The SA's lofty statements do not match the on ground reality

August 23, 2012: Press Release: "The Salvation Army remains Committed to Howard Hospital":  Commissioner Brian Peddle, Territorial Commander, Canada & Bermuda: "We consider the health of its patients and the well-being of the staff at Howard Hospital to be of paramount importance." 

If the health of the patients had been of "paramount" importance, reasons to move Dr. Thistle would have been "secondary" and would have been delayed and coordinated with the on site arrival replacement surgeon, and is not yet resolved 11 months later. And was any logical thought or consideration given to how Dr. Thistle, given just 24 hours to vacate the hospital and another 24 hours to leave the country? Seventeen years of accumulated files, research, medical records to sort through- patients needing their medical charts updated and shared with those taking over Thistle’s typical 18-hour daily rounds. And what about all the patients scheduled for surgery at the hands of this exceptionally skilled physician? And children in a boarding school…  The expulsion was rushed and negligent of any patient safety or concern with reprehensible consequences: many patients died.  In Canada (Dr. Thistle’s home country), such a situation would have led to charges of criminal negligence leading to death.

Many staff members spoke out against Thistle’s dismissal, fully aware that retaliation, including bodily harm might follow. As far as Commissioner Peddle’s assurance for the well-being of the staff, at the time of the above statement, eight nurses from the hospital had been beaten, arrested, tortured and denied food.  It was reported that the Hospital Administrator gave the police names of nurses who opposed Dr. Thistle's move.  No Salvationists (HQ) visited these nurses in prison except Dr. Thistle, who refused orders from IHQ to abandon them. It’s logical to assume that THQ Toronto was simply echoing the hollow assurances being sent out from IHQ.

Officers from Zimbabwe THQ witnessed against them at their trial.  However, their witness (THQ officer?)  was "contradictory" and "unreliable" according to the judge, who set seven free for "lack of evidence".  When asked about the nurses' plight by Stephen Lewis, Lewis reported that the General replied, "They were inciting violence."  The nurses presence must not have been of sufficient threat as all but one returned to work at Howard Hospital, Martin Zindoga, still charged but under appeal.  He has been dismissed from the hospital.


26 October, 2012: "Statement Regarding the Salvation Army's Howard Hospital, Zimbabwe": "The Salvation Army is able to report that:

▪                there is no sign that donated funds have been diverted from their original purpose

▪                donated goods, falsely reported to have gone missing, are all accounted for"

Donors in Peterborough, Ontario have requested some $10,000 donated to the hospital and receipted, for construction of a duplex residence, be returned, as the residence has not been built. They have received no answers to these requests. The money remains missing to this date, obviously diverted from its original purpose.


Donated goods, including building materials for the above structure and medical instruments owned by SHUMBA Medical were not ‘falsely reported to be missing’;  they are indeed missing and unaccounted for, and remain so. It has been reported by the SA Zim that some of the building materials are at the hospital (door and window frames) and that photographs have been taken and are available, but no photos have ever been provided. When asked about bricks, sand, lumber (roof beams) and roofing sheets, the Salvation Army Zim would not respond. They did acknowledge that that the cement, a highly valued black market commodity, which had already been purchased, had not yet been delivered. 

November 7, 2012: Online press release, reported in Peterborough Examiner, November 13: "The hospital continues to operate with qualified medical personnel serving thousands of people each month and reports the hospital is functioning at 10% are false, the church said.  Spokesman Andrew Burditt said the hospital served 7,623 patients in September, down from 9,571 in June, meaning it was running at about 80% capacity, he said.  Patients continue to be treated at Howard and more difficult cases are being referred to other facilities, Burditt added."


Maternity services at the hospital are popular and highly valued, thanks to an excellent midwife and staff, however, the quality has lessened since Thistle’s departure. Doctors do perform Caesarian sections, though maternal mortality is up.  In contrast, the main hospital wards, usually operating at 100% capacity, were at a disturbingly low10% of capacity at the time Burditt’s statement was written, and remains between 10% and 20% of capacity to this date, August 5, 2013. 

