Across the Wide Zambezi: A Doctor's Life in Africa (26 page)

The reader may wonder how I had reached
the ripe old age of forty-six without getting caught. All I will say is, I had
met women I wanted to marry, and women who wanted to marry me, but until I met my
wife, a few years later, they were never the same ones. And I would have been a
less melancholy soul if I had known about the bright day that was not too
distant.

As I say, I went fishing - first with
George. He was often to be seen at the bar of the Falcon, or with his wife and
sister at the tables outside. He always wore an old shirt and pair of trousers
held up with braces, a punched-out trilby hat like the Africans and again like
Africans, sandals made of old car tyres. He was then about sixty. Like June, he
had been born and bred in this little town - called a 'dorp' by those who did
not live in it, and by some who did. He had worked on the mine and lived all
his life in Umvuma except for five years away in the army in East Africa during
the war. Now he was retired. He was short and fat. He and his skinny womenfolk
lived in a dilapidated house near the station, which smelt of the sixteen cats
they kept. In South Africa, he would have been called a 'poor white'. Nobody
thought that way in classless Rhodesia or used that term (
not quite
true
).
He would buy the future earl a drink
in the bar, and the earl-to-be would buy him one. And George had wealth of
another kind, which I envied him.

He had an encyclopedic knowledge of the
veld: every tree and flower and their seasons, every bird and animal, every
fish in the rivers. And he could speak fluent Shona, the main African language
of the country. Most of the white people spoke Fanagalo: 'kitchen Kaffir’ - a
sort of corrupted Zulu which is the native lingua franca from Cape to Congo and
very useful. Africans, however, find it degrading and 'colonial' (though they
would use it among themselves when they had to, as in the mines): white Shona
speakers are rare and respected by the Africans because they imply respect.
Shona is a difficult language. George never learnt it from books - which is
practically impossible anyway, say I, after a dozen failed attempts. George
learnt it by running about barefoot in the veld as a child with the black
children: something not so uncommon among the white countryfolk, at least for
the boys. The girls were kept away from the black children in case of 'moral
contamination'. Nevertheless, the farm language tended towards Fanagalo, and as
I said, true Shona speakers were rare. Town whites barely spoke either.

George showed me all the local dams,
where we caught bream and the universal barbel; and the Canadian bass on the
specially stocked farm dams. There was no angling society in Umvuma as there
were in the larger towns, but we were welcome to the farm dams and that at the
Catholic mission at Driefontein. George always gave notice of our arrival,
nevertheless, to farmer or father: a polite but not strictly required formality
I and my later friends usually dispensed with. George was very particular about
Ian McArthur's dam, which according to George, had problems with the 'railway
people'.

'Ian doesn't mind his own workers
fishing in his dam, doc; but he doesn't want those railway people coming here.'

The 'railway people' lived on the siding
where the railway crossed the main road to the south at an almost imaginary
place called Fairfield. One day, George spotted some railway children,
distinguishable only to his knowledgeable eye, fishing with bent pins. He
pounded bawling across the veld towards them on his bare feet, in imminent
danger to his heart, which was not sound. The ragged little brats snatched up
their primitive gear and easily outdistanced him, leaving him panting and
sweating, pulled up at the end of his puff, while they danced up and down and
cried: 'Fat man! Fat man!'

One morning at seven, I got a call from
George's wife. He had a pain in his chest and looked very ill. ‘Would I come
and see him?’

When I got to the house, it was as she
said. George was sitting in a chair, looking grey.  When I took his blood
pressure, I found him in shock. I asked him how long he had had the pain. ‘Since
three in the morning’. Why didn't they call me earlier? ‘Didn't want to disturb
you, doc’.

I gave him a shot of pethidine, and
within seconds he said: 'The pain's gone, doc.'

Those were the last words he spoke to
me. I ordered him to bed. At eleven o' clock his wife rang me at the hospital
to say he had died peacefully in his sleep.

I attended the funeral. I was held up at
work and too late for the service in the tiny church. I waited in the little
cemetery on the edge of the bush, and presently the coffin and procession
arrived. There, among other obscure colonial souls, they buried George, under
the msasa trees, and the blue sky of Africa, he loved so well.

Beyond the town lay the white farms for
twenty miles, and more in some directions; and beyond them the tribal lands
(now called 'communal lands'). We covered a number of hospitals and one clinic
over an area as large as North Wales, which has since been rationalised to form
two districts. There were two mission hospitals, as large as Umvuma; and one of
them (Gutu, sixty miles out) was later made into a de facto district hospital.

Gutu marked one boundary between white
farmland and tribal land. We had a rural hospital there, where an ambulance was
based to cover two further rural hospitals in the tribal lands themselves. Once
a week I would visit Gutu and take in one of the other hospitals, except for
the week I visited a hospital in the opposite direction  - Chilimanzi. Once a
week, on another day, I visited our clinic at Lalapanzi, which will be
remembered as one of the railway 'watering points'.

I travelled to Gutu in my own car along
a metalled road. After the usual clinic and ward round, I would be taken in the
Land Rover, banging and snapping like a biscuit tin over the rough dirt roads
to the outer hospital: Chinyika or Chingombe, each twenty miles further on. Now
we were in the typical tribal lands of Central Africa. We passed villages: not
the large villages of West Africa, but small family affairs, often bearing the
family name: Moyo; or the family totem: Gudo (baboon), Garwe (crocodile), Tsoko
(monkey). There was the family hut, made of mud and wattle and thatched, each
in its tribal manner; and round, so that evil spirits would have no corners to
lurk in (unlike the rectangular huts of West Africa), though richer people had
brick houses which were rectangular with tiled roofs. The women built the walls
and the men the thatched roof after. People from neighbouring villages
cooperated in the building.

