Medical Work
Realising that the acquisition of the language would be slow work, with
no books to study, and only five hours teaching a week, I had decided on
arriving in Toro to plunge into work right away. It was not a case of
going out in search of work, for outside one’s very door was the mute
call for help. When the tidings of our arrival had filtered through to
the villages, sick folk came from every direction to see if the white
women had brought medicine. In our courtyard each morning there was quite
a large company of maimed, halt and blind, who had hobbled along, or been
brought in, some from very long distances, by their friends. The very
prevalent forms of skin diseases, ulcers, and the hacking cough required
no language even for diagnosis by an amateur dispenser; other patients,
by eloquent grunts and gesticulations, managed to convey some idea of
their complaints; and the remaining class, whose language and sickness
were conundrums to the European “quack,” received a mild dose of nauseous
physic; certainly it did them no harm, and in some cases their faith in
that dose of “white man’s medicine” worked the cure.
At first I used to receive the sick folk on our verandah, but they became
too numerous, so a removal was effected. The first house of the European
missionary in Toro was still standing, but was quite uninhabitable, as
it had been made of reeds which rot very quickly. It stood in a very
forest of weeds. The long elephant grass barred all the windows and
doors against would-be intruders, snakes suspiciously lay hidden among
the thick tangled undergrowth, and a few half-choked flowers struggled
to exist as a witness to a past cared-for garden and in protest against
their present usurpers.
A few days of hard work with hoe and shovel cleared a breathing space all
round the house, the ceilings and walls were swept down and repaired,
new beaten mud floors laid in all the three rooms, shelves and boxes
fixed up as fittings, a rough table, chair, enamel wash-hand basin
brought in as furniture, and there was a splendid dispensary quite
formidable in appearance and decidedly pretentious for one who possessed
no qualifications beyond a few months hospital training. In Africa a
little knowledge is not dangerous so much as useful. The most appalling
forms of suffering are met with on every hand, and nothing but inhuman,
superstitious, and absolutely ineffectual means are employed to alleviate
it. Even if one can only cleanse and bind up the wounds and pour in oil,
the look of gratitude and contentment that reward the soothing of the
pain reminds one that it has not been wasted labour.
This first dispensary consisted of three apartments, the “consulting
room,” drug store, and waiting room, where patients assembled every
morning at 8.30 for instruction in reading and a short bright gospel
service. This primitive medical work was a distinctly effectual means
of reaching the bakopi (peasants), who had not hitherto been touched
in any large numbers. The King having been the first in the country to
adopt Christianity, the work in its initial stage had extended almost
exclusively to the upper classes, while the “foreign” language had been
an obstacle to the peasants who could not understand it.
It was frequently found that the curiosity and interest of patients in
the letters and syllables were so awakened that when there was no longer
need to attend the dispensary several passed on to the school to be
further instructed.
One of the first patients was an old man who had been receiving
ulcer medicine from the missionary then in charge. Although his hair
was sprinkled with grey, and he suffered from an impediment in his
speech, nothing would daunt him in his assiduous struggles to master
the alphabet. Day after day he came, and even when cured of his ulcer
continued coming, as he was afraid to go to the big school to learn.
Actually he did in time master words of three letters, and then, as he
was so anxious to be baptized, he was put into an old men’s daily Bible
Class for instruction. His joy was beyond description when with tears
streaming down from his eyes he came to me one day saying, “My mistress,
I have finished being questioned, and now I am going to be baptized.” I
asked him, “Mpisi, will baptism save us?” And he answered, “Oh no, only
Jesus who died for us on the Cross.” “Then what is the use of baptism?”
“Well,” said he, “Christ told us to believe and be baptized, and it shows
that we want to leave our bad habits and follow the habits of Christ.”
From that day he has rarely missed coming to the dispensary, not always
for medicine, but that he might teach the patients what he has learned.