Even if one were to include the Maternity wing, no one visiting the hospital in recent weeks has ever witnessed it 80% full.  The near-empty main wards contradict official statements to such a degree that visiting donors are not allowed to enter them.  Two recently entered secretly under dark, and another had his driver perform a count, a newspaper reporter managed to get in, and nearby residents keep count, all agreeing on the low numbers.

Patients who are referred to Harare hospitals, Zimbabwe’s capital, are treated only if they are able to pay the high costs demanded there.  Most are unable to do so, and have been left unattended.  Many have died.


11 July 2013: John Murray, IHQ: "IHQ Official Response to all Enquiries re: Howard Hospital": "However, for the record, the Salvation Army is pleased to advise that three doctors are in place at the hospital and staff morale is improving as confidence increases. The Salvation Army International Headquarters recently appointed Dr. Per-Gote Lindgren, a Swedish surgeon, and his wife Birgitta to Howard Hospital."

Today, almost one month later this third doctor is still not in place at the hospital, confirmed by telephone. Dr. Lindgren, a Salvationist and son of SA officers, is a retired surgeon, however, he will not be registered in Zimbabwe to practice medicine. His appointment is not as a surgeon, as implied above, but as Hospital Administrator.


These are only a part of the allegations. Only an independent audit conducted by a credible outside agency, with no restrictions placed on it as to the reporting of the outcome, is needed to restore confidence in the face of the false SA press releases.


In seeking credible verifiable information in researching our investigative report E-mails have been sent to the Army’s International Headquarters requesting clarification on Dr. Thistle’s removal. No direct responses have been received. All requests are automatically re-directed to the Army’s Canadian Territorial Headquarters. 


Comments posted by visitors to the SA Canadian website confirm unwavering support for Dr. Thistle and condemnation for the Army’s reprehensible handling of this matter.


All active and retired officers in the Canada & Bermuda territory have been told not to comment on-line or off-line about the Howard Hospital debacle. Secrecy and gag orders are how many militaristic organizations function: keep those on the front lines ignorant of the decisions being made by those in the war room.

Official reports continue to provide glowing reports of the restoration of the hospital, while visitors are not allowed to visit the wards and see first what the true conditions are. The count of patients in the wards remains at less than 10% of the 144-bed capacity. The two Zimbabwean doctors at HH reportedly keep busy with private practice patients in addition to the employment at the hospital. Medicines and supplies have run out or are in short supply.

And yet the Salvation Army continues to provide an exaggerated picture of hope and wellbeing, the opposite of the reality that we know to be is the Howard Hospital.

Many are suffering. Many are dying.

_____________________________________

Dr. Paul Thistle shared the following in a message received today:

We have often been asked on furlough for an update on the situation at Howard Hospital.  In response we have had little news to report. Unfortunately, the first-hand reports from the hospital staff, family members, and Chiweshe patients who are seeking medical care at Karanda continue to contrast sharply with the official Salvation Army communications. We request your prayers for: Peace in Zimbabwe after the elections.        The people of Chiweshe.  For reconciliation at Howard. Nurse Milton Zindoga who is out on bail over the Howard Hospital protest. His High Court appeal starts next week. Accessible and affordable health care for the people of Zimbabwe.  Karanda has a vital role to play here. Education assistance for our orphans and vulnerable children in Chiweshe and Mount Darwin.   The Thistle family.  For our health, and our safety on the roads as the boys go back and forth to school. James (Grade 7) and Alexander (Grade 3) will be starting their new year of school in August.

The Charges levied against Captain (Dr.) Paul Thistle

The Charges levied against Captain (Dr.) Paul Thistle

▪                Not following strict Salvation Army protocols regarding donation remittance (there is no suggestion that moneys were not properly submitted to the SA)

▪                 

◦                                  Those accusing Thistle were also guilty of sidestepping protocol-SA regulation

◦                                   

▪                Not following CRA (Canada Revenue Agency) protocols regarding donations as it pertained to monies donated by IFHH and other Canadian donor groups

◦                                  Canadian officials were aware of the circumstances and did not voice or register any complaints

Disobeying orders from THQ and IHQ.

