On-line version ISSN 2078-5135
SAMJ, S. Afr. med. j. vol.100 n.10 Cape Town Oct. 2010
KwaBaka. A story of compassionate care in a rural Zulu community
By Jon Larsen. Pp. xiv + 274. Illustrated. R125.00. Cluster Publications. 2010. ISBN 9781 875 5053 83 4.
KwaBaka - the story of the planting of the Charles Johnson Memorial Hospital and the remarkable caring community that grew around it.
In 1890 Charles and Margaret Johnson started a mission station at Masotsheni in Zululand, where, in 1889, the people had been involved on both sides of the battle of Isandlwana. Charles and Mary raised 10 children and remained at Masotsheni during the Boer War in 1897 and the Bambatha Rebellion in 1906. Charles died in 1927 and Margaret in 1930, leaving behind over 40 church buildings, many junior schools and a high school at Masotsheni.
In 1935 William Lee, the Bishop, bought a trading store building in the nearby town of Nqutu, recruited 10 nurses and Dr Bessarabia, the district surgeon who was to visit once a week, and called it the Charles Johnson Memorial Hospital. In 1945 Drs Anthony and Maggie Barker arrived to help the first full-time doctor at the hospital, Anne Borrow, who left soon afterwards.
The Barkers lived in the community, got to know the people and took a personal interest in each patient. They never bought a motor vehicle but bicycled around the area. Anthony grew a beard because the Zulus thought he looked too young to be a doctor, and became known as Mahlekelanthi - he who laughs in the forest. Maggie became known as Mabhadazela - she who never wears shoes. Anthony passed the higher Zulu language examination, obtained an MD from Wits on malignant malnutrition and passed the FRCS. Maggie became a skilled anaesthetist. They were very hospitable even though they were living in simple circumstances.
Because of the excellent care and teaching, the hospital attracted patients, students and visitors from far and wide. Regular contact with King Edward VIII Hospital's specialists included Professor Hugh Philpott, then a senior registrar in O&G, Professor Chapman - surgery, and Professor Barry Adams - internal medicine. Famous visitors included Oliver Tambo, Alan Paton, Gatsha Buthelezi, and the Archbishop of Canterbury. When, during apartheid, many black people were removed from white areas and settled in tent camps nearby, typhoid broke out. A visiting BBC television crew made a documentary called 'Dumping grounds', resulting in the hospital being visited by the security police.
Many nurses continued to work at the Hospital, although they were paid 25% less than at State hospitals. Chloe Zulu, the first Zulu matron, describes how ....'We all played together. Whether you were black or white, you were getting the same treatment. That made us stay. The chapel services and morning prayers were central to our lives. My greatest joy was to see patients treated in a holistic and human way. That was so different from Baragwanath.' The State subsidy for doctors' salaries was shared equally between doctors classified into different population groups.
Dr Jon Larsen grew up in Zululand and heard Anthony speak while at UCT Medical School. He and his wife Jackie joined the staff of the Charles Johnson Memorial Hospital in 1965. Jon took over as medical superintendent when the Barkers left in 1974. By means of stories, extracts from letters and pieces written by people involved at the hospital, Jon gives a real feeling of the living and working at Charlie J. One senses that the book is a labour of love. Jon left in 1977 to complete his specialisation in O&G. He helped to set up an excellent regional obstetric service for Zululand, which resulted in a marked drop in perinatal and maternal mortality rates. On the take-over of Charlie J by the KwaZulu-Natal government he notes with gratitude the support from Darryl Hackland, then a senior official in the KwaZulu Health Department. There are accounts from the medical superintendents who succeeded him - Greg Wells, Kevin McDonald and Richard Garratt. Richard graphically depicts the community violence between factions of the ANC and Inkatha that preceded the 1994 democratic elections.
The hospital has recently been beautifully rebuilt and the staff and community are justly proud of it. The staff in 2006 included Chief Executive Officer, Mr E M Xaba, who started as a personnel officer and served the hospital with distinction for over 20 years; Mr Khambule, Finance and Systems Manager; Dr Olfemi Dopeolu, Medical Services Manager; and Mrs M Z Khanyile, Nursing Services Manager. The nursing school campus is part of the University of KwaZulu-Natal. The hospital has received many awards and the vision of a health service in Nqutu fully managed by the Zulu people has been achieved.
The author poignantly describes his disappointment at the decision to disband the regional obstetric service, resulting in a marked deterioration in the perinatal and maternal mortality rates. Noting his own temptation to bitterness and resentment he then writes, 'If I can acknowledge that I am as vulnerable as the next man to become an oppressor - that often indeed, in the insensitivity of privilege, I have been the oppressor - then I can more easily walk in forgiveness and relinquish what I have striven for with great intensity, when it is taken from me. I can more easily give thanks for what has been achieved, for those lives touched with compassion, even when the opportunity for service is no more. I can more easily do what Bishop Zulu advised at that final mission hospital prizegiving and remember that I am called to serve the Lord and people, not the ideologies of governments.'
The Charles Johnson Memorial Hospital begun as, and continues to be, a beacon of light and hope in difficult times. It is a story that was worth recording and reading, and worth reading slowly.
Dr Neil Cameron