We lecture (on HIV), inspect facilities, discuss projects, are entertained hospitably. It calms our anxieties but must eat into the 0.27% of British GNP devoted to overseas aid. My Department For International Development (DFID) co-consultant and I are met at the airport of another sub-Saharan African country by a convoy of armoured landrovers. The unfortunate patient who died with bilateral subdural haematomas as a result of a myelogram even furnished a brief report to the effect of the dangers of this investigation.īut you, poor Tanzanian child, though I shrive you to the page, the horror of your immense iatrogenic suffering will not be exorcised.įifteen years later, I have become a “Bwana Kubwa” myself. After her three days of constipated torment, never again did the inexperienced SHO neglect that unpleasant final PR examination on the labour ward! Others' suffering was put to a different use. Some victims even forgave me themselves like the good natured woman whose rectum my episiotomy repair suture encircled.
When hail fellow folk cajole me upon the faux pas of my career, I can usually keep my sense of humour the remembrance of other unhappy cases have mostly been laid to rest. He recovered well postoperatively but if he survives today, he must be an accomplished beggar, I imagine. Just to fetch water they will often have to walk five or six miles each day. Life is hard enough for the Makonde even with both legs. Bed occupancy was no problem, extras just joined the other outliers on the floor once all the available bed space had been filled.īut this change was too late to help that boy. This patient changed my practice thereafter I would insist upon admitting all such fracture cases for 24–48 hours after applying the plaster of paris to make sure that the circulation was not compromised during the early phase of tissue swelling. A grisly amputation in a fetid theatre was the only therapeutic option. Beneath the discoloured plaster, no living tissue remained. The stench was terrible even by the extremes commonly encountered in such contexts. Only as I started to inch back the plaster bit by bit with the simple tools that were all we had, and despite his spartan heroism, the boy could not hold back his cries of agony, did the awful result of my intervention become plain. OK, so the toes certainly were a bit cold-especially for a hot day-and a bit black even for the Makonde race. His quite incredible and quite characteristic bravery at first misled me as to the graveness of his case. When the boy's father brought him back some 10 days later, I honestly could not remember what I had said to them after putting on that plaster. There were crocodile bites and obstructed labours and cerebral malarias and all the glorious panoply of doctoring in the bush. If I said something as simple as: “Rudi kama inauma” (come back if it hurts), the meaning should have come across. It was by no means the first above knee plaster of paris that I had applied to a young boy suffering the occupational accident of falling from a mango tree. In their air conditioned vehicles they seemed out of touch. Once I found they had negligently discarded imported food into Shimo la Mungu. Above majestic eagles soar and disport.įifteen years ago I was working for a voluntary organisation in a local government hospital, I slightly despised the “Bwana Kubwa” who occasionally passed by on various safaris. The air is cleaved by squadrons of sleek, needle tailed, amazingly aerobatic varieties of hirudines hawking myriad clouds of butterflies and other insects. Miombo woods of exquisite horticultural beauty clothe the escarpment which is too steep to allow browsing herds or woodcutters. Its clear, unpolluted air yields views of hundreds of miles to the next kopje. “God's Hollow” at the edge of Tanzania's Makonde Plateau is right up there when it comes to natural beauty spots.
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