◦                                  This charge is not disputed. Dr. Thistle resisted attempts by Harare THQ to turn Howard Hospital into a for-profit private hospital, thereby maintaining affordable fees low for the very poor. He has also spoken out for the welfare of his staff, guaranteeing sustainable salaries and preventing Harare THQ from demanding arbitrary payments from HH employees. When he was dismissed, lower level employees’ salaries were cut by over 50%, salaries were late in coming, and employees were required to contribute to THQ SA meetings at Victoria Falls.

◦                                   

▪                Thistle was accused of being stubborn, arrogant and unable to get along with people

◦                                  This certainly wasn’t the opinion of those who he served and of those with whom he served, nor of those who gave their money, or time and talents to travel halfway around the world to volunteer at Howard Hospital. Unfortunately, most of those at THQ and IHQ had not met or worked with Thistle, and the critique leveled again Thistle seeking his removal was based solely on the opinion of those wishing to get rid of him.

◦                                   

▪                Not communicating with IHQ

◦                                  All correspondence with IHQ would go to Commissioner Makina’s desk first, making this accusation suspect.

◦                                   

▪                Being "too big for his boots" and "going too far"

◦                                  True, but not out of pride. Humbly, he presented the world with the needs of the poor, and put Howard on a good financial standing.

◦                                   

▪                Using outdated drugs and thereby endangering the lives of his patients

◦                                  A research conducted by the US Food and Drug administrator on behalf of the US military has shown that no danger existed, and that most drugs are still at ‘labeled potency’ even years past their expiry date.

◦                                   

◦                                   Harvard University reported that medical authorities state expired drugs are safe to administer, even those that expired years ago. It's true the effectiveness of a drug may decrease over time, but much of the original potency still remains even a decade subsequent to its expiration date. There are a few rare exceptions, such as tetracycline, nitroglycerin, insulin, and liquid antibiotics, but these drugs do not represent the drugs used by Howard Hospital.
Dr. Thistle said: “I would rather give an outdated but still potent drug than no drugs at all”.

◦                                   

◦                                  One of the containers of drugs bound for Howard was labeled "near expiry date" (it had been delayed) and did not reach the hospital, having been  "disposed of".

◦                                   

▪                Performing complex procedures which the Army could not afford to cover in case of a malpractice suit

◦                                  This was said to Dr. Silverman, who became very angry and replied that the Army would not have to be concerned with malpractice, as Paul was held in the highest regard by his peers both in Canada and Zimbabwe

Turning the hospital from its original "Primary Care" model to a surgical specialist unit

◦                                  This accusation is false on both counts. From the start, Howard Hospital tried to provide total care, including dental, surgical, orthopedic, obstetric, and eye surgery, utilizing the skills of visiting doctors. The first doctor at Howard, Jock Cook, prided himself in being able to provide total care, including complex surgery.

◦                                  Thistle has been at the forefront of preventive medicine, especially in HIV and TB, with the collaboration of the highly respected Dr. Silverman and universities in Canada. This support has mostly come to a halt since he left, including a mobile educational team with puppeteers that covered schools and beer halls.

◦                                   

▪                Attracting patients from all over Africa instead of concentrating on his own community

◦                                  This is true, and to be commended. These were high-paying patients, the income from which was used in providing care for the poor in the local communities

◦                                  .

▪                Thistle is white, and the hospital ‘should have black African leadership’.

▪                 

▪                That his pattern of leadership was neo-colonial.

◦                                  This is hardly true, as staff were free to run their own programs and make suggestions on how to improve hospital health provision services. All black African staff. Now they are all under tight Harare THQ control with no input requested from the HH staff.

THE HOWARD HOSPITAL, ZIMBABWE: Financial issues and Failures

The track record for the financial issues involving Howard Hospital is disturbing. Over the last 20 years, there are a number of recorded instances where monetary and material gifts from foreign donors were delayed, misappropriated, misspent, or simply vanished.

Reserve account monies in the name of Howard Hospital totaling approximately US$42,000 went missing in the 1990’s when Harare THQ changed banks. THQ held all Army accounts, including that of Howard Hospital. A review of the bottom line of all monies held by Harare THQ reflected no loss or shortages of monies ; however, the balance sheet for Howard Hospital was mysteriously short a full $42,000. This was waved off as a mistake in bookkeeping and presumably entered as a ‘correction’..

