THREE DOCTORS: HIV, snake bites, 4,000 operations a year and no quitting whistle!

YEAR 2012  REPORT – Dr. Paul Thistle shared the below report with a Rotary Club in his native Canada.

Here’s the story of a (hospital) place named Howard. It began in 1923.  The school commenced first, in recognition of the need for education among the native population in rural Zimbabwe.  A clinic was attached to the school which grew into a hospital, ward by ward, wing by wing.  Today, Howard Hospital is well known across the nation having served, schooled and saved hundreds of thousands, perhaps millions of Zimbabweans.

Sub Saharan Africa has always had a lions’ share of poverty, pestilence and political unrest, but for Zimbabwe in the last dozen years it has been something different again.  We still fight inflation, 80 percent  unemployment  and a scarcity of health care professionals, medicines and surgical supplies. Old Mother Howard’s cupboards are often bare.  The escalating costs of transportation alone make travel to Howard prohibitive especially for the disadvantaged, the widows, orphans and child headed families in our villages.  Many will travel 18-20 miles by foot to seek medical attention ….  if they can walk.  Others will use wheelbarrows and ox driven carts.  On the other hand, half of our patients are from the cities and towns of Zimbabwe, in search of affordable care in a privatized system. Public health care in Zimbabwe remains underfunded, semi-privatized, a pay as you play. This has been exacerbated by the political stalemate in the unity government.  June is winter in Zimbabwe with shorter days, but when you are poor and sick, the nights are a little longer all year round.

We are a 144 bed general hospital with 3 doctors, 50 nurses, 100 general staff serving a catchment of 270,000 people on an annual government grant of $7,000 US.  Our outpatient services had 110,000 total attendances in 2011. That’s more than a mouthful of stats. The number of operations have tripled to 4,000 a year in the last decade due to the unmet demand for affordable surgical care in Zimbabwe. 

I am a Salvation Army officer and gynaecologist by training, not an orthopedic surgeon but I still need to set bones and reduce fractures; in the operating room they call me ‘Captain Crunch’.  

There is nothing sensational about treating the poor in rural Africa - just hard work day and night - and the following day. We are Club Med without the Club.

By the grace of God, our doors remain open to welcome the sick, and in turn, for us to reach out into the community with our messages of prevention, treatment and care.   It is HIV and AIDS that still places the single largest demand on our scarce resources  at Howard.  The good news here is that we know what works. Our HIV prevalence has dropped from 29 percent in 1999 to 5.7 percent in April 2012. We have our HIV clinic called Hope Clinic in Shona translation. With 3,000 people on treatment and 4, 000 more decentralized to our district clinics AIDS has changed from being a byword of shame and suffering to become a chronic disease to live with, like diabetes or hypertension. 

Talk is cheap. To the thousands in our community accessing lifesaving antiretroviral therapy they would agree with Benjamin Franklin, ‘Well done is always better than well said.’

HIV, pregnancy and poverty is a triple whammy.  There is the story of Unity, a 30 year old, HIV positive mother of three from a village 15 miles away, who has no antenatal care, and therefore no access to life saving ARVs. She presents in a coma secondary to fits at home for several days. We call this condition eclampsia. There was no affordable means of transport.  Her twins have already died in the womb. And Unity dies a few hours after arrival.  To top it off, it is the middle of the night and the hospital has no oxygen, and there is no money in the bank to purchase oxygen. 

It is the straw that breaks the camel’s back.  But when your back is broken from a night of broken rest, you still have to get up for work the next morning with a 100 more in the queue.   

And when your get up and go just got up and left what motivates you to continue on: professionalism, a sense of duty, compassion, and a glimmer of vision. 

A glimmer of vision. As Proverbs (29 v18) reads, ‘Where there is no vision the people perish.’  However, vision can be clouded by indifference. To quote Elie Wiesel, Holocaust survivor, it is indifference to suffering that makes the human being inhuman. At Howard we have to counter this indifference, apathy and despair with a message of hope and healing.  For we are not talking politics here but people.  At Howard and elsewhere, people are more important than programs.

There is nothing more liberating to serve people irrespective of race, colour, religion, and social status, …. simply because they are human, created in the image of God. 

A vision that sees a better world tomorrow than today, and a plan to bring it into place. 

I am privileged to report that Howard Hospital has captured this vision thanks in a big part to our network of international supporters, particularly Canadians. 

At a time in history when there is increasing skepticism over large NGOs and government to government aid, our friends have rallied to provide holistic care to the underprivileged in our corner of the country.  We stretch dollars on a shoestring budget (even when we have no shoes) and deliver the assistance to the community on the ground.  Rotarians are part and parcel of the community and know and apply this concept well.  In the past few years, Rotarians working together within their districts across Canada, with Rotary International and Rotary Foundation Matching Grants have improved the short and long term health of men, women and children at Howard through the support of laboratory services, the provision of antiretroviral drugs to pregnant women, and general medical and surgical supplies to our hospital and neighbouring clinics.

Bicycles have been provided for home based care volunteers.

Nurses have been able to complete their degrees at Howard by long distance learning. A cervical cancer screening program has been set up. Cancer of the cervix is the number one cancer of women in Zimbabwe .. and it is preventable. Diesel fuel has been purchased to fire up the generator when the national power grid fails day and night.   A four wheel drive vehicle was provided for our community care program and now an ambulance for our patients in distress out in the village. 

Vision without action is but a daydream. And Rotarians did not need skype or twitter to do all of this, but patience, perseverance and a personal touch.    Maita basa!  You have done work.

 

I am most grateful for my parents who taught me the value of a day’s hard work, my loving wife, Pedrinah, who holds down the fort at home, and our two boys, James and Alexander who have taught me on numerous occasions how to pick up the broken pieces of our lives and move forward … in grace.

At Howard, we must remain focused on our purpose, not our problems to providing quality affordable health care to an underprivileged corner of rural Africa.

Theodore Roosevelt  said ‘Do what you can, with what you have, where you are’ 

 Some believe we cannot, at least not in Zimbabwe, not at this time.  I believe we can, … or else I would not be standing in front of you today.