Thursday, 26 February 1987: Adventures in Kwa Zulu

May 21, University of Botswana Environmental Science computer room.

At breakfast, a 45ish white fellow in a suit seated at the next table asked me to pass the marmalade.  He was an inspector for white government (public) schools.  The times, they are a changin’, according to him.  People see that white and non-white students are getting along fine in private multi-racial schools.  These institutions are setting the trend for future education in South Africa, although he was sorry to admit that multi-racial government schools are still a long way off.  He was pleased to add, however, that equal rights for black South Africans are simply a matter of when, not if.

I left Dundee and drove about 25 km northeast along R33, then south another 20 km on a gravel road to the Blood River Monument.  This was the site of the 16 December 1838 Battle of Blood River in which 464 well-armed Boers in an ox wagon laager (circular formation) faced a force of 12,000 Zulus armed only with spears and knives.  The Boers under Andries Pretorius vowed they would henceforth celebrate 16 December as a day of thanksgiving to God if they were able to prevail over the swart gevaar (“black peril”).  Prevail they did.  So many Zulus were killed that the stream next to the laager was said to have turned red with their blood.  Ever since, 16 December has been celebrated as the “Day of the Vow”, though understandably, black South Africans pay it little heed.

The monument was an amazing sight.  It consisted of 64 life-size ox wagons formed in an off-round laager, a faithful reproduction of the arrangement more than 148 years earlier.  These were not the original ox wagons used in the battle.  Instead, wagons from the 1938 Vootrekker Centenary celebrations had been brought to the site.  They had been completely bronzed, forming a monument which is surviving time and the elements.

During my months of travels in South Africa, I had never seen such an impressive affirmation of the Afrikaner spirit.  The whole world might be against them, but they would gather in a laager and successfully defend themselves with the help of God, just as they had in 1838.  I shot about 20 pix in an attempt to capture this symbol of the “laager mentality”.  An hour later, I drove off contemplating Afrikaner resilience while Paul Simon’s “Graceland” album blasted away on the tape player.

My next destination was a related historical monument, Dingaan’s Kraal.  On 6 February 1938, a group of unarmed Boers were murdered by Zulus at this site.  The Boers had been tricked into thinking they were attending a peace conference with the Zulu chief, Dingaan.  They learned too late that Dingaan played by a different set of rules.  Blood River is considered a revenge for this earlier massacre. 

Driving southeast on R68, I noted that Nqutu was the next town along my route.  There was something familiar about the name.  Was this the location of the hospital where my friend Scott Nelson had once worked when he was a medical student?  I looked it up in my address book.  Scott had spelled it “Mqutu”, but that was close enough.  As I pulled into Nqutu, I saw an institutional-looking group of buildings to the left of the highway.  Sure enough – it was the Charles Johnson Memorial Hospital.  Dozens of blacks mingled in the late morning sun outside a clinic on the hospital grounds.

A battlefield slaughter, a hospital for Zulus, and a hair-raising river crossing:  My drive from Dundee to Empangeni was the most interesting day of my Natal trip.

 

I explained to the black security man at the gate that I was an American bringing greetings from a doctor in the United States who had worked there some 15 years ago.  He sent me to the clinic.  The admissions clerk sent me to the head matron’s office.  The head matron (nurse) was out, but one of her assistants took me back to the clinic where I was introduced to Dr. Kevin McDonald, a young white South African chap who was pleased to have a visit from an American writer/university lecturer.  Kevin seemed happy to take a short break from tending to sick Zulus and led me on a tour of the grounds. 

The 500-bed hospital is apparently much the same as when Scott had worked there.  There are four wards:  adult, pediatrics, obstetrics, and TB.  The hospital serves a population of approximately 200,000 in this area of Kwa Zulu (formerly called Zululand by the British), a patchwork of self-governing black areas within Natal province.   There are only four doctors in the area resulting in a doctor/patient ratio of 1:50,000.   Three white docs work full-time at the hospital.  A local black doctor with a private practice, works there part-time.

Clinic patients waiting to be seen at the inadequately-staffed Charles Johnson Memorial Hospital which serves a population of approximately 200,000.