A new facility was planned to replace the old Howard facility, with construction to begin in 2000. The project was doomed to fail from the beginning. The Territorial Commander at the time, Commissioner Amos Makina, spear-headed the project. The architect engaged had no professional experience in the complex field of designing a hospital, and was incapable of designing one in the African bush and this was noted when Makina was finally persuaded to share the plans with Major (Dr.) Jim Watt the Chief Medical Officer. Not only was the design inadequate for the intended purpose, it was also under-funded at US$1million. A more realistic figure was 3.5 times that when inflation, and other on spot payments were included in the total.  The plans were re-worked to fill the requirements of a bush hospital and approval was given to begin the project. 

IHQ provided an officer to oversee the project and the accounting; Commissioner Makina stonewalled him and kept him from doing either. At the conclusion of building, the project ended up costing US$2million, twice the original estimate.

Sadly however, in the end, the new facility was deemed unfit for its intended use, by the Zimbabwe government. Having never been used, it sits there near the old facility, dilapidated and falling apart. A colossal waste of money.

Donations had a habit of being delayed or disappearing altogether. Consequently, on an ever increasing and demanding schedule Dr. Paul Thistle had to rely on direct donations to keep the hospital operational, with donations often hand-delivered by volunteers or handed directly to him at fundraising events he conducted in Canada during his furlough periods. The direct donations were deposited directly into the Howard Hospital operating account, bypassing the administrative fees assessed by the different Salvation Army HQs as a donation passed through the official donation chain.

The Salvation Army has a long-standing policy of assessing a 10% administrative fee for monies passed through its books in transit to other Salvation Army entities. Therefore, Army policy dictated that a donation submitted at a divisional HQ level would have to be assessed at a 10% fee prior to forwarding the remaining monies to territorial HQ. Then THQ could assess a 10% fee before passing it to IHQ; IHQ could assess a further 10% fee before passing it to the receiving territory, which would assess yet another 10% fee before depositing the remaining balance into the operating account of the destination entity.

In the case of Howard Hospital, Canadian DHQs often waived their assessment fee, as did Canada THQ. It is unknown if IHQ assessed a fee on transferred funds, although we have no reason to believe that they waived it. However, the assessment fee of 10%, and sometimes more, was levied on incoming donations into Harare THQ. There are first-hand accounts of Commissioner Chigariro requiring a 30% assessment fee against designated funds coming into Harare specifically earmarked for mission-based projects in Zimbabwe.

Dr. Thistle’s actions in obtaining direct donations and which bypassed the assessment channels could not be tolerated by Commissioner Chigariro, and she therefore terminated the volunteer medical professionals program, instituted by Thistle, and set about to engage a more pliable doctor as her man in charge of Howard.

Without his knowledge, various charges were brought up against Dr. Paul Thistle at IHQ until his reputation suffered causing a shadow of doubt on his credibility among IHQ and THQ officers. All this is in sharp contrast with the views of the Zimbabwe people at all levels, and fellow doctors and renowned surgeons who think very highly of him and celebrate his achievements. So when Chigariro asked for Dr. Thistle to be removed, the General consented (acquiesced to the demands of Chigariro and Makina) and tasked Commissioner Makina, International Secretary for Africa, and Chigariro to carry out the order, which they did in a vindictive manner that was negligent in not providing (even a year later) a replacement for his skills, nor assuring a continuity of the antiretroviral programs in place for those suffering with AIDS.

FSAOF (Names of contributors on file)

Army leaders Come and Go, But Integrity is Forever

Zimbabwe VP promises church leaders houses, farms

MASVINGO - Vice President Joice Mujuru has promised church leaders farms and houses if they ensure Zanu PF wins the forthcoming vote. Mujuru told church and cooperatives leaders at the Civic Centre last week that her party would allocate farms to leaders of indigenous churches, saying they were left out during the land reform programme.

