ZIMBABWE HOWARD HOSPITAL

UPDATE RECEIVED - PLS Share all updates W7 FSAOF

Dear Sven,  2018

Just under a year ago, a headmaster in the area of Howard Hospital was so concerned about the deterioration of services there that he devised a questionnaire for people served by the hospital.  The results are enclosed above.  It is not possible for people outside Zimbabwe to realize the bravery of people willing to speak out in this way, but people in Chiweshe (most of whom are Salvationists) have reached their limit. Since the survey was done, services have diminished further:

• Promises of a surgeon and even an obstetrician to replace Paul Thistle have been forgotten.
• All three doctors at the hospital at the time of the survey have left (though one is on leave and may return).  There is presently a junior doctor couple at the hospital who cannot do  operations, inculding emergency Caesarians.  All these are referred to town where fees are high.
• There are no pain medications at the hospital, nor blood pressure pills, nor diabetic medications, and only one antibiotic. 
• Other medications are sparse.  One person noted that drugs appear before official visits.  Patients are given prescriptions, filled by relatives at great expense in town.
• There are no plaster  bandages.  Though X-rays are still taken, no treatment can be given for fractures.
• There are even fewer patients on the wards.  The last check I got from a visitor was 10 patients on the 90 general ward beds.  Maternity ward is still popular, though maternal and newborn deaths are said to have increased.
• Water supplies depend on an old pump that breaks down from time to time.  Sometimes water has to be drawn from the distant river in buckets for up to a week.  This water is contaminated.
• There is little in the way of intravenous fluids.  The hospital is unprepared for cholera and typhoid epidemics, expected with the heavy rains.

Behind all this stands the estimated US$ 5 million new hospital.  I have been unable to find videos of the work at the new hospital filmed since it opened.  I have asked visitors to take a picture of the new hospital from the outside, but locals warn them that even this simple act is too dangerous.

Officers seeing the hospital on official visits are surrounded by so many "handlers" that it is impossible to see any of these problems.  I have asked them to check registers or stocks to get a more realistic view, but they are reluctant to appear to mistrust the leadership there.  They have been free, however, in blaming Canadians for "spreading lies about the hospital and discouraging donations".  Donations have gone down, in reality, due to a lack of accountability, the donors themselves even being accused of lying.   Howard Hospital has been a cash-cow for THQ Zim in the past.  It would appear that the cow has been milked dry.

Dr. Paul Thistle continues also to be blamed for what has happened ("if only he had obeyed orders and returned to Canada...").  It should be clear, however, that in bravely risking everything for the sake of his patients and staff, he has saved many lives, and continues to serve as a Salvationist at Karanda Hospital, bringing glory to God.  Chiweshe (the district served by Howard), however, continues to suffer its loss of medical services.  This will inevitably affect the spiritual work of the Salvation Army, though it may not be reflected in statistics, as soldiers cannot be removed from the Corps roll, even if they die, without permission of the Divisional Commander.  

It is possible to revitalize Howard Hospital -- Karanda went through the same problems, and recovered marvelously -- but not without confession, repentance and prayer.  It is strange that we, as officers, recommend that to our people, but are reluctant to try it ourselves.

regards to the FSAOF,

Survey of local views of the removal of Dr. Thistle and present care at Howard Hospital:

In May, 2016, Nyachuru Secondary Headmaster, Thomas Kavhai, expressed concern about the ongoing problems at Howard Hospital.  Realizing that the voices of the people served by the hospital were not being heard, he designed the structure of the following paper, with local people who were not afraid to speak up, writing (or dictating) their comments under the headings shown in bold print.  I have asked to see these, and summarized the 52 pages of testimonials, quoting the thoughts expressed, then following that quote by indicating other people who expressed a similar thought, identified by number according to the list below.  My few explanations have been bracketed []. 

NUMBER	NAME	VILLAGE
01	Augustine Mufuka	Mukodzongi
02	Fidelis Maponga	Chitengu
03	Sarudzai Mbanje	Munyengeterwa
04	Witness Gutsa	Gutsa
05	Erica Choto	Mukombochoto
06	Farai Muringai	Mufuka
07	Farai Kamudzandu	Mukodzongi
08	John Chandavengerwa	Nyamukonda
09	Shebba Motsi	Motsi
10	Edwin Ushe	Ushe
11	Edith Muza	Nhamburo
12	Remember Manomano	Manomano
13	Wonder Nyamukonda	Nyamukonda
14	Patuma Kamando	Mukombachoto
15	Chenai Muchenje	Muchenje
16	Wellington Ngandu	Nhamburo
17	Lazarus Manyewe	Munyengeterwa
18	P. Chonera	Gavanga
19	Bruce Timuri	Mandaza
20	Reason Chikomo	Chikomo
21	Stanslay Chidanhu	Nyachuru
22	David Zvomuya	Mandaza
23	Tariro Kumadiro	Motsi
24	Stella Chandavengerwa	Mufuka
25	Livingstone Ngandu	Chinyemba
26	Chipo Handara	Gavanga