A daily attendance of thirty to fifty sick folk soon exhausted our
limited supply of drugs, and when Dr. and Mrs. A. Cook, on an itinerating
round, paid a medical visit to Toro twelve months after our arrival
they found the medicine almost completely used up. Till the arrival of
fresh stores the patients were being kept together by supplementing the
diminished stock with table salt, mixed spice, and curry powder. This
latter I found was a much-appreciated prescription, and as none of the
missionaries were partial to it and each had a good supply among their
stores, I dispensed it generously to dyspeptic patients. You never saw
such agonizing grimaces as when they swallowed a spoonful raw, but they
smacked their lips, saying, “Omubazi mubingi muno muno,” “Medicine very
very good,” and would have finished off the whole tin if they had been
allowed.
That visit from the real “medicine-man” was a grand time for our people,
and they were not slow to show their appreciation and wonderment when
opthalmic patients found themselves with “new windows,” and surgical
subjects, the possessors of “new bodies.” After that the Toro dispensary
became amalgamated with the Mengo Medical Mission, and was regularly
supplied with medicines. The chief diseases met with out there are skin
complaints, malaria, dyspepsia, pleurisy, bronchitis, besides paralysis,
muscular rheumatism, dysentery, and pneumonia. Owing to the inexperience
of the dispenser nothing surgical was attempted in those days beyond
lancing abscesses and gums, cutting tongue-tied infants, and stitching up
leopard-torn patients. One man was brought in from a leopard hunt in a
terrible condition; limbs and body were badly damaged, while the face was
scarcely visible, the flesh of forehead and one cheek having been torn
away, exposing bone and teeth. The extraordinary thing was, that after
weeks and weeks of careful treatment, some very deep scars were the only
signs remaining of the terrible ordeal he had passed through.
These Batoro have grown absolutely reckless in the hunt. Their method
is to surround the spot where the leopard is known to lie crouched,
and slashing down the thick vegetation that conceals their prey, they
gradually draw closer and form a smaller circle round it. All the time
they scream and pour down invectives on the head of the leopard, and by
the time it actually appears in sight they have worked themselves up
into such a state of excitement that, losing all self-control, some will
actually throw themselves upon the infuriated creature. With one last
death effort the leopard throws all the strength of its fury into its
final attack; torn, and perhaps with mangled limb, the man is released
from the grasp of his foe by a hundred spears being run through its body.
The injured are then borne on stretchers in triumph to the dispensary,
and while the wounds are being attended to, the carriers and friends laud
the extraordinary prowess of the patient. Every man who is able to carry
home a blood-stained spear is sure of his wife killing the fattest goat
or cooking the best possible meal in their honour.
One day, while dispensing medicine, an unusual shuffling and pushing
seemed to be going on in the doorway, and walking round to find out
the cause, I saw a cow being pushed by force toward me. The herdsman
explained that it was very sick with “Kifuba” (chest—generally meaning
indigestion). In order to quickly get rid of this undesirable patient I
mixed up some castor oil with salt and ordered it to be administered in
one hour’s time. I thought that would allow the cow and its master to get
a safe distance off.
I rather regretted this afterwards, for very soon another veterinary case
was brought in for treatment. This time it was our own faithful Muscat
donkey; it was suffering terribly from the plague of flies that generally
appear in the dry season. The poor creature’s legs were absolutely raw,
and it had almost lost the power of standing. After the donkey boy had
applied antiseptic washing and ointment I tried to fix on bandages,
but donkey’s legs were evidently never made the right shape for that—I
could not get the bandages to stick. Mr. Fisher was then consulted on
the point, and of course, man-like, he suggested trousers. It really
sounded very suitable, so I set to work on a pair, and when the donkey
was put into them he looked most distinguished. The people gathered round
in numbers to see it, and exclaimed, “What honour the European gives
his animal!” There were several spectators who were not clothed so
magnificently, and being afraid of giving the impression of extravagant
waste, I explained to them the object of the garment and our ideas of
kindness to dumb animals. The donkey did not take at all kindly to his
first pair of trousers; perhaps they did not fit well; at all events, he
kicked them to pieces in two days. A second pair was made on a modified
scale, and whether or not the owner had cultivated more civilised
instincts, it is not easy to affirm, but they remained intact till they
were no longer needed, and the owner was able to run about and be up to
his usual pranks again.
