when Lizette entered the small tea room for a cup of tea. Her speech was back when she said that she was amazed how fast things were changing what was unforeseeable one week ago. I agreed and tried to explain the situation with the people who had suffered under the segregation by putting them down to beings without the basic human rights, and under the war situation so much. Lizette asked with great concern regarding the future: “Do you think the blacks will do it better?”
It was a question where the answer was hardly to predict. I said: “One should hope, but more worse like now is impossible. The people are tired and sick, many have lost their relatives or lay poor and broken in front of their huts or are deceased by starvation, sickness and maltreatment. A generation will pass before the wounds can heal.” Features of great concern was on her face. It was readable from her moving eyes that Lizette did not trust the blacks, if they come to power. “The colour will change, but the blacks will do nothing better for the people when they come to power”, she said. She saw black in the future before the black future with the black crew has begun. She saw even more black than I could imagine who had the sandy tones with the various grey shades in mind where biracial children with beautiful faces were put from a certain dark tone onwards and despite their intelligence and charm behind colour bars to a life of desperation and privation. Dr Lizette was white, but of an African origin that I was not.
We went back to theatre 2 for the amputation of the right foot on an old and emaciated woman. All five toes of the foot were dead and dried up. The operation was the below-knee amputation and it was clear to everybody around the operating table that the old woman would never walk again. I put the dressing on and a bandage around the leg stump and wished the old woman a merciful death which had grasped already her right foot. The ‘body-light’ patient was lifted on the trolley and brought to the recovery room. Dr Lizette told that she had given only little of nitrogen monoxide [laughing gas] and more of oxygen. She was relieved that the patient had survived the operation.
I thanked Dr Lizette and the nurses for the teamwork and left the theatre room. I changed the clothes in the dressing room and left the theatre building for the outpatient department where the Philippine colleague was working on the patients in consulting room 4. I took my seat at the table. A mother had a small girl on her knees with the skin-connected fingers on both hands [syndactyly]. I remembered the girl when I had seen her the first time what was six months ago. The nun doctor Maria Gottfried from the Catholic mission hospital in Oshikuku had referred the girl with the question, if I could help. I explained the kind of operation to the mother and told that I would start on the right hand, while the operation on the left hand should be done some months later. I admitted the girl and the mother thanked and carried the girl on her back to the orthopaedic children’s ward with the admission form in her right hand.
The Philippine colleague showed the X-rays of an old man who complained of pain in both knees due to an advanced arthrosis and asked what could be done. I explained that a stiffening operation [ankylosis] of the knees would be indicated, since a knee prosthesis for the poor people was unthinkable and also technically at Oshakati hospital impossible. The old man said that he will think about it. He stood up with the health passport in his hand and the grinding sounds in his knees and left the consulting room for the dispensary to collect a small plastic bag with the prescribed anti-inflammatory pills. Some casts were removed and others applied after fracture reduction in the plaster room, and wounds were treated in the casualty theatre room. The half of the benches were cleared up when the colleagues made a break for lunch that the Philippine colleague was to take with his family.
Dr Nestor took a seat at the dining table. Both struggled cutting the meat with the blunt knives. Nestor spoke of the new surgeon and asked me, if I have met this doctor. I told that the paediatrician had introduced me to the new doctor when I had left the theatre. We shook hands and called our names when the paediatrician said that this is the new surgeon. It was all and the two doctors continued their conversation. The meeting lasted two minutes. Nestor stopped chewing and asked with a face of regret, if that was all. I said yes. We spoke like friends when Nestor said that this behaviour was inappropriate. He mentioned that the new colleague was a hard worker who does a great work at the Lutheran mission hospital in Onandjokwe. He said that he will speak to the colleague. I asked, if the new colleague had some knowledge in orthopaedics that we could rotate on a yearly basis from surgery to orthopaedics and vice versa that I as a surgeon could keep up my surgical skills.
I had done orthopaedics with respect to the request of doing bone surgery on the many patients and injured. Nestor understood the point, but he couldn’t answer the question regarding the orthopaedic skills of the new colleague. He said that he will speak about this point with him. The superintendent came back to the advertisement which was sent to Germany. He said, if German doctors would react positively then the shortage of doctors at the hospital could be solved and the hospital could be run more smoothly. I was convinced that German doctors would respond to the advertisement, since West Germany had a glut of doctors that graduates were waiting for a place as houseman in a hospital or for a postgraduate training in an academic hospital or for a place in a joint practice.
The difference between the north and the south could not be bigger: north of the Mediterranean, the doctors stood in long rows waiting for work under the optimal working conditions with up-to-date technical equipment, and south of the Mediterranean, the patients stood in long rows waiting to be seen and treated by the few doctors working under poor conditions with the defective and outdated technical equipment. In other words: the north was rich and had an abundance of doctors in relation to the small number of patients, and the south was poor and had only the few doctors in relation to the huge number of patients.
We left the dining room and parted in front of the secretary’s office. Dr Nestor as the new superintendent entered the office and closed the door of the secretary’s office. I took the way on the small concrete passage to consulting room 4 to continue the work on the waiting outpatients. An old man sat on the chair with a broken wrist confirmed by the X-ray. I put the man on the couch in the plaster room, gave the injection for local anaesthesia and reduced and immobilized the wrist with a padded cast. When the cast had dried up I cut the cast in length on the dorsal aspect with the oscillating saw to prevent the compression on the blood circulation by swelling of the soft tissue what causes a nerve and muscle damage leading to the clawhand [Sudeck disease] with permanent stiffening of the fingers. Forearm with cast were hung into a neck-arm sling as a holding support. Treatment and pain killers were noted in the health passport. The old man thanked for the help and left with the instructions the plaster room for the dispensary to get the medicine prescribed. I took the X-rays from the windowpane and put them into the bag and removed the plaster from hands and forearms in the bucket with water and went back to the consulting room and put the bag with the X-rays on the pile of the other X-ray bags.
The Philippine colleague had problems to reduce a dislocated shoulder, since he didn’t follow properly the second step of Kocher’s rotation manouvre with the outside rotation of the right-angled flexed arm. I helped the colleague that the humerus head jumped back into the shoulder socket [glenoid cavity]. A circa ten-year-old girl sat on the chair with a right swollen upper arm. There were signs of inflammation and the girl complained of pain by pressure. The girl told that she had fallen some weeks ago and had bumped the arm against a stone, but there were no marks of contusion or abrasions. I filled in the X-ray form and sent the girl for radiography. She came back after circa half an hour and sat on the chair. The bag with the X-rays lay on the table when I came from the plaster room with spatters on the clothes, sandals and rhe feet. I pulled the radiographs out of the bag and looked at them, while the girl looked at me as an innocent child.
I got shocked and felt sad and looked long and pensively at the X-rays without saying a word. The Philippine colleague asked me, if I was not feeling well. I did not respond by speech, but handed the X-rays over the table to the colleague who looked at them and returned the X-rays speechlessly. I had the problem to explain to the girl what I saw on the radiographs, while I looked at them again. I asked the girl for her mother. The girl said that she