“We know that church leaders, who are important to the nation and our party, did not get land when others were given,” Mujuru said. “So we want you to come and get it from us. “We will give you land because you are just like everyone else who should benefit from our programmes since we also rely on you.” She instructed Masvingo governor, Titus Maluleke, politiburo member Dzikamai Mavhaire and provincial administrator, Felix Chikovo to immediately allocate farms to the church leaders ahead of the polls. “I instruct our party leaders here who form the Lands Committee, Maluleke, Mavhaire and Chikovo the PA to immediately see to it that the men of cloth get land,” she said. Mujuru also promised church leaders houses. “We have read so many stories of church leaders refusing to leave church houses when their mission to lead the people is over,” Mujuru said. “This is because they do not have proper houses for their families as they spend most of their time preaching the word of God.

“Our party will see to it that they get nice houses for their families because it is because of them that President Robert Mugabe continues to rule this country.”

Mujuru later paraded Zanu PF candidates at the meeting and asked the people to vote for them and Mugabe.

________________________________________

Integrity in Zimbabwean politics isn’t talked about often, probably because it’s such a rare treasure, unlike the diamonds and gold reserves that prop up most of the wealth held by the country’s elite, including Mujuru. In that the current political maneuverings include the country’s Vice President, a Salvationist with the title of Senior Captain, one wonders if her desire for victory and control, no doubt fueled in part by her desire for the greatest good, doesn’t mirror an equally well meant end, but equally lacking true integrity that caused a SA travesty and tragedy. 

Many of the hundreds commenting on our many HH articles suggest that the HC are circling their wagons, bringing to mind the scenes in USA films featuring the fearless pioneers seeking a better life in the 'west'! 

The films' conclusions often result in a typical last ditch maneuver before the inevitable scalping! 

We live in a world where “the end justifies the means”, an all too common compromise that’s become an acceptable school of thought for far too many, including some in our beloved Army. Their actions, or lack of, has sullied our standard. Unfortunately, that momentary lack of integrity has come at an incredibly high price with far reaching consequences, including avoidable suffering and death. 

That compromising person looses their ability to be trusted as a person of integrity. Profit in policy or power is temporary, and word of one’s character generally surfaces in time and the value of the trust others have in you is far beyond anything that can be measured or ever regained.  A person’s lack of integrity – lack of credibility- will eventually catch up to them. It may not be today, and it may not be for several years, but you can rest assured that at some point there will always be a reckoning.

In the Army it means having a loyal group of fellow officers, a soldiership of more than a million, loyal to the core (corps) because they could never fathom that a SA leader could bring damage to their own or the SA’s reputation of sustained integrity.

Warren Buffet, Chairman and CEO of Berkshire Hathaway said it best when speaking to graduates at the Harvard Business School:, “In looking for people to hire, look for three qualities: integrity, intelligence, and energy.  And if they don’t have the first one, the other two will kill you.” 


A word of advice to those who are striving for a reputation of integrity:  Do not make excuses for your colleagues. Inevitably we become more and more like the people we surround ourselves with day to day. Do we want to follow a pattern of first enduring their failed behavior, then accepting their behavior, and finally adopting their behavior?

Do what is right, and the desired consequence will follow.  Army leaders will be elected, they will come, lead and go, but integrity is forever.

Sven Ljungholm
Former Officer
Liverpool

Did indifference lead to this humanitarian tragedy?

If the SA at IHQ level had acted immediately on the demands for Captain Paul Thistle's dismissal with integrity it is not unreasonable to believe that a win win result might have been worked out. Instead what we've been handed is a heart breaking situation for so many and on so many levels. 

It is not the intention of the FSAOF to see The Salvation Army brought down, we simply want to see integrity in our leadership.

If our series on the Howard Hospital prods the conscience of leaders one key purpose will have been realized. And, if it further brings justice and healing to the Thistles and the people in Chiweshi the prayers of hundreds of former officers will have been answered.

A retired SA leader with vast missionary service shared: "There will always be those who should not be in positions of authority and your reminders of integrity are well timed. Change comes slowly in an autocratic system. We may not be able to clean house but I pray that as we are at a critical time in our history that necessary changes will give God greater freedom to accomplish His purpose for what is a unique organization."

Dr. Sven Ljungholm

Presently on FSAOF mission trip in the Crimea, Ukraine

A humanitarian tragedy

Those of us in the Western and European countries give little thought to our health care costs. We accept it as routine that we can go to the doctor for care. Diagnostic tests, lab work, expanded medical and surgical services are typically covered. Even in catastrophic events, most people find a way to manage. It is usually the truly catastrophic events that hurt families financially.