 

As one might expect, the major business of the hospital is deliveries – some 5000 babies per year.  Most of these are handled by a staff of midwives, but the M.D.s are called in case of complications.  Kevin noted that they do 600 Caesarean sections per year.  “My god.  That’s an average of nearly two per day.  You guys must get run ragged!”  I exclaimed.  Kevin assured me that this is the case.  Theoretically, there are sixteen slots for M.D.s at the hospital.  He said they would royally welcome any American doc who wanted even a few months experience with Third World medicine.  They pay would be little or nothing but good housing and all meals for the doctor and his family would be provided.  Keven suggested that some American doctors might be able to use the experience as a tax write-off.

In addition to delivering baby Zulus, the hospital handles numerous Third World diseases related to malnutrition.  TB is quite common.  Hundreds of people queue up at the clinic for medical attention every day and are charged only R2.00 ($1.00) per visit which covers administrative costs.  The hospital was named for its founder, Charles Johnson, an Anglican medical missionary.  It has recently been taken over by the Kwa Zulu government.  Kevin noted that the facilities are in need of refurbishing, but there are plans for an entirely new hospital which makes them hesitate to put much money into the old one.  He added that the government has been building clinics in villages, each staffed by a trained nurse.  The goal is to have clinics within walking distance of most of the people. 

Kevin invited me to join him in an hour for lunch to meet the other doctors.  In the meantime, he sent me back to the matron’s office.  I was introduced to the matron, Miss Chloe Zwane, a gracious, aging Zulu who had worked at the hospital for some 20 years.  She couldn’t remember a Scott Nelson, but I suppose she has seen many a young white doctor or medical student come and go during her years of service.  The hospital administrator was relatively new, and Miss Zwane couldn’t think of anyone else who might have worked with Scott in the early 1970’s.  Nevertheless, she was very appreciative of my visit.

At lunch, I was introduced to a British doctor and another South African one.  There were also three medical students spending a few months in Nqutu on rotations.  One was a young South African woman from University of the Witwatersrand in Johannesburg.  There were also two Germans – a man and a woman.  Conversation covered the local health situation and inevitably drifted into politics.  Both the South Africans and the expats had snide comments to make about the National Party government.

The young German woman had a problem.  She was originally working at the Ekhombe Hospital, 70 km from here.  It was such a lonely, isolated outpost that she had decided to abandon ship a few days earlier and caught a ride in an ambulance which was bound for Nqutu.  Now she was in a bind.  Dr. McDonald would let her work at Johnson, but he would only sign off for the work she did there and not for the weeks she had been at Ekhombe.  Thus, she was going to wind up three weeks shy of the time she needed on this rotation and would have to do it all over again.  So, now she wanted to return to Ekhombe but wasn’t even sure they would take her back at the hospital there.

The German medical student wondered which direction I was headed.  I told her southeast toward the coast.  She wasn’t exactly sure where Ekhombe was located, but thought she would recognize the turn off.  Apparently, it was in a southerly direction though I couldn’t find it on my map.  By this point, the rest of the staff, save the British fellow who was new to the area, had disappeared to do another C-section.  I was lonely for company and figured trying to find Ekhombe might prove to be an adventure, so offered to take her there.  She quickly shoved all her belongings into two small suitcases and we were off.

The student’s name was Suzanne and she was a tall brunette in her early 20s who hoped to become a gynecologist.  As we drove further south on R68, she became more anxious and worried that perhaps this was not the right road.  But it was the only road south, so I pressed on.  Finally 30km south of Nqutu, she recognized the turn-off to the right.  What an experience!  The bumpy gravel road climbed high into the green hills of Kwa Zulu affording views of traditional native farmland and deeply incised river valleys.  A few of the hills were forested, but most of the land had been cleared and the steeper portions showed the ill-effects of erosion.  I made several photo stops along the way. 

After more than an hour, we finally reached the hospital.  Suzanne ran in to find out if she was now “persona non grata”.  If so, she would continue with me on to the coast, catch a bus to Durban, and return to Germany with her tail between her legs.  She was told she could stay over the weekend.  However, the administrator would ultimately decide her fate, and he wouldn’t be back until Monday.  Suzanne decided to take her chances, and she thanked me profusely as we said goodbye.  My guess is that they allowed her to stay on, although they may have made her clean bed pans for a couple days to teach her a lesson. 