This is raw data, as expressed by the people of Chiweshe, many of whom are Salvationists.  There may be minor errors in details, dates or grammar, especially working in a second language.  They only ask that their concerns be heard, investigated and remedied.  Some will call them “ungrateful” for the multi-million dollar hospital the Salvation Army built for them after having removed their beloved surgeon/ obstetrician. They come to Howard, however, to seek treatment, not architecture – they would rather be cured in a tent than die in a palace.  These views stand in stark contrast to the “all-is-well” view expressed for the past four years among the leadership of the Salvation Army and in its periodicals.   I pray that our General have success in making the Salvation Army more transparent and accountable, and that the name of God will be praised, not derided, by what we do or fail to do.

Major (Dr.) Jim Watt, MD, BSc, retired.

a) Date of departure:

“On 15 August, 2012, Dr. Paul Thistle was forced to leave Howard Hospital in the witness of hundreds of people.” 

“Major F Kapere and Colonel Ncube enforced the eviction.” (6,7,13,14,15,16,17,18,19,20,22)

“… amidst patients who were almost dead on beds.” (1)

“Some patients scheduled for operation were left unattended.” (3,2,24). 

“He was told to leave everything he was doing in theatre.  He had to plead to them to finish the patient who was on theatre who was already given medication to sleep.” (26)

“A day of war with people saying ‘no’ to the chasing of Dr. Thistle from Howard Hospital Mission.” (4).  

“We shall never forget that day as a people.  It was and still remains a dark day to us.” (5,23). 

“Church leaders shocked us the way they chased Dr. Thistle carrying out surgery work leaving a patient’s stomach open with intestines out which were put in a paper bag and taken to the Governor in Bindura.” (8,9,10,11,12,21)

b) Immediate trauma to patients:

“Woman Mrs. Mware under operation was left  intestine outside when Dr. Paul Thistle was forced to leave whilst in the theatre room.  Patient was taken to the resident Minister in Bindura whilst intestines were in a plastic paper.  The patient later died the following day (“2 days later” (4)).  This no secret – all people know about this caused by Majors Kapere & Ncube.” (1,4,7,13,15,16 17,18,19,20,22,23,25)

“The patient died two days later.  We saw and still remember how bad and how cruel the Salvation run church is run. We can not believe or imagine that happening being directed by personnel of that church.” (3,8,9,10,11,12,21)

“Pharoh Ngandu discharged during the confusion and later died at home.” (7,13,15,16,17,18,19,20,22)

“Patients cried and the chaos caused some patients to die.  The hospital records can prove this correctly.”(24)

“The patients have lost trust in the administration of the hospital.  There is a low turnout now.” (3,26)

c) Period of non-competent expert doctor:

“When the new doctor came in, he failed to get trust from the Community although he tried very hard to earn their support.” (3,26)

“Theatre practices are horrible”(1) [as are] “cancer related treatments” (25)

“Dislocation of shoulder – woman was injected and shoulder socket forced back in the ward – woman died instantly.” (1,2,5,8,9,10,11,12,21,23,25)

“Woman operated twice within two [days] died who had perforated intestines.”(1)

“Gilbert Gunyere’s intestinal obstruction died without being attended whilst doctor delayed attention to the patient – died in the eyes of other patients in the male ward.” (1,25)

“The expert doctor’s utterances are frightening – ‘I can do as I please with patients in a African country because Africans do not know their rights.  I will experiment to the fullest in the theatre room.’ This is more than shocking and abusive.” (2,5,8,9,10,11,12,21) 

“Sexual harassment of female patients by the so-called doctor (white Indian)” (1,25) 

“People have continued to die because of poor treatment and shortage of medical drugs.” (4,6,7,13,14,15,16, 17,18,19,20,22,23,24,26) 

“At most you find the male ward with 2 or 3 patients.  They fear to stay in the ward having seen other patients die.” (4,5,7)

“Patients on the run to Karanda Hospital seeking alternative treatment.” (4)

d) Death examples:

“Cancer patient died after being opened twice and closed twice in an operation that was done as an experiment” (1)

“Several growth patients [? cancer] receive no meaningful treatment.  They died after paying US$400 per patient.” (1)

“Unknown patient deserted the male ward and found mutilated by dogs & rotting 50m. from hospital (1,2,8,9,10,11,12,21,23)

“Many deaths occurred during the period up to now.  Lives are being lost daily and some of these deaths can be easily avoided, but there is a serious shortage of drugs.” (3,5,13,14,15,16,17,18 19,20, 22)