In a developing country like Zimbabwe, the bar for financial ruin due to medical expenses is lower… much lower. A simple X-ray at a hospital in Harare could cost the equivalent of 4 months or more of salary, leaving nothing for food or shelter. 


Do you starve or do you have an X-ray?


But what has been ignored by the Salvation Army is that the abrupt removal and non-replacement of Captain (Dr.) Paul Thistle as CMO of Howard Hospital and the only bush surgeon in a rural area has done more than just cause families who live on $1 a day to suffer financially; it has caused a tragedy.

People are dying because the Salvation Army was and continues to be negligent in removing Dr. Thistle without anyone to step into his shoes. According to Major Dean Pallant (IHQ) in his press release of October 26, 2012, the move of Thistle had been under discussion for 2 years. How can a Christian organization spend two years discussing the move of a critically-needed surgeon, and then rip him out of the fabric of the Chiweshean residents’ lives and not have someone ready to fill in immediately? This is negligence and apathy of the highest order.

Many in Chiweshe are dying because surgeries that had been scheduled weeks and months ahead of time were cancelled the minute Dr. Thistle was evicted from Howard Hospital. Whatever the need that required the surgery, they still suffer with to this day.

Patients that the Howard cannot treat, including surgical cases (a "surgeon" was appointed but will not be performing surgeries),  are referred to central hospitals.  On arrival, if they cannot pay the extremely high fees, often several thousand dollars, they are placed on a waiting list until they can.  


Many have died in town, according to relatives.  

This is the main reason there are so few patients coming to Howard Hospital – fear of referral to a central hospital in Harare and of financial ruin for the family.


You have already read the account of the first known death placed at the feet of  the Salvation Army for the removal of Dr. Thistle.  We have received another account of how a man with burns was to be transferred for skin grafts, but he discharged himself and went home to die a (likely) slow, painful death from infection. 


How many more are suffering? How many more have died? How many more will die because they have no longer have access to life-saving medical care?


Major (Dr.) James Watt (R) still has a heart for the Howard Hospital where he served for so long as Chief Medical Officer. This tragedy prompted Watt to speak out. 

According to a statement from him, “I wrote the General at the time (August 15, 2012) warning her that this would result in deaths, with consequences bordering on the criminal, but she refused to inquire into the veracity of what she had been told by the International Secretary for Africa.” Later on, after hearing of the sufferings and deaths because of Thistle’s dismissal, he proposed a solution on how to get those with a medical or surgical need the help they so desperately needed. 

His solution was for the Salvation Army  to arrange the transfer of patients to Karanda Hospital (Dr. Thistle’s new place of service), where the poor are taken care of without the ruinously high fees associated with central hospitals.  He shared the proposed solution with Canada THQ and directly to Major Dean Pallant of IHQ. Neither HQ responded to nor even acknowledged this solution.

Watt also gave this first-hand account: “I have seen a letter from the office of the IS (International Secretary for Africa) telling Paul to forget about his patients, forget about his nurses, "they are in God's hands now," something his medical ethics, let alone Christian ethics, would not allow him to do. It was an illegal and unethical order, and refusing to obey it cost him his officership.”


The heartbreaking tragedy of this situation affected the Thistles also. A statement he made was shared with the Former Salvation Army Officers Fellowship group who have been following this issue:

“Pedrinah and I remain deeply disappointed, that in official correspondence from IHQ, and in official Salvation Army press releases, no one ever wondered if people might be suffering. When you abruptly reduce the physician staff from 3 to 2 including removal of the only surgeon, it doesn’t take a rocket scientist or any health care experience to deduce that people will suffer. Surgeries booked weeks and month in advance were cancelled.

When you receive phone calls from relatives stating that their mother or sister has died for lack of medical care at Howard, it is devastating. The people, poor and disempowered, have had a basic human right withdrawn over a ‘routine transfer’ without stated reason. There has been no hint of an apology from the Salvation Army and very little has changed on the ground since August 2012 in regards to the delivery of health care services.”


THE FSAOF

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  selmoscow@aol.com  marked HH REPORT

The report is a compilation of reports, private and public, written by former SA officers.