For Justice, Understanding and Humanity. Helmut Lauschke

in the beginning, but when he has realized that there were only empty talks, he did not attend this nonsense any longer, since he did not like this kind of delusion and disrespect. Dr Lizette laughed and agreed and said that it is a cheek to speak always the same without anything done. Dr Tabani replied with seriousness that politics does not belong into a hospital. The young colleague kept quiet, because he felt himself as part of this politics, though he had put his uniform even temporarily on the rack in the dressing room.

      Tabani sat in the tea room waiting for the anaesthetic doctor, while I and the young colleague and Lizette went to theatre 2 to fix the neck fracture on the thigh bone [femur] on the man referred from the Finnish-Lutheran mission hospital in Engela what is as far as hundred-twenty kilometres from Oshakati and only one kilometre from the Angolan border. The patient was put on the operating table and both legs were stretched by a leg extension device. The femur neck fracture were reduced and fixed by a plate on the lateral aspect of the femur shaft and three long femur head screws. The operation got monitored under the visual display of the portable X-ray machine. When the operation was finished the extension device were removed. Dr Lizette pulled out the breathing tube from the throat and put the oxygen mask on the face of the patient. A nurse removed the operating coats and the lead aprons from the surgeons who stood with huge sweaty spots on their green operating shirts. The patient were lifted from the operating table on the trolley and carried to the recovery room. The young colleague and I went to the dressing room and rubbed the sweat from the skin.

      We made a short break in the tea room. The young colleague filled two cups and put them on the pen-scribbled wooden plate of the small low table. The superintendent entered the tea room with his packed side pockets of his white linen jacket and his pale face and informed me that the patient with the breast lump had given her consent for the operation. We fixed the day and made notes on separate paper sheets. The superintendent filled a cup of tea and mentioned the new colleague as a specialist surgeon who would come soon to the hospital. He said that the new colleague would be a relief for the department. Dr Lizette stood up and filled a cup of tea as well, while I sat and kept quiet, since I had met the black colleague whom the black paediatrician had introduced to me in a disrespectful manner. Lizette asked the superintendent from where the new surgeon is coming. “He is a Namibian and did his postgraduate in South Africa”, he said. Lizette expressed her surprise that Namibia had already some specialists. She leant back with a pensive feature as she saw the train of the new era passing by in her mind. She was amazed at this stage what she didn’t expect.

      In my mind was the vessel with the black masts carrying the black crew when the siren wailed over the village with the crescendo and decrescendo of two waves. The time of the upheaval had started. This was readable on the faces of the whites who showed the signs of fear and uncertainty, as on the faces of the black people who showed the signs of hope for a better life. The superintendent had finished his cup of tea. He stood up and said that things are not as easy as he had thought. I asked, if he meant his patients. “With my patients I have no problems”, the superintendent replied standing with his bulged side pockets of the white linen jacket in the door and looked with a slit-eyed pale face over the small table with the pen-scribbled wooden plate. He laughed, turned and left the tea room.

      ‘This I will believe’, I thought about the superintendent’s leaving remark. Dr Tabani came from theatre 3 and asked the people in the tea room about the meaning of the wailing siren. I made a joke when I said thet the people are not falling asleep in the morning. Tabani laughed with a sneering undertone of the system hater. He said that the sleeping time is over and that the people must get awake and become alert to avoid mistakes which they may regret later. Lizette asked for the meaning of the sentence. Tabani replied: “Everybody must decide for the one or the other side before it is too late. I cannot say more.” He leant back on the worn-out upholstered chair, while the others went to theatre 2 to continue with the next operation. We washed our hands and forearms when the young colleague stated that the remark of Dr Tabani had a serious background. It corresponded well with the picture of the sinking vessels with the white echelons and the white commander-in-chief that everybody had to look for himself not to miss the right moment for jumping off to avoid drowning with the vessel like the crew in the stern.

      We dried the hands in the blotting paper when I gave into consideration that only the good swimmers with the life vest have the chance to survive what will be impossible for ‘Joe Blow’ without the life vest. People with the broad short necks and the spare tyres around their bulging bellies will reach the shore. They will not lose a tear of sadness for those who have drowned. This was in respect to the saying: those who have the most, live longer than those who have little or nothing.

      The second operation was an internal fixation on the upper arm bone [humerus] which had been broken in several fragments. I exposed the radial nerve crossing the proximal half of the long bone and showed the young colleague the upper and the lower course next to the nerve crossing. The colleague held the arm in flexed position of the elbow and under traction. He understood that the radial nerve could be easily damaged at this part of the course. I aligned the fragments and put the eight-hole plate on the fractured bone shaft. The fragments were temporarily held in place by bone-holding forceps and finally by the screwed-on plate. The young colleague closed the wound by suturing the muscle fascia and the skin, and I assisted him. The dressing was put on and bandaged when Dr Lizette removed the breathing tube from the patient’s throat. The patient were lifted on the trolley and carried to the recovery room, while I thanked the team for the cooperation and left with the young colleague the theatre room.

      It was Friday. The academic meeting had started shortly after eleven o’clock when Dr David gave a lecture on pulmonary TB underlined by demonstrating X-rays of various stages starting from a primary focus up to the destruction of lungs with cavity formations and caseation. He mentioned as the most common disease transmission the inhalation of TB-contaminated cough particles through the branches of the respiratory tract into the air cells [alveoli]. People with a compromised nutritional and physical status are particularly exposed to the pulmonary disease because of the weakened or abolished immune system. The disease was extremely widespread in the north of the country. Dr David gave a great importance to the early detection of the disease when TB is still curable by taking the necessary drugs that there is the chance of a full recovery. If diagnosis has failed, the disease affects the whole lung causing finally the galloping phthisis. The patients lose body weight down to emaciation and skeletisation and cough themselves literally to death. It is the galopping ‘horse of death’ on which the patients are riding, if the diagnosis was not made in time and TB were not treated. Dr David went into details of the various stages when he mentioned the symptoms and complications including aspects concerning the differential diagnosis. He highlighted the rules of the pathology with a ‘second hand’ of the prognosis of the disease and the stopwatch, if life comes to an end because of the failed diagnosis and treatment. The lecture dealt with a core topic, since malnourished people and children passed away like flies due to their weakened and abolished immune system. If a bed became vacant in the male and female TB-wards, it was occupied by a new patient not later than one day, while many more patients were waiting for admission.

      The presentation of the topic was brain catching. In the following discussion, the black paediatrician ‘corrected’ the lecturer that there is something different in the TB of a child compared with the TB of an adult. It was something small with what the paediatrian tried to make himself big. Dr David of the higher intelligence brought the weird position back into the clear line by a logically stronger definition showing the intellectual power when it came to the accuracy in summarizing the basic principles. Other questions from the colleagues were plain and clear and were answered in a plain and clear manner.

      David thanked for the attention and the constructive questions. He received the applause, he did deserve. He took his seat on a chair and kept control of his pleasant humbleness. This doctor was a specialist of internal medicine who did his postgraduate at Wits-University in Johannesburg. He was a motivated and committed doctor and did a marvellous work on his patients at Oshakati hospital. David was always on time when he started the round through the packed wards of internal medicine. He was an excellent teacher and did once per week an academic round with his junior doctors who had praised his knowledge, experience and didacticism. Under