Beside the hut were the granaries, also
of mud and wattle and thatched, like tiny huts themselves. There would be the
cattle kraal made of wood stakes and woven with branches, to protect the beasts
at night. There were overhead holders for storing grass feed. Outside the huts
were racks for pots and pans. Everything showed the shapeliness of skilled
hands.

Women hoed the fields and reaped the
meagre crops of maize and native corns. The men did the ploughing and planting.
Young children minded cattle and goats out in the veld all day. Older children
walked to school, sometimes ten miles each way, with no food from breakfast
till supper, sometimes crossing fords where crocodiles lurked.

Evening was a time of much activity.
Women and older girls fetched water from dams and rivers, which they carried in
buckets on their heads, cushioned with coils of cloth. Older children watered
the beasts at the same time, while boys ran about hunting a hare for the pot
with their half-wild, skinny, whippet-like dogs. Women fetched firewood which
they carried in bundles on their heads. Women pounded corn outside the huts in
mortars with pole-like pestles, sometimes two together in rhythm. Cooking fires
were lit before the hut. In winter the fire was carried inside and left to
smoulder all night in the middle of the floor, while the family slept around
it. And people fell into it - drunks, children, epileptics - so that was our
main burns season. The huts were so smoky, it was our asthma and bronchitis
season too. The toilet was the bush.

The cattle were too many. They were
hardly eaten, except on ceremonial occasions, and gave little milk. They were
not exactly the sacred cows of India, but they represented a man's wealth and
status. They were also bride price. Young men went away to the mines or
factories to earn money to buy them for a girl's father. A girl with O levels
came very expensive, to say nothing of a teacher or a nurse, though among the
middle classes, money was accepted in lieu of cattle. The custom was instituted
in the hope that the wife would be cherished.

The cattle wasted the grass, and the
goats finished it off, eating the roots also. The goats were eaten with rather
more regularity than the cattle. Chickens also ran around the huts and were
eaten, but not their eggs, which were thought to cause sterility.

Looking always for sources of protein, I
asked my driver once if the people drank goat's milk.

'What, docketa! Do the people drink the
milk of the goats?'

'Yes.'

'O, no, docketa.
The people cannot drink the milk of the goats.'

'But the Magriki and the Ma-italiani
drink goat's milk.'

'O, docketa! They do not drink the milk
of the goats?'

'Yes. It makes them strong.'

'No, docketa. The people cannot drink
the milk of the goats!'

As in England, every two or three years
we had a measles year, and smaller outbreaks at any time. Measles is a serious
thing in the undernourished children of Africa, causing chest infections and worse
(unless they are fatal), blindness.

At one outer hospital I found three
little brothers with measles and their eyes in a very bad state, with
keratomalacia, or softening of the eye, on the brink of blindness. I ordered
them a teaspoon of vitamin A each, and when I returned in three weeks' time,
found that each child had one blind white eye and one clear healthy eye.
Meantime, I had reiterated instructions to all our medical units to give
vitamin A to all cases of measles.

And we saw cases of kwashiorkor and
marasmus: the former swollen and water-logged, due to protein deficiency in
children fed on maize alone; the second thin and wasted, due to simple
underfeeding, especially in drought years. So I had fresh protocols made out
for feeding children with nourishing local foods; though even so, in drought
years these were unobtainable.

And with the rains in November came
first malaria, as the mosquitoes were able to breed again; and typhoid, when
everything in the unclean villages was washed into the rivers and dams.

I came to one outer hospital and found a
large number of people sitting around outside, huddled in the wet weather in
great-coats and blankets. After the clinic I did my ward round. Most of the
patients had typhoid. The nurses were handling them as I had instructed. If someone
had fever, treat first for malaria, as this was more urgent. If the fever did
not go down in three days, when indeed the tell-tale 'step-ladder' temperature
chart of typhoid would have shown itself, treat for the second disease.

I did my ward round, males first, and
all seemed under control. The nurses knew how to recognise complications - the
commonest, perforated typhoid ulcer, producing severe abdominal pain - or
pneumonia; and would send these to the district hospital by the Gutu ambulance
straight away. I was about to pass on to the female ward when, as at the Last
Day, all the patients able to walk rose from their beds and went outside. Then
their places were taken by another lot from the waiting people I had seen. At
the end of my second ward round, the same thing happened again. On the female
ward it was the same story. One hundred and twenty patients, mainly typhoid,
sharing forty beds, God knows how, many on the floor, no doubt. I wondered how
many of my old chiefs in Liverpool were ever asked to repeat their ceremonious
ward rounds twice in an afternoon, and what they would have said about that.

The rains were heavy that year - good
for crops, not for diseases. I realised something would have to be done about
the hygiene of the district. I wrote an agitated letter to the Gutu DC, Mr
Menzies, asking about the possibility of making the people dig pit latrines,
with fines for non-compliance. I said, if cholera appeared, the district would
go up in flames. The DC must have thought, we have a right stirrer here!

He wrote back and invited me to drop
into his office on my next visit to the district. Next time, on my way home, I
did so. He gave me tea. He was courteous and sympathetic; had noted my concern
about the district 'going up in flames'. First he said he understood public
health came under the provincial medical officer of health (correct), but could
see my point of view as the chap on the receiving end. He agreed that pit
latrines were the obvious answer, but there was no question of coercion. I
quickly retracted this gaffe. He said he would do what he could - no doubt,
what he had been doing long before I came on the scene: the ungrateful task of
Jenny's in Ghana of trying to stop Africa from back-sliding. But now he was
preoccupied with the security situation. The bush war had already started in
the north-east - the 'sharp end'. The first rumours were reaching our part of
the country.