NO DOCTOR IN THE HOUSE?

Canadian volunteers stranded in Zimbabwe after Toronto doctor’s ouster sparks protests  By: Niamh Scallan Staff Reporter

A group of Canadian volunteers are stranded in Zimbabwe's capital after a Toronto doctor's removal from a rural hospital sparked protests last week.

Dr. Paul Thistle, originally from Scarborough, was ordered by the Salvation Army to return home from Zimbabwe in early August after spending 17 years working as a doctor at the Salvation Army Howard Hospital, in a rural part of the country north of Harare.

The group of Canadian medical volunteers had just returned from lunch Thursday afternoon when they saw the chaos unfold in front of the Salvation Army hospital in rural Zimbabwe.

Outside Howard Hospital, drums throbbed as hundreds of local people — who had gathered there earlier in the day to protest a decision made weeks before to remove the hospital’s head doctor — grew violent, some lobbing rocks through the air as others reportedly overturned a Salvation Army truck.

Soon, tear gas filled the air outside the hospital as Zimbabwean police officers moved in to clear the crowds. “There were kids running, yelling at us, ‘Don’t go there! Don’t go there!’ ” said Veneta Anand, a Waterloo-based pharmacist, describing the turmoil. As the tear gas spread, officers moved into the hospital to arrest community members and hospital staff, including several nurses, on suspicion of inciting violence.

The next day, Dr. Paul Thistle of Scarborough — the hospital’s chief medical officer for nearly 17 years and the subject of last Thursday’s violent protest — was told by the Zimbabwe’s Salvation Army headquarters that he had 48 hours to pack his bags and leave the country.

The Canadian volunteer team of 11 doctors, pharmacists, dentists and others — in Zimbabwe with Short Term International Medical Missions Abroad,  had arrived at Howard Hospital, about 80 kilometres northeast of Harare, just days earlier and had planned to help out at the facility, which serves about 270,000 people in the surrounding region, until Aug. 29.

But on Saturday afternoon, fearing for their safety, the Canadian team fled to Harare, where they remained Monday afternoon trying to find a flight out of the country. “It was unsafe for us to be there . . . and we were told it was unsafe for us to go back,” said Anand, reached in the capital city Monday.

Thistle had told his supporters via email on Aug. 6 that the Salvation Army had ordered him to leave his post as of Sept. 1. But Commissioner Vinece Chigariro, the Salvation Army’s head in Zimbabwe, told the Associated Press on Sunday that last week’s violent protest had prompted the organization to issue a 48-hour removal notice.

While the circumstances leading to Thistle’s removal remain unclear, Thistle sent another email to his supporters Saturday morning, explaining that it had to do with the organization’s funds. “The root of the problem has been financial, and control of funds,” he wrote. “Within the current Salvation Army system the funds do not arrive, or arrive very late. People are suffering today.”

Anand, who also volunteered at Howard Hospital in 2011, described a hospital in need, with nearly bare pharmacy shelves and a ward operating at half-capacity due to a lack of staff and medical resources.

Chigariro, however, told the Associated Press that Thistle had challenged church leaders and that he was being reassigned “for the good of the church.”

On Saturday morning, the Canadian volunteers and local supporters gathered inside Thistle’s house as … the doctor prepared his departure.

Though he was expected to leave Zimbabwe for Canada on Sunday night, Thistle skipped his flight after hearing eight Howard Hospital nurses detained after the riot were still behind bars, according to Warren Viegas, a close friend who spoke to the doctor Monday. “Paul and Pedrinah (didn’t) want to run away and abandon the staff that has been so loyal to them,” said Viegas, later noting that all staff members were believed to have been released on bail.

But all is no longer well at the hospital.

Hospital staff there said that conditions have deteriorated seriously following the controversial dismissal last year of Dr Paul Thistle by the Zimbabwean Salvation Army church authorities. The Howard depends largely on donors, mostly from Canada, but, since Thistle’s departure, they have been withholding funds because they are afraid that they will be misused. Thistle was at the helm of the institution for 16 years.

… Compared with previous visits, the Mail & Guardian found that the wards were generally dirty, lacked fresh air and were mostly empty. The few patients who were in the wards were said to be awaiting transfer or to be discharged… The hospital is left with only two young doctors. But nurses said they were not experienced enough to carry out major surgery or carry the entire medical workload of the institution…

“We are deeply pained because this is the hospital that we used to rely on,” said Shelly Mhundwa, who lives in Chiweshe and was seeking treatment for a broken leg… 
“Many of us are very poor in this area. Many people are farm labourers. Getting money for treatment elsewhere is something we cannot afford,” Mhundwa said. “During Dr Thistle’s time, there was  nothing this hospital couldn’t offer. It was even better than Parirenyatwa Hospital … we are very worried about how we are going to survive.”