“After the departure of Dr. Thistle, many deaths occurred at the hospital, some die before being attended by the doctor.” (6,7,24)

“Statistics can give a clear record of unwarranted deaths, some caused by negligence and incompe-tence.” (25)

“Quite a number of maternal deaths occurred due to shortage of drugs, especially those with pregnancy induced hypertension.  Also neonatal deaths occurred in preterm babies after scanning a pregnant woman saying she is past dates and induces them resulting in mother delivering a severe preterm baby who dies.” (26)

e) Drug shortages: 

“The administration fails to purchase ordinary drugs for blood pressure and diabetes saying they are not important at all.” (1,4,5,23)

“Non-medical personnel are in charge of drug buying.” (5)

“No drugs like pain killers or even BP tablets.” (6,7,13,14,15,16,17,18,19,20,22)

“Pharmacy records can only prove the actual shortages on the ground.  If there was a way to establish the facts the world would be shocked.” (2,8,9,10,11,12,21)

“The situation is so severe patients are being told to buy drugs from pharmacies.” (3)

“No drugs at all.  If drugs are there, very dear to buy.” (24)

“On and off drug supplies.” (25) “Worse those for chronic patients: hypertension, diabetes, asthma, epilepsy, psychosis to mention but a few.  Intravenous fluids are hard to come by.” (26)

f) Anarchy or chaotic perceived on the medical practice(s):

“Utterances ‘I am working in an African country where I can do as I want…Africans do not know their rights.  I came to carry out my experiments especially here at Howard Hospital.’ [You can] investigate from any ordinary worker at Howard Hospital.” (1, 25, 90see also under c) above)

“Out patient department patients at most are never attended to even after being referred by senior nurses.  At times 3-4 days no medical attention from the expert doctor.” (2,8,9,10,11,12,21)

“Older people who used to get free treatment and children under 5 years are paying now… $10 consultation fee but no drugs.” (3)

“Proud doctor killing and liking women for sex.” (4)

“Dr. Isaiah is not doing theatre operation properly resulting in many deaths to patients which can be prevented easily.” (5,6,7,13,14,15,16,17,18,19,20,22,)

“Dr. Isaiah stresses patients especially women.  The doctor Isaiah is a womanizer.” (23,24)

“The chief medical doctor … delegates night duties to junior nurses in most cases.” (23)

“Clerks are sent to buy tablets whose knowledge we believe is very limited to medical world.” (23)

g) Proposed or would-be solution(s) – (Medical administration proposal)

“Must have a medical practitioner as administrator.” (1,2,4,5,6,8,9,10,11,12,21,23,24,25)

“[this] is the only possible solution to a well-run Howard Hospital.”(25)

“Doctor knows what is wanted at hospital, not mufundisi [preacher].” (4)

“Procurement committee should be composed of medical practitioners.” (1)

“Rosa Rural Hospital [a local clinic with beds] is better equipped with medical drugs and has higher patients statistics.” (1)

“There is need for committed doctor who does not delegate night duties to ordinary nurses.” (1)

“Specialist theatre doctor must be appointed.” (2,5,8,9,10,11,12,21)

“More better qualified medical nurses should be appointed.” (5,23)

“It would be in the best interest of the patients as well as the community at large if Dr. Thistle is allowed to come back to Howard Hospital and be given the sole responsibility to administer the hospital.” (3,6,713,14,15,16,17,18,19,20,22,24)

“I think a more experienced doctor should be employed to win confidence in some of the patients who have resorted in seeking medical treatment from the private sector.” (26)

“More resources should be sent especially drugs to ease the critical shortage. Also the administration should be well-versed with what is important to run a hospital.” (26)

UPDATE, February 2017:

Despite many promises to maintain the hospital and provide a surgeon to replace Dr. Thistle, and despite several glowing official reports, the reality is that the hospital steadily declined after Dr. Thistle was abruptly dismissed, and has declined further since the above survey was done to the point of near-collapse today.  

At present, only one over-worked doctor remains, a very good Zimbabwe doctor who was trained by Dr. Thistle to do common surgical procedures, but is unable to do much due to a shortage of medications, including anesthesia, intravenous solutions, pain medication, antibiotics, diabetic medications and blood pressure pills.   He is unable to treat fractures, as the hospital has no plaster bandages. Patients needing these things are sent to town, so most simply bypass the hospital and go directly to Parirenyatwa Hospital in Harare ($16 round trip, but with very high fees), or to see Dr. Thistle at Karanda Hospital in the northeast ($30 and low fees). 

 Paradoxically, God has been glorified by Dr. Paul Thistle’s brave refusal to obey orders to abandon his patients, saving lives. Unfortunately, many others are dying.  There are solutions, but direct help to the hospital is forbidden, and the territorial headquarters has other priorities for outside funding.