious.) I diagnosed a sprained ankle. I thought Jannie might be more comfortable in a plaster, so ordered one.

  On Sunday evening I was in the bar of the Falcon when Jannie's wife came in. Jannie was in great pain and wanted the plaster off. I scribbled another note to the people at the hospital, asking them to remove it and replace it with a crepe bandage.

  Next morning Jannie telephoned the hospital, still complaining of pain. June received the call, and believing (with the rest of the town by now) that he had only a sprained ankle, was less sympathetic than she might have been otherwise. She asked Jannie to send his wife up to the hospital for more Panadols.

  Not surprisingly, Jannie's wife did not appear, and next Saturday evening, I was surprised to see Jannie in the club on crutches with his leg in a fresh plaster. He was telling his friends (who by then did not include me) all about it. He had been, he said, to see a 'decent doctor'. To my concerned inquiries,
he informed me that after June's (innocent) rebuff, he had got his wife to take him to my colleague, the DMO at Enkeldoorn, thirty miles away. I gathered that the doctor there had taken more X-rays and (to my selfish relief) had seen no fracture either, but having the advantage of the previous history, had sent him to a specialist in Salisbury. The specialist, according to Jannie, had said he had a fracture which might need a screw.

  At the earliest opportunity on Monday morning, I got out Jannie's X-rays again and, with the help of Crawford Adams, re-examined them very carefully. Finally, I discerned that two of the bones in that Rubik's cube of the upper foot, whose names nobody remembers after medical school, were really one, divided by a line which looked less smooth than the articulating faces of the other bones. I was seeing the first (and last) fracture of the talus (the bone which forms the tenon to the mortise of the ankle) I was to see in forty years of practice. And instead of happening to some uncomplaining black African, it had to happen to the unforgiving white African, Jannie van der Merwe.

  A few days later, David Taylor came out on his monthly visit. Over a cup of tea I told him the story (I had to unburden to some colleague), and, before I got to the solution, tested him with the X-rays (which was probably an unfair thing to do to a member of the Royal College of Physicians - whose specialty is not bones). To the satisfaction of my ego, he also failed to recognise the fracture.

  By now, Jannie was going about the district blackening my name to all who would listen. Not everyone approved of this attitude, including his own wife; but being conscience-stricken and feeling sorry for him, I sat down one night and wrote him a letter. (This was not as mad a proceeding as it might have been in a more litigious country than Rhodesia.) I explained that I had taken another look at the X-rays and could now see the fracture, which was a very uncommon fracture, and apologised for any lack of sympathy I may have shown when under the impression that he had simply sustained a badly sprained ankle.

  I received no reply to this, or any verbal acknowledgement. In the event, Jannie did not need an operation and made as good a recovery as he would have made in any case. But he never had a civil word for me after that.

  At a place like Umvuma in those days, there was only one government doctor, who was on call all the time, day and night, week in, week out, for years on end. He could only escape by leaving the station - a long way behind. Then emergencies would be sent to the next suitable place - usually the next district, where one's colleague would also stand in for weeks or months while his neighbour went on leave, and vice versa. In the case of Umvuma the matter was simpler, and emergencies were sent to the provincial hospital at Gwelo, a mere fifty miles away.

  Otherwise they called me by telephone or they sent the ambulance out for me, if I went fishing say. Sometimes I would play bowls at Enkeldoorn. I would tell them to telephone me there, knowing that they would never drag the doc off the bowling green on a Saturday afternoon for anything less than a caesar or a major road traffic accident (RTA).

  I was fishing at a river pool once, a little distance from my friends, and started pulling bream out like rabbits from a conjuror's hat. After I had about half a dozen, I was about to call my friends to share the lucky strike, when a black face appeared through the reeds and the ambulance driver said they wanted me at the hospital. I packed up, fish and all, and followed him in my own car. I found a woman with a ruptured uterus - labouring out in the bush too long, perhaps, with an old caesarean scar (I forget) - and performed my second subtotal hysterectomy. 'Another life saved,' as Howell in Birkenhead used to say, to the fury of the theatre sister (both of them Welsh), every time he did a circumcision.

  One night there was a sing-song at the Falcon. Somebody brought a guitar, and I was one of the strummers. The old Southern African favourites were bawled out over the cups: Sarie Marais, Come a Rookie, Marching to Pretoria - there was nothing effete about Rhodesian singing; in those days, at any rate.

  Billy Campbell and Phil von Lilienfeld (yes, another Umvuma aristocrat) left early - ie, about midnight - in Billy's pick-up. Soon a report was brought that they had been involved in a road accident.

  The two young cops (whose departure usually signalled closing time, giving the rest of us plenty of scope), who had a remarkable gift for sobering up at a moment's notice, took off. The ambulance went out, and I went to the hospital to prepare for casualties.