(At its peak, the Howard Hospital treated more than 75000 patients a year.

It also runs operating theatres, a pharmacy and a laboratory, and has X-ray, ultrasound and rehabilitation facilities. The hospital also ran a mobile clinic that offered immunisation, paediatric and obstetric care, and family planning services)

As a practicing physician, as a former SA officer, as one who has 

experienced the SA in many countries on six continents and as one who 

has personally visited the Howard Institute,  I was saddened in the extreme and shocked by the events that involved the sudden forced dismissal by the SA of Dr. Paul Thistle and his wife Pedrinah in a manner that seemed almost criminal leading in turn to the creation of a massive humanitarian crises for the thousands of people in the North 

Eastern part of Zimbabwe.   As with any disaster, be they natural or  man-made, that there should be a major and significant increase in the 'all-cause morbidity and all-cause mortality' in the population served by the hospital surely should be no surprise to the SA leadership as also intimated by my very good friend Major Dr. James Watt who for years like Dr. Thistle gave of himself in dedicated service day after day, as well as night after night - as physicians are often called to do for the benefit of the people that they serve - physically, mentally, and spiritually.   That this happened in an essentially 'failed country' where up to now the Howard Hospital has been such a shining light of hope - is all the more tragic.

I understand, that there has been no acknowledgement nor apology from the SA to the thousands and thousands of people so negatively affected nor specifically to Dr. Paul Thistle and his wife Pedrinah which surely is an additional tragedy and speaks sadly about the leadership of the Salvation Army in Zimbabwe as well as at the International level.    For the sake of the SA and also for the people  of Zimbabwe, I sincerely hope that such will change.   For this to be taken up as an urgent issue by the forthcoming High Council would seem appropriate and I personally hope that this will happen.

Sincerely yours,

Bent Hougesen - former SA Officer

MSc, MD, FCFP, MPH&TM, FRCPC

Hazelton, British Columbia, Canada

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This appointing of a hospital administrator is a little odd: Andrew Burditt
, National Director of Marketing and Communications
, TSA said the same thing in August last year. Almost a year has passed, and we are no further forward. What happened to the plans they had when the Thistles left so suddenly? It beggars belief that a Christian, humanitarian organisation that trades on its public image is allowed to play with people's lives like this. The people who have been denied medical aid through TSA's inability to act this last year are HUMAN BEINGS - and we should treat them as if they were our nearest and dearest - after all, TSA preached that we are all one in Christ. 
If the political situation is out of their control, then TELL US - we are all aware of the political situation in Zimbabwe - it's no shame to be caught up in it - there is evil all around us - and if there HAS been weak leadership, then we need to know about it and the leaders need to repent.
At the beginning of this topic, I was inclined to believe TSA's account - but having followed the case through, to me there are anomalies in its accounts from the initial statement right up to the latest statement by John Murray.
I have spent many, many years proudly raising funds for TSA, and have been proud to wear my uniform, but this sad story leaves me feeling sullied.

 UK

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Jennifer Reid

When I first went to Howard Hospital in 2001 I was struck by how old and dilapidated its buildings were, windows with no screens let alone glass, peeling paint, out-dated equipment, empty supply shelves. People line up for care, and then again for medication (which often runs out), and family members sleep on the floors beside patients’ beds. And yet, those ramshackle buildings were filled with life and hope and service. On day two of my visit, I was shown “the new Howard Hospital”, a fine expansive building, with fresh walls and wiring and plumbing for updated medical facility. I was told that a Salvation Army donor had left millions of dollars to build this new hospital that the people so desperately need.

So what happened to this new Howard Hospital? Somehow, those millions of dollars given to the SA “ran out.” The buildings are there, but are as empty as a ghost town, right beside the old hospital which pulses with life. There now becoming delapidated from non-use and neglect, and the Zimbabwean authorities declared it unfit for use in 2006, but you’ll not find a single word about this in any SA press statement. Such massive waste and mismanagement of donor dollars.

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I was teaching clinical midwifery at Howard in 2001 and we were asking Canadians to donate $4 so that we could administer AIDS drugs to women in labour to prevent spread of HIV to their babies. We knew the women were going to die because there were no AIDS medications available then, but the babies were more likely to be adopted by other families if they were HIV-negative. The people see the new hospital, empty, and reports from people in Zimbabwe are saying that service provision in the old hospital is a shell of its former self since the Thistles left. And people there seem to be talking about corruption in the handling of funds, and how unfair it is to them that the Thistles have been forced out.

