“It is a disgrace that we cannot help this old man ”, I thought when I saw how difficult the man was walking. Patients came every day to the hospital with joint pain with or without effusion [hydarthrosis] due to the degenerative alterations with the advanced signs of wear. It were the old people who have worked so hard through their lives of privation. It was a hard message given to them after the X-rays were seen that they have to live with their worn joints by taking drugs against the pain. It was the discrepancy between the rich and the poor that for the poors the adequate treatment was not available, while the rich had the better life without pain. This gave me many times a headache. The old man with the painful hip disorder of restricted mobility walked with great difficulties with his thin and worked-up hands on the long stick in front. He had understood the situation as most of the old people did. It was the wisdom of his age and of his life in poverty and privation that the old man did not argue or complain except from pain. He should think and ask himself about the advantage of getting stiffened his hip joint.
A younger woman took the seat on the chair. She could not move the right elbow after she was beaten by her husband. The X-ray showed a dislocation of the joint with a fracture of the radial head. I put her on the couch in the plaster room and gave the injection for a short-time anaesthesia and pulled the forearm in flexed arm position back into the elbow joint and immobilized the joint with a cast in the flexed position. The next patient was a woman who had torn the right index finger and dislocated the middle joint of the middle finger when she had collected branches for firewood. I took the patient to the casualty theatre and put her on the old operating table. After the pain injection to the second and third fingers, I cleaned, debrided and sutured the laceration on the index and reduced the middle joint on the middle finger.
The patients for further treatment from the Finnish-Lutheran mission hospital in Engela, one kilometre south of the Angolan border, were brought in an old and shaky ambulance over the distance of hundred-twenty kilometres. Some of them had to be admitted. This ambulance was packed with patients with or without new or renewed casts for the trip back. It started not later than five o’clock due to the curfew restriction in the war zone from sunset to sunrise. If there was an engine or any other technical problem on the outdated ambulance that it could not leave Oshakati in time, the patients had to overnight with the other patients and family members on the concrete floor of the passage in front of the outpatient reception.
After the last patient had been seen and treated, the two doctors left the consulting room and the outpatient department. I made the short evening round through the wards to look after the operated patients of the day. The small girl after separation of the long fingers of the right hand [syndactyly] smiled and put up her arm with the fist bandage. The fourteen-year-old boy after the corrective osteotomy was happy about the shape of his leg. The old woman on whom the malignant skin lesion were removed from the right forearm and the skin defect were covered with a skin graft taken from the right thigh, thanked for the work done. The sincerity how the old woman thanked was above each dictionary.
I looked after the patients in the intensive care unit where the three injured after the emergency operations showed progress in terms of stabilization of their physical conditions. The two wound drains on the patient after laparotomy with bowel resection and anastomoses did produce small portions of blood-stained fluid. The bandaged limb stumps on the second patient who lost his right forearm and left leg, were dry. Dressing and head bandage of the third patient after plastic-reconstructive surgery because of the extensible face lacerations with the piece of metal in the left eye’s vitreous body and loss of the major part of the left ear, had dark-stained blood spots.
After the workday of twice around the clock, I left with my beetle the hospital. I saw in the rear-view mirror the people who prepared their sleeping places in front of the outpatient reception. The gatekeeper chewed on a piece of meat and held a bigger piece of meat in his left hand when I passed the gate. The gatekeeper pushed the gate wings together with his right hand. The sun was already sunken, but the sky had still the violet touch. I switched on the headlights and drove to the post office. There were two letters in the post box which I put on the passenger’s seat and drove to the mini-supermarket for a small box of milk, a grey bread and something to spread on the slices and a pack of Stuyvesant.
I had not reached the flat when a convoy of five Elands with the long ninety-millimetre barrels and the headlights on full beam took the sharp left curve and blinded my eyes five times that I stopped driving. The convoy has passed and left back a sandy cloud on the gravel road. When the cloud dispersed I started the engine and drove the last fifty metres to the flat and put the car on the parking place. I closed the gate by pushing the latch into the notch and wished myself a restful night. The sandals with the sweaty cork soles were left in the verandah when I entered the small sun-heated sitting room and put the bag with the shoppings in the kitchen and the milk and the sausage in the fridge.
I looked for the senders of the two letters. One letter with a handwritten envelope came from South Africa and was stamped in Pretoria. The other letter with the typed envelope that came from Germany. I put the letters on the small table between the outseated armchairs and went back to the kitchen to make a cup of rooibos [red bush] tea and something to eat. I put the stuff on the small table and ate my supper. I felt exhausted and drank from the tea and tasted the tart aroma of the bush. It reminded me of the people who walked barefoot or in self-made sandals with soles cut out from scrapped tyres to look after their small herds on the arid ground with the sparse vegetation. I took a second cup of tea and lit up a cigarette and opened the envelopes. The handwritten letter came from Dr van der Merwe.
Dr van der Merwe wrote that the ‘Herkules’ was jampacked and the returners were excited. The plane touched smoothly on the ‘Waterkloof’ airbase where the families and friends were waiting. The greetings with parents and friends were heartfelt. There were tears of relief and happiness in their eyes that he and his wife had returned unhurt from the far north. The father brought the homecomers to the farm not far from Bloemfontein in the Free State where they were warmly welcomed by the workers and their families. He knew some of the workers since he was a child and spoke even their language. They stayed two weeks on the farm where they were spoilt. He weighed the cattles and put the brand marks on them and repaired engines. He shot two kudus and followed the track of a leopard which had killed three calves. It took three days and two nights when he shot the leopard from the hideout in a tree.
He and his wife enjoyed the life on the farm and both gave the joy to some workers’ children as well. Van der Merwe wrote that he would have become a farmer, if he were not a medcial doctor. They left the farm after two weeks of nature and rest and returned to their flat where they met their friends. Life in South Africa had changed. The black people are seethed with unrest. The signs of resistance against whites are obvious. The crime had increased especially in Johannesburg. Robberies and murders occurred every day in South Africa. Farmers and their relatives were robbed and murdered. The people carry guns to defend themselves and their families. The white-ruled system is close to come to an end. The big change is in front of our doors.
Dr van der Merwe had contacted the academic hospital in Bloemfontein to start his postgraduate in orthopaedics, since he had appreciated the work in orthopaedics at Oshakati hospital so much. He asked how things were in the north when the few doctors had to cope with the work, if the wards are still overcrowded and the toilets are still stinking, if the air conditioner in theatre 2 is repaired and the old and defective operating table is replaced by a new table. He asked about my life and thanked for everything I have taught him. Under my professional and human guidance and advice he had collected a wealth of experiences and directives of great value that he will keep in mind for his life. Van der Merwe wished all the people in the north a better future what he did not describe in details. He wished the people strength to go the