The Patient. Olive Kobusingye

flag, as bold and beautiful as the women that danced to the loud drumming throughout the night, those that had experienced the indignity and scorn of the colonial master up close knew freedom had come. Nowhere, perhaps, was the awareness of the difference between colonial master and servant sharper than within the medical fraternity.

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      Nkore worked as a senior clerk at the District Commissioner’s office in Kabale. He had heard a lot about the independence plans. On the morning of 9 October 1962, just as he was preparing to leave the house, his pregnant wife quietly announced that the baby might be arriving the same day. “Really?” Nkore asked, not quite absorbing the full import of the information. The wife could tell that his mind was already out there in the Independence frenzy. Besides, what would he do to help even if he were home? Cane and hat in hand, Nkore was already half out of the door when he asked if she had alerted the midwife.

      “Yes, she is aware.”

      “Good”, and with that he was gone.

      So, while the rest of the country was preoccupied with the Independence preparations and festivities, Mrs. Nkore’s one thought was the imminent arrival of the baby. The friend and self-taught midwife that had helped her to deliver previous babies was on high alert, and had been for days. Both women knew it could not be too long now. By midmorning, however, all discomfort had subsided, and Mrs. Nkore thought she might have misread the signs. She went about her chores without any sign of labor. In the evening though, with hardly any warning, her waters broke. In a couple of hours she gave birth to a bouncing baby girl. Nkore returned long past midnight to find that the baby had arrived in his absence. “Of course the baby must be named ‘Independence’,” he exclaimed, as soon as he heard of the birth. Independence, or Kweetegyeka, in Rukiga. By the time the baby was a month old, nobody but the father used the whole name, considered too weighty for a tiny little baby. Everybody else called her Kweete.

      On 16 October 1962, the New Mulago Hospital opened its doors amidst great pomp and fanfare. Queen Elizabeth’s cousin, Her Royal Highness the Duchess of Kent, traveled to Uganda to officiate at the opening. Alderdice, a former Medical Superintendent of (the old) Mulago hospital, writing in the Lancet of August 1963, said this of the new hospital, “A 900-bed hospital has been constructed in Kampala, Uganda, of a standard that compares favorably with teaching hospitals of recent design elsewhere.” With regard to the medical school, he was equally full of praise. “Throughout the course, standards obtaining in the best British medical schools apply. … Library facilities for students and staff are of a very high standard. The Albert Cook library has the best collection in East Africa and very few journals to which a member of staff may wish to refer are not available.”

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      At Mulago the intention was to build a 750-bed general hospital (to which was later added a private wing of 130 beds). Once the figure of £2 million for the building, £220,000 for medical equipment, and £80,000 for an extension to the nurses’ home was arrived at and voted by Parliament, the architect and the planning committee were determined to cut their cloth accordingly. Although experience elsewhere in Africa raised serious doubts about the adequacy of the money voted, the hospital was in fact completed and equipped virtually within this figure.

      Two factors helped to keep the costs within bounds. The first and more important was the speed with which the hospital was designed and building started: the whole project from the first sketch to completion took less than five years; and this gave less time for prices to rise. The second was the determination of the architect (who controlled expenditure and held the vote book) and the planning committee to keep within the figure set, even though this meant a good deal of give and take.

      A. A. Alderdice, M.B. Sydney, M.R.C.P. The New Mulago Hospital. Lancet August 3, 1963.

      On 22 February 1966, Health minister Dr. Lumu had a premonition that the Cabinet meeting he was going to attend at State House would not end well. He nonetheless prepared a technical brief about the plans for the new regional hospitals in case he had to give an update. Political tensions had been rising, and allegiances had been shifting back and forth for months. Although the Uganda People’s Congress had managed to build a clear majority in the legislative house, the party was deeply divided, and things were coming to a head. Minister of State Grace Ibingira had abandoned all subtlety as he sought to pull the rug from under Prime Minister Obote. Lumu had been in meetings with the Ibingira group, and they were beginning to feel confident of their advantage both in Parliament and in Cabinet. For his part, the Kabaka of Buganda and President of the republic, Sir Edward Mutesa, was considering pushing Obote out, and creating a new government. It would seem that he had gone so far as to seek the advice of Attorney General Godfrey Binaisa about the legal implications of removing Prime Minister Obote from office. Clearly, all of this plotting was not discrete enough, as Obote’s checkmate move would soon reveal.

      Driving through Entebbe town, Lumu noticed that there was unusually tight security. A bigger surprise awaited him at State House. He arrived to find that rather than the usual Cabinet meeting, there were only three other ministers waiting to meet the president: Mathias Ngobi, G.B.K Magezi, and Grace Ibingira. A fifth minister, Balaki Kirya, arrived shortly afterwards. Beyond the brief greetings, nobody spoke. Every man sat quietly with his own thoughts. Obote was seated in his usual spot. Sam Odaka, his personal assistant (aide-de-camp), was the only other person in the room. A soldier came into the room, and Obote asked the ministers to follow him. At the door they were met by soldiers who led them to a waiting van. Some seven hours later they were ushered into Patiko prison in Gulu, and later transferred to Kotido in Karamoja where they were imprisoned without trial. Seated in a remote prison in Karamoja, Dr. Lumu could not have felt more removed from his patients and students at Mulago. The purging of the Cabinet to remove the troublesome Ibingira and his group was not the end of the political headaches for Obote. It heralded more turbulence as Obote sought to consolidate his control and eliminate all possible threats to his presidency. On 30 April 1966 Obote announced a new Constitution which was passed without debate, and he was then promptly elected President under the new constitution.

      President Milton Obote talking to Narendra Patel,

      Speaker of the National Assembly. DS Archives

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      The operating rooms on the ground floor of Uganda’s largest and most prestigious hospital were abuzz with activity. Thursday was the main theatre day for Red Firm, and Dr. Sebastian Kyalwazi, who had returned from Britain a year earlier, had a long list of patients lined up for surgery. It was said that he had been among the top students in the exams that saw him becoming a Member of the Royal College of Surgeons of Edinburgh. For many of the junior staff that was wonderful news, but it came with a fair amount of confusion. Was he now to be treated the way they treated Prof. Ian McAdam? Was he going to have special theatre gowns with his name on them? Up until that time only the white doctors had personalized gowns. The easy bit was his joining the white doctors in the surgeons’ room, but these other privileges were still somewhat unclear. In that exclusive club Kyalwazi would soon be joined by another British trained Ugandan surgeon, Alexander Odonga.

      In truth Kyalwazi and Odonga did not have to be as good as their British counterparts to attain membership to the Royal College of Surgeons. They had to be much better, in order to be considered as good. The door to the surgeons’ room was very narrow indeed for the so-called natives, and the Ugandans that got in during those early days were resilient and especially brilliant. The struggle for equal professional recognition went as far back as the late 1930s, in fact for as long as the Africans had a role in ‘modern’ medical care other than that of being the patient.

      Kyalwazi pushed through the main double-door entrance to the theatre and made an immediate left turn into the surgeons’ changing room. Here the doctors would exchange their street clothes and clinical coats for special gowns, usually used only here. In a couple of minutes he had changed, and he exited the changing rooms directly into the main corridor within the theatre. There were six spacious operating rooms, each separated from the next by scrubbing bays, equipment storage, and trolley preparation