Lives are at stake. Is it really okay with all of us that the same people who allowed the “slippage” of the new hospital funds to do this investigation? Doesn’t the SA need outside assistance to get to the bottom of it? And if its not a personal vendetta agianst the Thistles, why do they have to leave while the investigation is occurring? Lives are at stake and the right actions need to be taken.

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It is an absolute disgrace what has happened to Dr. Thistle at Howard Hospital recently. I am not a member of the Salvation Army, but I am a physician (obsterician/gynecologist) who has volunteered at Howard on 4 separate occasions. I just got back from Howard Hospital in July after working there for 3 months. I know the situation on the ground there very well. Your (SA) press release that says that the hospital is functioning well is completely inaccurate. When I was there, the hospital was busting at the seams, stretched beyond capacity with sick patients. The only reason it was staying afloat was because of the extraordinary efforts of one man, Dr. Paul Thistle. He was working ridiculous hours, seeing over a hundred patients a day and doing complex surgeries. On top of that he was doing the duties that the hospital administration should have been taking care of. It was quite obvious when I was there that the hospital administrator was completely incompetent and downright obstructive.

How can you say that the hospital is running well with 2 doctors? What nonsense is that? I know these 2 doctors. They are not obstetricians or surgeons. They are general doctors. Dr Thistle is formally trained as an obstetrican and gynecologist, who has done extra training in general sugery, oncology surgery, urology surgery, complex wound management. How many of these types of doctors (with the surgical skills of Paul Thistle) do you have waiting in your ranks to replace him? The decision to transfer him back to Canada with one month notice (and then later at 48 hours notice) is an irresponsible and downright dangerous decision. You cannot replace a doctor like that without at least a 6 months transition period with him and the new doctor both in place. I know for a fact that many women in that region will die of complications of pregnancy because he is not there.

And where are all the sick and dying patients right now that I saw in the other wards? They are not at Howard; that has been confirmed. There are hardly any patients in the hospital right now. I can tell you they are not in Harare; they cannot afford the transport or the hospital fees.

I urge you to wake up. Stop trying to protect your organization and focus your investigations on where the real problem lies, the leadership at the SA Territorial headquarters in Harare. Get Dr. Thistle back to Howard as soon as possible so more people in the Chiweshe region don’t die and suffer unnecessarily.

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Kim MacDonald, MD

I too worked as a physician at Howard Hospital for three months this past year. You won’t find a more dedicated, kinder or skilled physician in Zimbabwe, or pretty much anywhere. You don’t replace Paul Thistle, or go on at Howard Hospital without him, you can’t.

This statement from the Salvation Army is marketing smooth talk and diversion, nothing more. They either have no idea at the incompetence and corruption that is occurring at the administrative level at Howard Hospital, or don’t care.

I encourage Canadians, and caring citizens everywhere, to speak in number with your donations. Send them to reputable, professional and sincere international organizations. There are many to choose from, but the Salvation Army has shown from its handling of this matter, that they are not one of them. Demand answers as to where your money has gone…

There are hundreds of us that have volunteered money and time to the people of Zimbabwe. We know the community and hospital well. There is nothing humanitarian, Christian or right about this entire matter.

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Major (Dr.) Jim Watt (R) said...

I would like to thank John Murray for the “IHQ official response to all enquiries re Howard Hospital,” (July 11, 2013, “Just to do my Master’s will” blog). I do not, however, see any answers to the very big questions raised in these blogs.

“Personnel issues are between the employer and the employee and they are…confidential…” does not explain why Dr. Thistle was given no hearing, no chance to defend himself, no reason for his move. Even the Jewish leaders knew it was improper to accuse a man without a hearing.

A bigger issue has been the deaths resulting from the sudden removal of the only surgeon. I know of many by name. Transferring difficult cases to town has not worked. I have been told that patients without the very high fees charged have been left to die. If an administration separates a doctor from his patients, resulting in their deaths, no amount of official excuse will avoid what amounts to a criminal charge.

When will IHQ realize that life-and-death issues are vastly more important than Salvation Army protocols?

IHQ must also learn that “spin” no longer works in a world of instant communication. “The Salvation Army IHQ recently appointed … a Swedish surgeon… to Howard Hospital” does not mention that he is appointed as Hospital Administrator, not as a surgeon. To my knowledge, he is not able to undergo the difficult registration procedure, and thus will not be registered to practice medicine, let alone surgery.

John Murray may not be aware of this detail, and I would be pleased if he could check it out even if he proves me wrong. A lie can consist of what is not said, as much as by what is said. 

Howard Hospital has had a reputation for complete (not just “primary”) care for the poor, starting in the 1960’s with the amazing Captain (Dr.) Jock Cook, a reputation I would love to see restored.