It was time for the morning meeting. Dr Witthuhn as acting medical director had taken a seat on an old upholstered chair at the window side under the rattling air conditioners. It was Dr Nestor who had decided that the medical director should be Dr Witthuhn despite his white skin, this with respect to his outstanding commitments for the benefit of the hospital and its patients when he was the superintendent. The white Bantu-administration however had with view of the expected power change offered the post to Dr Nestor to be the first black medical director. The matrons, the pharmacists and colleagues were attending the meeting except the one black female doctor who more or less did never attend.
The black paediatrician had taken his seat next to the director at the window front as well. He started a conversation with the director which caused a laugh of the paediatrician, while the black superintendent opened the meeting with a ‘good morning’. The paediatrician continued chatting that the medical director had to put it to an end. Dr Nestor informed the attendees that the missing drugs had arrived with the hospital bus. The bus had a delay of one day because of a wheel change due to a flat tyre. The superintendent told that no patients could be sent to Windhoek in the following two weeks for intern-medical and urological specialist treatment, since the specialists were on leave and the wards at Katutura Hospital were overcrowded.
Dr Nestor gave a brief report on the conversation he had with the koevoet commander who had asked, if his people behaved better during the nightly raids. He could not answer the question, though he had not received new complaints in this regard from the nurses. He however had asked the commander, if he considered the raids as helpful. His answer was that no Swapo-fighter had been found in the hospital yet what however could not exclude that they will do so in the near future. He promised to discuss the matter with the brigadier. Dr Witthuhn who was the acting medical director, said that the hospital administration is powerless against the military that it is useless to object. The black paediatrician considered the topic as explosive. He did not see the necessity to follow up the topic of the nightly koevoet raids and rather suggested to be quiet.
The courageous matron expressed her different opinion. She said that the hospital administration is obliged to do everything possible to ensure the resting night peace for the patients that would accelerate the recovery time and would reduce the overcrowding of the wards. So were her arguments of practical relevance. The paediatrician leant back and kept his legs crossed, while his eyes viewed along the asbestos mats in the ceiling. The acting medical director reiterated his experiences with the military that it would not deal with the nightly peace argument of the matron.
The superintendent gave room for other points to speak on. Dr David the physician took the floor and described the unhygienic conditions of the wards in the internal medicine as catastrophic, this not only because of the defective bedsteads, the dirty mattrasses, the spotted bed linen and sheets, but also because of the poor washing and toilet facilities and the missing hospital clothes and the lack of washing bowls and spittoons for the TB-patients. He criticized the insufficient and lacking meal portions for the patients of the low protein content, and emphasized the urgent need of milk for the convalescence and improvement of the poor nutritional status. The superintendent understood the problem and requested the matrons to look into this matter and to take care that the meal portions are sufficient and the patients get milk of one litre each per day.
The matrons did not object, but the matron highlighted the critical situation to provide the wards with more hospital clothes, bed linen and sheets and washing bowls and spittoons, since the storeroom for clothes is empty and a few washing bowls and spittoons are left on the shelf that were defective and useless. The superintendent made a note and responded that new hospital clothes, bed linen and sheets and washing bowls and spittoons should be ordered. In terms of improving the washing and toilet facilities, I expressed the hope that the ‘Sekretaris’ will send soon people from the works department who should bring the defective things in order. The superintendent underlined the notes from the previous day.
The acting medical director gave notice that a medical student from Germany will come to do a part of her practical year at Oshakati hospital. He said that this student will collect her experiences in a short period of time and could assist the medical staff. The superintendent did welcome the news. He raised the hope that the advertisement in the German ‘Ärzteblatt’ should be effective that some German doctors would fill the gap at the hospital. The time was too short to speculate on the effectiveness of the advertisement which was sent to Germany. However, the first intercontinental thread from Oshakati to Germany was spun out which could get effective by the arrival of doctors from above the Mediterranean. The meeting had ended and the attendees left the superintendent’s office with a trace of optimism that the things what were discussed would become transformed into practice.
I went straight to the theatre building and changed the clothes in the dressing room. I entered the small tea room. Dr Tabani was not sitting there as usual and waiting for the anaesthetic doctor, since he had refused to attend the morning meetings with the speeches and comments which had never brought any practical results. He was probably busy with his ward round.
I put the ten-year-old girl into my mind on whom I had to cut off the right arm within the next hour. Psychologically, it would be a very difficult operation. Certainly it had its medical indication with respect to the high malignancy of the bone tumour, but it would humiliate and threaten the life of the girl at the same time. I looked at the chest X-rays again what I did several times before and could not see any sign of lung metastases. I hoped therefore that this operation could save the girl’s life, though it downgraded it to a pitiable being. The result of the operation was unthinkable for the girl that she had never imagined and wished before. Fate had badly crossed a thick black line through her life which was already heavily burdened by the death of her father and the sickness of her mother.
Dr Lizette entered the tea room and called the forthcoming operation a ‘terrible’ one, because also she could hardly imagine the whole impact of the loss of one arm on the girl. The operation had not started and I was still in the tea room when I stood in front of the question, if a short but integer life with both arms would not be preferable against a long life with a mutilated body, since with both arms the girl could laugh what she would never do full-heartedly with only one arm.
Dr Tabani had entered the tea room and looked at my face of concern. He asked me for the reason that I gave him the question about life and life quality. The colleague said after a while of thinking with his soft voice that individual life in its quality is maybe comparable with other lives, but cannot be predictable and measurable. “Any kind of generalization will fail”, Tabani said who was able to share my concern in regard to the young girl and the forthcoming operation. “You have to follow the medical ethics, everything else is beyond your power and capacity”, he added and I made a ‘note’ in my brain.
Dr Lizette left the tea room to prepare the anaesthetic tools in theatre 2 while I showed Tabani the chest X-ray with the question, if he could see a lung metastasis. He screened carefully the radiograph and gave it back with the comment that he couldn’t see such a sign. I thanked for his comment and left the tea room with the sad feeling that the operation had to be done following the rules of the medical ethics. Tabani wished me strength for this operation. The girl was on the operating table and I washed hands and forearms longer than normal because of the heaviness of the thoughtful reflections.
It was an oppressive silence over and around the girl what remembered of the silence of grief in the moment of a child’s burial. The lakes of tears were in the eyes of the parents and other family members and friends who follow speechlessly in the deepest shock the small coffin and say goodbye stunned with a speechless grief and the sounds of sobbing, while the coffin gets lowered down to the ground for the child’s eternal rest. And all this without the opportunity for a last goodbye kiss from the mother and the father. After the service and leaving the grave with the resting child bedded down into the soil, people would start remembering and reiterating their experiences of joy what this child had brought into the family and the family’s life.