Great care has to be exercised in administering drugs, as the people have
absolutely no idea as to how they act on the system. Medicine intended
to last for some days has often been swallowed down in one dose, as they
argue that if so much physic can cure them at all, the sooner it is taken
the better. Powders for internal use have been received with incredulity
and sometimes scorn by those suffering from skin diseases, and they will
insist on impressing the dispenser that they are quite well inside.
If, with all their persuasion, they cannot obtain some blue stone to
apply to the sore (which they simply love, as it causes them to scream
uncontrollably), then they go off with their packet of powders and show
the superiority of their wisdom to that of the white doctor by using it
externally.
One of the very few medicines that it is absolutely necessary to keep
under lock and key is sulphur, which is well known to them as an
unfailing skin remedy when mixed up with butter. Our cook once bribed one
of my little assistants to smuggle some away for him, and being misled by
the similarity in appearance, the lad gave him iodiform instead. This he
mixed up into an ointment and smeared well all over his body. As he sent
up dinner that evening iodiform was as pronounced as oil is in a German
table d’hote. It was soup à l’iodiform, viande à l’iodiform, confection à
l’iodiform, café à l’iodiform, in fact there was no getting away from it.
When we left the table in despair we were like a chemist’s laboratory.
As for ideas of hygiene, these are absolutely absent from the native’s
mind. When a person is very ill, regardless of her station in life, she
is carried into the dirtiest and smallest hut. This is soon crowded up
with well-meaning and sympathetic friends, whose one idea of condolence
seems to be to assure the invalid that she is on the point of dying.
The hut continues filling up till the only inlet for fresh air (the
cramped doorway) is entirely blocked up, by which time the condition and
atmosphere of the hut becomes so indescribable that it is a wonder anyone
comes out alive. These things suggested to my mind that a few elementary
lessons on hygiene might perhaps prove beneficial, so, taking to my
afternoon class a diagram of the human body, I described to them the
anatomy of the body, blood circulation, &c. Their interest and surprise
were great. They had always imagined that blood circulated from the head.
This was their argument for cutting their heads in cases of fever; they
reasoned that malaria was an over-heating of superfluous amount of blood,
so they must let out some. At first they were inclined to doubt the
soundness of the new theory of circulation from the heart, and asked “can
a river flow up, does it not always flow down?” “What about a spring?”
said I. They thought for one moment, and then answered “The European’s
wisdom has overcome ours.” Then a new difficulty struck them, how was it
in the case of women, for they had no hearts. Their old King Kabarega,
when he killed off his wives, had cut open some, and never found one with
a heart. So the statement had become an accepted fact with them. How
could they have believed such an error!
They also imagined that mind was tucked away in the heart, and did not
in the least associate brain with intellect. Poor woman, minus heart,
therefore minus mind, was very poorly endowed.
Their attention and interest were very keen, and did not seem to diminish
when the moral was applied in the shape of ablutions, fresh air, and the
care of the body being essentials to health.
It is sometimes difficult to arrive at an exact diagnosis of a patient’s
ailment. One will describe her complaint, pointing to her lungs, as a
voice inside that says “Chew, chew.” Another affirm that a spear is
running into every part of his body. Infants are always suffering from
evil spirits or poisoning, in cases when a dose of dill water would be
generally prescribed.
Although I have occasionally met with a native doctor in a sick house, I
have never been able to discover a native drug or remedy outside cupping,
branding, and revolting forms of witchcraft. These men make a regular
study of the art of deception and exact exorbitant fees in the form of
goats or even oxen. As an example let me give the case of a lad who was
suffering from tuberculosis. He had consulted the witch doctor, and after
having paid his fee was told that he had been poisoned. Whereupon the
“surgeon” drew his knife out from his belt and made a number of small
incisions. He then declared he could see the poison inside the youth and
took it away. But the lad was not cured and so came down to give the
European’s wisdom a trial.
This ignorant credulity of the people has sometimes proved useful to
the white man in times of extremity. In one instance a European noticed
that his daily supply of milk was continually disappearing in an
unaccountable way, and one day he determined to investigate the cause.
It had been proved that the cows were not to blame; they had given their
usual supply. The milk boy was cleared, for the boys of the household
vouched for having seen it being delivered. The discrepancy in the
amount had unmistakably occurred in the cook house, where the cook alone
was resident at the time. So the culprit was called up to be examined.
