Nestor opened the second button under the collar. He had understood that he had to meet the decision and to carry the heavy burden of responsibility without the moral support of his black colleagues as he had possibly expected. The superintendent had a serious face by taking the burden. The faces of the participants looked into other directions or as the paediatrician at the ceiling in exactly that moment when the eyes of the superintendent were to meet the eyes of this particular colleague. Nestor did not leave the subject. He asked if the detonation had caused any damages. Nobody responded that I reported on the broken windowpanes in the outpatient department and in the wards. I said that broken glasses could endanger the children in particular. The superintendent made a note and said that he will look that the broken glasses get replaced as soon as possible.
He informed the forum of his telephonic conversation he had with the central medical store in Windhoek to get an explanation for the delay of the delivery of the ordered drugs. The reason as was told was the delay of transport from South Africa, but in the meantime the drugs had arrived and the orders were packed and ready to be collected that the hospital bus could take the drugs in the course of the week. The superintendent said that he had informed the bus driver to collect the drugs from the central medical store. The other important point was that Dr Nestor had contacted the secretary of the administration because of the unacceptable toilet situation at the hospital. The secretary had promised to send people from the works department within the next days to bring the toilets in order.
The white matron praised the efforts of the superintendent in regard to the stinking toilet facilities when the black matron supported her with pulling her grimaces of disgust. Finally, the superintendent mentioned the operations on the three seriously injured in the night and praised my hard work and skills. He said that my commitment does not know a word of complaint. Nestor closed the meeting with the words: “I wish you a good day.”
The paediatrician stalked with the face of great importance and his right hand in the trouser pocket through the room and left as the first the superintendent’s office followed by the other colleagues and the pharmacists. I changed some words with Dr Nestor and made some encouraging remarks. Nestor thanked for this kind of support with a smile. “You should know that you are not standing alone.” With these words of confirming my support, I left the office and closed the door.
I changed the clothes in the dressing room and thanked Lizette in the tea room who put a cup of tea for me on the pen-scribbled wooden plate of the small club table. She said that the detonation had caused such a fright that she had nearly fallen out of the bed. Her husband had wondered that the house was still standing and not damaged. The impact was not far from the military camp. “We had luck once again”, I replied and Lizette drew the hypothetical conclusion that things could otherwise go wrong. She asked about the injured and I mentioned the details about the injuries and operations. Lizette called the word ‘disgusting’ and asked which kind of life one can expect after one of these injuries. She answered her question that there would be no future with joy and dignity.
Dr Lizette confessed that she had learnt the fear in Oshakati, since she had not the right imagination of the war reality in the north that she could not get in South Africa. If her parents were informed of the reality in the north, they would have said no, you should not go to Oshakati. I brought a point that there are advantages as well, if one does not know everything or the full story. Lizette understood and put a charming smile on the point.
We went to theatre 2 for the operation on the girl with the skin-connected long fingers on her hands [syndactyly]. Lizette put the girl into sleep and the instumenting nurse cleaned the right hand and forearm of the girl with the brown disinfectant solution and covered the rest of her body with sterile green sheets. The skin incisions were done in a zigzag pattern with preparing small skin flaps from the hand dorsum for covering the skin defects in the interdigital folds. The fingers were separated and the skin defects on the lateral finger aspects were covered with multiple small zigzag triangular flaps and the rest with small pieces of full-thickness skin grafts which were taken from the flexor side of the right forearm. I appreciated this kind of surgery with the plactic-reconstructive challenge to improve function and aesthetics of the hand. It was a long operation due to the particular challenge which required patience and skills from the surgeon. The fingers were dressed and the hand got bandaged in fist position. The operation took two hours.
Lizette praised the art work during the small tea break. She asked after the outcome of these operations and I was able to give good news. In the same break Lizette mentioned the young colleague and writer of the story of the forbidden love of the racially mixed couple. She said that this colleague was an interesting person what I fully agreed with and called him an extraordinary person in terms of commitment and gift, since this colleague was devoted to his work as a medical doctor who critically reflected on the burning points of apartheid. “He had put his finger on the small-mindedness of the ruling system. If this colleague keeps up his strength of protest and got his fingers not broken that points on the evil of the moral seediness, we can expect something extraordinary from him.” Lizette said that she spoke with her husband about the colleague who regretted of not having met this doctor.
“How is your husband?”, I asked. “He comes back quite often exhausted. Then he sits in the armchair and is sunken in the world of thoughts”, Lizette answered. I had no problem to imagine the psychologist sunken in his thoughts, because it was psychologically a dubious enterprise to encourage young soldiers without experience to shoot human beings dead, if the young soldier was of a higher level of education and had the pensive character with the fine sense regarding life and its values including the Commandments. Lizette and I had faces of concern about the madness of killings what was against human reason and reasonableness, and an arrogant imposition against the clear conscience. The blades of purpose and reservation did not pair to one scissors where the problem stood between the gaping blades with the axiomatic antagonism of sharpness and cutting properties. The gap between those blades was psychologically not to fill and to close in the understanding of the common sense and in such stronger terms irreconcilable with the human conscience.
I left the tea room to continue with the operations. A young man lay on the operating table with a ruptured left shoulder edge joint and the stand-out position of the lateral end of the collarbone. The anatomic disorder was called ‘the piano key phenomenon’ when the lateral end of the collarbone should be pushed down to get its anatomic position, but came up again when the pushing finger was taken off. After a curved skin incision, the shoulder edge joint were exposed and the lateral end of the collarbone were pushed down into anatomic position and fixed in this position with two wires inserted from the lateral aspect through the shoulder blade spine into the collarbone. The bones were tightened together by the tension wiring in the figure-of-eight shape.
The correction osteotomy [bone cut and internal fixation] on the thigh bone of a fourteen-year-old boy was the next operation. The shaft fracture had healed with a malalignment in valgus position [kink with outward deviation of the leg]. Therefore, the bone shaft was cut through the kink with the oscillating saw and the shaft parts were brought in anatomic alignment and stabilized by a long nail put into the medullary cavity. The layers of the soft tissue were closed with sutures. A dressing and bandage has finished the operation.
Humane psychology versus war psychology
Dr Lizette said during the tea break, while the nurses cleaned the theatre room that her husband would not do long this work with the war psychology, because the demands were simply too high which exceeded the normal physical and mental capacity by far. “What is normal in a war?”, I asked and said: “Also we doctors are over-challenged and over-burdened, but war does not care about human issues and needs, because war is the destroyer of civilization and mankind. War is