By now I was fairly sure of where I was on the map.  A policeman at the nearby Kwa Zulu police post confirmed my suspicions.  I could turn left about 3 kms up the road and head back east about 50 kms to R68.  This would save me an hour of backtracking.  I reached the turn-off where a sign warned “no caravans” (travel trailers).  The road snaked ominously down into a gorge, and I nervously proceeded.  Near the bottom of the gorge, the going got really hairy, and I was down to second gear and 20 kph. 

A few miles after dropping off a German medical student at the Ekhombe Hospital, I encountered this deep gorge of the Nsuze River which gave me that unsettled feeling in my stomach.  Could my little Mazda get across it?

 

Eventually, I reached the bottom of the gorge.  Oh Christ, now what!  In front of me was a small but swiftly flowing river and no bridge.  The water looked fairly shallow and the road continued on the other side.  Still, it was late afternoon and there was no traffic.  Memories from 18 years earlier in eastern Utah came back to haunt me.  In the summer of 1969 while attending Ohio State’s geology field camp, I had nearly busted the drive shaft of my Chevy when I hit a big rock while fording a large arroyo during a flash flood.  The cautious wisdom of my 41 years won out over any remaining youthful adventurism, and I started to turn around. 

Suddenly, I saw a bakkie (pick-up truck) heading toward me on the other side of the stream.  He forded the river slowly without incident, and I got out of my car to meet him.  It was a Kwa Zulu police officer.  

Oh shit!  To cross or not to cross?

 

“Good afternoon, sir.  Do you think it would be safe for me to take my Mazda across?”

“How high did the water come when I crossed?”

I indicated that it didn’t get to the top of his large tires. 

He jumped out to give me directions.  “Put it in number two and drive slowly and straight this way,” he said while motioning.

“Are there any more river crossings between here and R68?”  I inquired. 

He assured me that this was the only one.  I’d have no trouble from here on.

I drove very slowly and carefully and got across the little river with no sweat, hooting my hooter (that’s South African for “honking my horn”) and waving back to the policeman once I was on the other bank.  The road continued out of the gorge and gradually improved, but it was nearly dark when I made it back to R68.  I never did find Dingaan’s Krall but the afternoon’s excitement seemed to be a suitable alternative.

Continuing southeast for another 100 km, I reached Empangeni where I found a cheap hotel room for the night.  After the large, delicious lunch with the doctors, I wasn’t very hungry, so I scarfed down some cheese and peanuts.  Then I was off to the hotel bar for my usual cold Castle or two.

The patrons in the bar were predominantly black and the TV was switched to a black station.  I hadn’t seen much black TV in South Africa, but if this was any indication, it was superior to the American re-run trash on white South African TV.  I didn’t understand what they were saying but they were playing some great rock videos.   

 

Addendum, 21 May 1987

My visit to Nqutu got me thinking about the role of Western countries and medical personnel in developing world health care.  True, Kwa Zulu is part of South Africa and, therefore technically their problem.  But the doctor shortage there is repeated in dozens of countries and thousands of villages all over Africa.  It makes me angry that American “cavaliers” like Colonel Oliver North are allowed to throw millions of bucks into death and destruction in Central America, when that money could be going toward building and staffing more African medical schools and hospitals.  We could be involved in the education of more African engineers and agricultural personnel who would improve the infrastructure and nutrition of their people.  Instead, we send arms of mayhem to revolutionaries like Jonas Savimbi in Angola, who get our backing simply because they are anti-communists.  The American government has no conscience nor do the naïve masses who elected it!

I also keep wondering why more American professionals don’t volunteer their services where they are most needed.  Are they only motivated by money and the security of their own nuclear families?  Why is there so little interest in the human family?  Guess I should mind my manners and not step on the toes of my friends in America who live conventional lives.  They will probably dismiss me as self-righteous and naïve. 

With the time approaching for me to return to the States, I’m nervously anticipating culture shock.  Will I be so put off by American materialism, provincialism, rudeness, and the hectic pace of life that I will want to jump on the first plane back here?  Or will I ease back into the self-indulgent, good life?  Guess it’s about time to find out.