The black superintendent understood the metaphor and got a smile what I interpreted as a smile of hope. He said that the time is overdue and he put his trust in the power of the united nations to bring the system of injustice and segregation definitely to an end. The picture of the two black specialists whirred through my mind who were talking to each other apparently on important future-related topics that they gave me not more than two minutes to greet the new colleague.
Dr Nestor and I left the tea room and went to theatre 2 and put the injured with the missing right forearm and the missing left leg from the trolley on the operating table. The lab assistant brought five bags of blood and Dr Nestor connected two bags for simultaneous transfusion to the injured. The operation consisted of ligation of the big vessels and of shortening of the big limb nerves and the long bone stumps which had to be covered with skin-muscle flaps. The flaps were prepared and kept in place by stitches. The wounds were dressed and bandaged over the stumps. The patient was carried to the recovery room where the first patient was still under observation with the oxygen mask on his face. The third injured needed plastic-reconstructive surgery on his torn face with the missing left ear. It was impossible to save the left eye. The metal had torn the lens and iris in pieces and stuck deep in the vitreous body [transparent jelly-like tissue filling the eyeball behind the lens].
The reconstruction of the eyelids took long, since the left inner eyelid corner [canthus] was torn up to the lacrimal point. Of the lost ear some skin-cartilage debris were left that I shaped a kind of ear which had less than half the size of the normal ear. The tip of the nose and the cartilage part of the nasal bridge were missing what made the reconstruction extremely difficult. The defect got covered by a rotation flap from the right cheek and the nose became flat with an angle at the end of the bony part of the nasal bridge. There were defects on the torn lips which were closed by shifting parts of the lips after mobilization. The operation lasted more than four hours and more operations were still needed on the face to a later stage. It was quarter past five when we left the theatre. I did not think of sleep and went under the shower in the dressing room where the first rays of the sunrise came through the window. I dried the skin and put on my civilian clothes. I went to the tea room and boiled water for a strong tea when I put two tea bags in the cup. Nestor had not fully recovered from the shock. He went home for a short rest and refreshment.
It was one of the sleepless nights of which there were so many to get through regardless of the physical and mental conditions. The workload was heavy, but the work had to be done. Fingers on both hands were dressed because of pressure sores, excoriations and cracks on the skin by frequent handwashings and the use of defective instruments in the huge number of operations. I left the theatre tea room to start the ward rounds earlier and looked after the operated patients in the intensive care unit. Two of the three patients of the night were in critical conditions with low blood pressure and high pulse rates. On the first patient with the prolapse of the intestinal bowel where some injured loops were resected and an anastomosis was done, the two abdominal drains produced blood in smaller amounts. The dressings on the shortened stumps of the second patient who lost his right forearm and his left leg, were bloody that new bandages were put on. New bags of blood were ordered from the lab in consideration of the possibility that all blood units were used during the operation and no more blood was available.
The face of the third patient after plastic-reconstructive surgery due to the extensive injury was widely covered with the head dressing except the right eye and the mouth with the reconstructed lips that were swollen. The circulatory system was stable and the patient was on infusion drip. Antibiotics were ordered for all three patients. The intensive care unit was overcrowded that those patients in stable condition were transferred to the general wards. I looked after the old man with the inoperable colon cancer in the surgical ward. The old man breathed with the longer intervals in between and was about to bring his life to an end.
I went to the female ward where the old woman after the above-knee amputation due to the femur malignancy showed a strong will to live. She waited for her discharge as early as possible to support morally her daughter with the two small grandchildren. The leg stump of the old woman looked satisfactory that I discharged the patient earlier after putting on a new dressing and bandage. I gave the necessary instructions which were translated by the nurse and agreed by the patient. I understood that the human aspect played the major role in the decision of the old woman.
The other old and emaciated woman after the below-knee amputation due to the forefoot gangrene had the great problem to find the inner peace. She told that she did not know to cope with her life, since she had nobody who would look after her. She had two sons and both had left her. One son was a worker in a South African mine and where the other son was, the old woman could not say. I felt the predicament and plight in which this old woman was and I knew that the words of sympathy I gave to the patient could not improve her hopeless situation.
The nurses told that the huge detonation had smashed some windowpanes. I went to the children’s ward where some children ran around in the bedrooms and the corridor. The nurse showed me the admission of the previous day which was the small girl with the skin-connected long fingers on both hands. The girl was on the operating list for separating the fingers on her right hand. The detonation had also smashed windowpanes in the children’s ward. The nurse said that some beds had moved over the place and the children were deeply shocked that they sat up and screamed of fear. I understood the great concern, but what could I say to calm down the agitation? What I said was that I would report on the broken windows in the morning meeting.
It was time for the meeting and I set off for the superintendent’s office. Dr Nestor sat behind the large desk and made some notes. The lean white matron with the pale face and her black deputy had taken their usual seats straight opposite to the superintendent’s desk. Colleagues entered the room in small crowds together with the pharmacist ladies. The pharmacist husband in charge of the medical store arrived later. The last was the black paediatrician who passed the room with the right hand deep in his trouser pocket. He took a seat on an upholstered chair at the window front under the rattling air conditioners and crossed the right leg over his left. His eyes focused something in the far distance and on the ceiling. The Philippine colleagues sat side by side showing that they belonged together. The two anaesthetic ladies also sat together and had a chat.
Dr Ruth and I sat on the hard chairs opposite to the window front. The fright from the detonation of the previous evening was still readable on the faces of all participants. Dr Nestor opened the meeting by saying that the hospital was not hit. He expressed his hope that the hospital would be spared in future as well, since a blow by a shell would be catastrophic. The white matron said that the impact of the shell was only some hundred metres from the hospital. She proposed that the superintendent should get in contact with Swapo to explain the critical situation for the hospital. “They should know about the consequences it would have for our patients. If the life of our patients is at risk, a way of communication must be found before it is too late”, the matron argued and her point was taken by the superintendent who made a note.
The black paediatrician took the word, though he had nothing substantial to say in regard to the seriousness of the hospital situation when he mentioned the problems with the military authority which would consider such a contact as a hostile act. The white matron disagreed. She said that the life of the patients had to be regarded as the top priority. Everything else has to come afterwards. It was again her unbroken commitment and dedication to the innocent and helpless patients in regard to their safety, while the paediatrician crossed the left leg over his right leg and stared into the space beneath the ceiling. Both, matron and paediatrician were farsighted, but the farsightedness of the matron was exclusively directed toward the hospital and the welfare of the patients.
The spark had jumped over and the superintendent thanked the matron for her suggestion which he liked to discuss with the medical director. Everyone did imagine that such a contact was like a tight-rope walk with the risk of a crash. The superintendent asked for comments. I agreed with the matron’s proposal and said, one cannot be silent if the life of innocent people is at