It has been said that there are two sides to every story. In most cases, there are more than two sides. For the past several days, we have been covering the tragic events of the last year at The Salvation Army Howard Hospital. The information presented was drawn from a number of sources; the Zimbabwean press, the Canadian press, broadcasted podcast and YouTube video interviews, online blogs authored by supporters of Dr. Paul Thistle and Howard Hospital listing first-hand accounts of patients, visitors and volunteers at Howard Hospital, email exchanges from those with first-hand knowledge, and from press releases issued by The Salvation Army International HQ and Canada HQ.
We freely note that we have not had any direct input from either Dr. Thistle or any one in Salvation Army leadership. It is understandable that Dr. Thistle would refrain from speaking out directly. Zimbabwe is a country that faces many difficulties and challenges, and for Dr. Thistle to speak out directly could likely have serious, if not dangerous, repercussions from certain people within Zimbabwe. However, Dr. Thistle does not speak out mainly because he sees no reason to defend himself, nor does he speak out because he doesn’t want to give the impression that he is speaking badly of anyone.
We also recognize that there are certain aspects of this issue that The Salvation Army must withhold comment on in order to maintain good relationships with the government of Zimbabwe, in order to be able to continue the work of the Army and to maintain a positive environment for the tens of thousands of its soldiers in Zimbabwe. Additionally, we recognize that there are personnel issues that remain to be settled between Dr. Thistle and The Salvation Army.
However, The Salvation Army has shown a disturbing lack of transparency, accountability and truthfulness about this issue. We find these actions to be wholly unacceptable, as there are several points that should have been addressed that would not have compromised the relationship between The Salvation Army and the government of Zimbabwe. Not only has The Salvation Army been haughtily silent, they have also issued the equivalent of gag orders to officers involved in and aware of this issue.
The dishonesty displayed by The Salvation Army is unacceptable, period. There is never a reason for dishonesty. It is no secret that there are difficulties working in countries where there is wide-spread corruption. The Salvation Army should never deny that problems have arisen, nor should they deny that solutions take time. Such denials lead to a lack of trust.
Our intentions have been and will continue to be those of holding The Salvation Army accountable for their actions, or lack thereof, and a call for a change in the leadership methods so that such tragedies never occur again.
Let’s begin with some background information about the places and people.
The Salvation Army Howard Hospital is located in the rural Chiweshe communal lands, approximately 80km (50 miles) north of Harare, the capital city of Zimbabwe. It serves a population of over 270,000 residents of all ages and health conditions.
Howard Hospital was established in 1923, and from its inception provided some types of medical care. The Howard Hospital roots started in 1918, when Major Bradley was providing medicines and medical care in the bush. The facility grew into a hospital slowly as the need for a regional health care provider became apparent. The early Howard facility of a clinic with four wards was built in 1928, and the core of the present facility was constructed in 1958. The Howard's full-fledged expansion into a semi-modern hospital in the 1960s was started by Captain (Dr.) Jock Cook, who arrived at the Howard in 1967. Captain Cook added X-ray capabilities, an operating suite, and TB and isolation wards. Although surgeries were performed prior to Cook’s arrival, Cook began to do quite complex surgeries. Assistance for Cook came in the persons of Dr. Pedersen in 1969, and Major (Dr.) James Watt (Retired) in 1970.
With a 144-bed capacity, Howard Hospital provided a vast number of services to the community; in-patient and out-patient, newborn to elderly, primary care and advanced surgical procedures. In addition to the on-site health care practice, a mobile clinic supported an area ranging up to 100km from the Howard, providing immunization programs, pediatric & obstetric care, and family planning.
On-site at Howard Hospital, other associated programs were running with a nurses’ training school and a school for training midwifes. The epidemic of AIDS in Africa was being addressed with a comprehensive counseling and treatment center, including antiretroviral therapy. The children left orphaned when their parents died from AIDS could receive a sponsorship at the The Salvation Army’s Chinyaradzo Children's Home. Chinyaradzo is an orphanage in Highfields, a suburb of Harare.
After the fight for Independence, Zimbabwe struggled with staggering inflation. Inflation has been under control since the introduction of the US dollar and the Rand as currency. However, the overwhelming increases in the cost of health care often puts needed medical care out of the ability to pay of many Zimbabweans. To provide a comparison, farmers in the areas surrounding Howard Hospital live on an average of $1 per day.
A recent account was shared about the X-ray machine which had broken down at Howard Hospital. A young man came in with pneumonia and was sent to Harare to obtain an X-ray. This cost the patient US$250, which represents over 4 months of salary.
Minor operations performed in Harare costs US$3,000, and that does not include tests or hospital admission costs.
In contrast, the fees charged by Howard Hospital under Dr. Thistle’s administration were small when compared to what private doctors and hospitals charge. Howard Hospital charged $2 for a consultation, between $1 and $5 for medication and between $5 and $100 for surgery. Children and seniors receive free health care. The hospital has a serve first, pay later policy. It asks families to pay for surgeries in installments after the fact. Most families do their best to repay the debt, but non-payment is not a barrier to future treatment.
Before Dr. Thistle was transferred from Howard Hospital, the hospital was seeing an average of 300 people a day and reached 75,000 people through its in-patient and out-patient departments a year. About 2,700 babies were born at the hospital each year and thousands of patients relied on it for life-saving HIV treatment in a country with staggering infection rates.
The reputation of Howard Hospital was well known and well respected. In fact, on many occasions, the private and government-run hospitals referred their patients to Howard Hospital.
A Canadian, Dr. Paul Thistle graduated from the University of Toronto with a degree Medicine in 1989, and completed further training as an obstetrician and gynecologist. He acquired extra training in general surgery, oncology surgery, urology surgery and complex wound management. He has spent time in Indonesia, Pakistan, and in the mid-1980s, in Afghan refugee camps, working with the Salvation Army.
In 1995, Dr. Thistle came to Howard Hospital, where he served under Major (Dr.) Watt, who passed the title of Chief Medical Officer to Thistle in 1999.
During his first years in Zimbabwe, Dr. Thistle met his wife Pedrinah, a Zimbabwean-born nurse and midwife, who served as an educator at the hospital. They married in 1998. They have two sons, James, born in 2001, and Alexander, born in 2004.
In 2005, The Salvation Army invited the Thistles to become Salvation Army officers. They attended the Booth University College and the officer training facility. They were commissioned in 2007, with the ranks of Captain.
On June 11, 2008, the Chancellor of the University of Windsor conferred on Dr. Paul Thistle the Degree of Doctor of Laws, honoris causa.
The Salvation Army issued marching orders to the Thistles the beginning of August, 2012, ordering them back to Canada. The community which depends on the Howard Hospital protested and the Territorial Commander, Commissioner Venice Chigariro, responded by giving the Thistles a 24-hour notice to leave the Howard Hospital and a 48-hour notice to leave the country of Zimbabwe.
The Thistles were stripped of their officership in November 2012 for refusing to leave Zimbabwe.
Dr. Paul Thistle began working in his new position in Karanda Hospital in July, 2013.
END PART ONE
The remaining pages of this report are available by request only, and only to those persons who share their name and reason for their interest. Send your request to: Dr. Sven Ljungholm email@example.com marked HH REPORT
The report is a compilation of reports, private and public, written by former SA officers.