  They had hit an African bus, almost head-on, knocking off its outer wheel and sending the bus plunging into the ditch, with no one hurt. Billy had been killed on the spot. John Holland, the owner of the Falcon, remarked philosophically: 'He knows it all now.'

  Billy's truck was crumpled up. Phil had a fractured ankle. He had, of course, provided his own anaesthetic. I put a plaster on it and sent him off to Gwelo: I was not up to screwing ankles at that stage.

  In the early hours one morning, a young African man, a teacher, crashed his car into a train at the Fairfield crossing and was killed instantly. His brother came to the hospital to identify the body. I met him outside the little mortuary.

  The brother was a fellow doctor, Dr Mazarodze, who later became a minister of health in the post-independence government, before his own untimely death after only a few months in office.

  I had made sure the face was washed and the body covered with a blanket. I simply said to my colleague: 'I am very sorry.' I led him into the mortuary. The attendant lifted the blanket from the face. Dr Mazarodze sobbed: 'O, my God! Stephen!'

  I put my arm round his shoulders and gripped him firmly until he had recovered himself. Then I led him outside. I asked him if he would like a cup of tea. He said quietly, 'No, thank you,' and left.

  After a week I received a letter from him. 'Thank you for your kind sympathy on the sad occasion of my brother's death.'

  My touch had not gone unnoticed.

  A medical student came to stay with me. He was a friend of one of the policemen and still in second year. This was earlier than usual for an attachment, which comes in the clinical years ahead. But Graham was very keen, and I have always had a bit of the schoolmaster in me, so I was glad to have him and his company.

  While at my house he became addicted to a certain drug. It did not affect his studies, as he shortly after passed his second MB, gaining gold medals in every subject: he was the brightest student in his year, and many other years too.

  The certain drug was Russian literature.

  He was a reader. He was a pale dark lad and, unlike most Rhodesians, not interested in sport. But he had never met Russian literature before, of which I had a fair collection.

  He devoured War and Peace in three weeks, The Brothers Karamazov in a fortnight. Then he started on Chekhov.

  He read the Russians morning, noon and night. He took them to the toilet. He sat at the side of the bowling green and read them when I dragged him off to the club. In the Falcon he sat with Raskolnikoff in the taverns of St Petersburg while the darts flew over his head.

  Trying to vary his literary diet, I offered him Dickens and Hardy. He gave them ten minutes each, before silently replacing them on the shelf and taking down another Russian.

  While at Umvuma, I attended the annual bush doctors' refresher course at Bulawayo, where I met 'Jock' Scott for the first time: a man who was to play a big part in my life later. He was then DMO at Belingwe.

  In spite of his sobriquet, which like Mav's was used by all his friends, including his wife, Jock was a Londoner. He was then about sixty: a tall, swarthy man whose remaining hair sprouted rather wildly from the sides of his head. Altogether, he looked as much like a gipsy fiddler as a doctor.

  The musical appearance was not inapt. Jock had a teacher's certificate from the Royal College of Music, and played both violin and piano. He had considered a musical career but decided, in his own words, 'he would rather be a second-rate doctor than a fourth-rate musician'.

  We had some chat about music. I took an instant liking to him and was glad, as the narrative will show, to find him my neighbo
ur some years later.

  The circumspect DMO at Enkeldoorn was succeeded by an Australian, Dr Sadd, who was rather less so. Unfortunately, the poor man was rarely sober: only, in fact, in the morning, before the pub opened, when his work was impaired by his hang-over. He did not last long, and was dismissed the service after a few months.

  I met him in his local one Sunday afternoon on my way home from Salisbury. Dr Sadd sounded as unhappy as his name in Enkeldoorn. He complained about what he called 'young Rhodesian lay-outs'. Moreover, most of the whites in the town were Boer farmers, who reminded him every other day about who started the 'bloody concentration camps', which was pretty hard on an Aussie. (My younger readers must not imagine his persecutors were referring to the Germans.)

  He invited me to his house for supper. About four o' clock, we went to his place in separate cars. We sat down in the sitting-room with more beers. His wife strode in. Without a glance at me, she started in on her husband in an abrasive Australian voice. 'Where have you been till this time, you drunken bum? As if I didn't know! You told me this morning you were going to the bank. Mrs Oosterhuizen tells me the banks don't open in this country on a Sunday, you lying bastard! If you want your lunch, you can scrabble for it, 'cos it's in the bin.'

  There must have been some conversation of a more general nature in the course of the afternoon, because I was introduced to the lady and their two young sons, before, under another assault from his more sober half, Dr Sadd slid out of his chair and into the arms of Morpheus. The visit ended with me taking the wife and the boys back to the hotel for supper.

  A few days later, I got a call from Mrs Sadd at the hospital. 'Tell me, Warren. Is there such a thing as an alternator in a motorcar?'

  'I've never heard of it,' I answered, truthfully. The internal combustion engine has always been a closed book to me.