He insisted on his innocence declaring all the while that he did not
know how to drink milk. As no eye-witnesses could be called the idea
struck the “magistrate” that he would conclude the matter quickly and
unquestionably by their own means. Turning to a youth close by he said
“Just fetch me my little pocket knife to bore a hole and see if the milk
is inside the cook.” Whereupon the culprit fell on his knees exclaiming,
“Oh, master, I did drink the milk. Forgive me, I pray you.”
After the affiliation of the Toro branch with the medical headquarters
at Mengo, the work was placed on a far more satisfactory basis. A report
had to be sent in every three months with statistics dealing with
daily attendance at the dispensary, out-patients’ visits, etc. Then,
in addition to this, a list was made out yearly of drugs and dressings
needed for the forthcoming twelve months, which ensured an adequate
and regular supply of medicine. The work, however, passed through a
varied succession of small vicissitudes. Our faked-up building had to
be pulled down, as the site was needed for a new missionary’s house,
but in exchange we got a brand-new airy dispensary. We scarcely knew
ourselves with such spacious surroundings, and the two little native
assistants, who had been trained to attend to all dressings, assumed
quite a ridiculous air of professional importance, to say nothing of
the feelings of the quack doctor! But at the end of a fortnight we were
completely evicted from our grand premises—patients, staff, drugs, and
all. A violent storm had destroyed the only house that had been standing
ready to receive a fresh addition to the staff of missionaries, which was
then only within a few days of arrival in Toro. As there was not another
available inch, the new dispensary had to be speedily converted into a
domicile.
Feeling decidedly crest-fallen, my little assistants and I packed up all
the medical impedimenta and carried them over to a little reed building
that had been the reading school till the constantly increasing inside
pack had necessitated more ceremonious premises.
We completed our removal, and had not been installed many weeks when a
furious hurricane swept over the little hill capital, and succeeding in
throwing our new dispensary completely over on its side. When the debris
and roof were cleared away, a most heterogeneous collection of medicines
were revealed, all hopelessly mixed up in wild confusion. Pills of every
shape and form were scattered about, bottles of liquid drugs, and stock
mixtures had been smashed up, and the combination of odours was enough to
frighten away all the microbes for miles round. Once more, and for the
fourth time, the dispensary was transferred to different quarters, and
there it remained until the present complete medical compound was erected
at the advent of the much-longed-for and long-expected doctor in 1904.
Through the generosity of a friend in England the “Gurney Hospital” and
new dispensary were then built, together with the doctor’s house. The
former is a good-sized building consisting of two wards for thirty-four
patients, besides consulting and waiting rooms, while the broad ten-foot
verandah which runs all round allows ample space for convalescents.
At first the Batoro were inclined to be fearful of undergoing chloroform,
but King Kasagama, half out of curiosity and half out of a real desire
that his people should derive the fullest benefit from the “doctor’s
wisdom,” successfully banished these fears. One morning he came down to
the dispensary asking that a slight ulcer from which he was suffering
might be lanced under chloroform. This was kept a profound secret from
his people till it happened to reach the ears of his mother just as he
was getting over the operation. The poor old lady came bustling down in
breathless speed very fearful of the effects the “sleeping medicine”
might have had on her son. She was intensely relieved to find that
nothing worse had resulted than rather a sorry expression on the usual
smiling countenance of the patient. It soon became the topic of the hour,
and even to the distant villages the news spread. From that time surgery
was in great demand; in fact it became a kind of fashionable epidemic.
The need for medical work in these parts is seen in the one hundred to
one hundred and fifty out-patients that came up every day for doctoring,
and the scarcity of vacant beds ever since the opening of the new
hospital. Indeed it seems a practical impossibility to carry out to
these people the message of love, peace, and goodwill unless one can at
the same time do something to alleviate the terrible physical suffering
to which they are subject. Besides being a most effectual channel for
conveying balm and healing to their souls, the object lessons given
to the in-patients must accomplish much in introducing new ideas of
cleanliness and possible comfort into their own poor, dirty homes.