Kenya & Uganda
Kendu Hospital, near Kendu Bay is on the Kavirondo Gulf of Lake Victoria, in Kenya.
We were assigned the "Old house" which had been built by Pr. F. H Thomas. It was a lovely old building, of the "colonial" type, with many large rooms and verandahs on three sides. This made it cool during the day. One room was set aside as a schoolroom for the children.
I replaced Dr Calkins who returned to the U S before we arrived. The other doctor was Alan Peripelitza, who later became a plastic surgeon, and shortened his name to Dr Al Perry. Before we arrived, we were offered the option of Dr Calkin’s half share in a milk cow, named Essa. During the week, the "garden boy" as he was called, would milk Essa and deliver the milk to the two doctors’ houses, but on Sabbath Dr Al and I took turns to do the milking. One Sabbath morning, I decided to do the milking while still in my pyjamas and dressing gown. This change of routine must have upset Essa, as she took off, at a gallop, down the road to the hospital, with me in hot pursuit. I can’t recall how I managed to get her back to her stall and milked, but do remember that I was highly embarrassed.
As is common with mission hospitals, we had several clinics that we had to visit regularly. We dreaded having to go to those in the Kisi area when it had been raining, as the roads were covered in red Kisi clay and vehicles were liable to get stuck.
Details of the operations we did and the patients treated tend to blur together after these years, but one does remember some of the more dramatic cases.
There was one case of a woman of the Luo tribe who had been stabbed In an inter-family feud and was brought to the hospital in a very poor condition. Dr Perry did emergency surgery, while I gave the anaesthetic. Unfortunately, but not surprisingly, the patient died. When the relatives, who were waiting outside, were told of her death, they tried to storm into the operating room to collect her body. We had to lock the doors and were virtually hostages, for several hours, until the police came to take the body away for post-mortem examination.
After about a year, we were asked to move again, this time to Uganda, where I would replace Dr Bill Taylor at Ankole Mission Hospital. It was built on the side of a hill and the doctor’s house (only one doctor) was on the top of the hill, with wonderful views in all directions. On a clear day one could see the volcanoes in the Congo to the west and the Ruwenzoris (popularly called the "Mountains of the Moon") to the north.
The eastern part of Ankole district was famous for its long-horned Ankole cattle, while the western region was very fertile and had some large tea plantations. The staple diet was "matoke" which consisted of cooked green bananas and had a bland flavour, like tapioca. It was eaten with a sauce, prepared from groundnuts for everyday use, but with meat for special occasions. Every little village had its matoke plantation and patch of groundnuts, so that the people were largely self-sufficient for food.
During my time there, we changed the hospital’s name to Ishaka Hospital, as we did not serve the whole of the Ankole district and Ishaka was the name of the village at the bottom of the hill.
Being the only doctor at the hospital presented many problems. Operations had to be done under local or spinal anaesthesia or one of the sisters would give the "general anaesthetic." This was usually ether, given on an open mask, or via a vaporiser, that looked like a pressure cooker. This type of vaporiser was a modern invention then but would only be found in a medical museum today.
As it was necessary for me to be away for clinics, shopping trips and holidays, and since we had many complicated deliveries, I taught the nursing sisters to do vacuum extractions and forceps deliveries. If that was unsuccessful, the patient would have to be taken to Mbarara hospital , about 40 miles away; or would wait for my return.
Most normal deliveries were done at home by the village midwives; we only got the difficult ones – often when it was too late to save the baby. The midwives used a potent herbal remedy which stimulated uterine contractions. This must have helped in many cases, but if the delivery was obstructed so that the baby could not be born, the medication could cause the uterus to rupture, with severe internal bleeding. During the two years I was at Ishaka we had ten cases of uterine rupture, in eight of which we were able to save the mother’s life, sometimes by obtaining blood for transfusion from relatives and once by taking the blood from the abdominal cavity, straining out the clots and then returning it to the patient intravenously.
An interesting episode occurred one day in the operating room. We had a young man from Rwanda, called Samwele, who knew Swahili but very little English, who was helping in the operating theatre (O R). Here I must explain that the Swahili word for "bring" is "leta". Also that occasionally a domestic fly would slip into the OR when someone went in or out and so we had a can of fly spray to deal with the intruder.
On this day, while operating, I spotted a fly in the room and so I called out, "Samwele, Leta spray! Leta spray!" Looking very puzzled, Samwele put his hands together, bowed his head and closed his eyes. We all had a good laugh, glad that it wasn’t that serious!