To work as Medical Doctor and Surgeon under extreme conditions E-Book

Helmut Lauschke

• Herausgeber: neobooks
• Kategorie: Fachliteratur
• Sprache: Deutsch

Seitenzahl: 409

Veröffentlichungsjahr: 2023

Beschreibung

It was between eleven and twelve o'clock. I had started the operation when a huge detonation occurred. The floor of the theatre room was shaking and the instrument nurse got shocked that the scalpel fell from her hand in my hand and had cut my middle finger. Dr Lizette fell over with the stool. She was severely shocked when she came up with a pale face. The instruments had slipped around on the moving instruments table that the nurse had to put them back in place. I spread some brown solution for disinfection on the wound and changed the gloves and continued the operation. The middle foot were cut off through the lower ankle joint and the large tarsal bones were covered with soft tissue flaps which were sutured together over the short foot stump. The huge detonation had shaken the bones of the people not only in the theatre building, but in the whole hospital. It was my concern that the impact could have taken the life of many people. I read the fear in the eyes of the people in the theatre room. The book gives insight into life and the medical work. It demonstrates the exercises of learning and work under extreme conditions by understanding the people in need and in evaluating the challenges by fulfilling the responsibilities and tasks. To put the good intentions into practical perspectives, education must improve to strengthen the willpower for enhancing the capability and skills in the work performance. The biggest goal is humanity. To reach this goal, the prerequisites are personal humbleness, true honesty, tolerance, dedication, passion and determination in commitments and high ethics in the performance. The principles comprise mutual respect and understanding, the willingness to help people in need and to educate children to the best level, and to keep up the values of humanity, which has to be praised and practised sincerely from generation to generation. Everybody is responsible to act accordingly that life maintains the values in its deeply rooted meaning.

Leseprobe

Helmut Lauschke

To work as Medical Doctor and Surgeon under extreme conditions

Urgent needs in the most critical time

Dieses ebook wurde erstellt bei

Inhaltsverzeichnis

Titel

The bridge over the Cuvelai has been restored

Heavy thunderstorms and fierce lightnings

The indifference of the superintendent in major’s uniform

A civilian successor as superintendent

The brigadier intervenes in the morning meeting

The last battle was in full swing

Visit to the Mission hospital in Oshikuku

Dr Johan mentioned ophthalmology

Crippled children and adults sit along the passage

A brutal night raid of koevoet

Impressum neobooks

The bridge over the Cuvelai has been restored

Urgent needs in the most critical time

All bridges of the strategically important tar road in the north from west to east through the Ovamboland were guarded by the military. The situation was tense. The conflict came closer and the war was escalating. PLAN (People’s Liberation Army of Namibia), the military wing of Swapo, and its allies were fighting for an independent Namibia against the occupying South African colonial power and white apartheid regime of Pretoria which was supported by the majority of white people who fought for the white privileges in a status quo. The black population did sacrifice tremendously and the number of victims has become uncountable. People were brought to the hospital with lacerations, bloody wounds with bloodshot marks on the chest or back, on arms and legs after they were interrogated by the special forces of koevoet (Afrikaans for crowbar) on the field or in the villages or at the police station. Since koevoet had recruited black people, it often happened that black koevoet men beat and tortured their brothers and sisters, if the white captain was of the opinion that the person was a supporter of Swapo. It were most innocent people who became victims of the brutal stick treatment. The suspicion was enough to get beaten, tortured and deported. It was the spiral of force and violence which was cruel and awful. It was seen on the bodies of victims, who came to the hospital for treatment. If there was a suspicion of collaboration that for instance a PLAN-fighter was hiding in the kraal, the heavily armoured Casspir vehicles flattened the kraal down that the inhabitants with the old people and their children were literally left behind with nothing on the open field.

This civil war lasted for more than ten years and became more destructive the longer the war went on. The insecurity in the north and the military struggle in the close-to-border region to Angola escalated. The white perspective became increasingly critical what had consequences for the hospital as well. Dr Witthuhn as the civilian superintendent was removed from office and replaced by a tall man of the mid-thirties with the dashing uniform of a major. The new superintendent was a medical doctor, but this in second line of smaller importance. He spoke Afrikaans and English eloquently and juggled between the languages ‘ad libitum’ and made repetitions ‘ad infinitum’. He repeated a sentence in English five times and added the repetition of the same sentence in Afrikaans ten times. With each repetition the sentence got stretched longer up to a chewing gum hanging out of his mouth without any further meaning. The nouns were colourfully decorated with adjectives and the verbs were attached with numerous adverbs, thread-like appendages and other threadbare substitutes like empty shells that in the end the core was gone, and what was ‘invisible’ in the beginning were hidden in the end behind all these nonsense decorations.

The verbs about what had to be done what gave the noun the meaningful substance, had disappeared in the trapdoor. Subject and predicate were buried under a jumble of useless decorations and word rubbish. The sentences became irrational that one could not find out what was first and what not or what the superintendent in his dashing major uniform did try to say, not to mention what he was thinking under his word covers. It became clear that this man enjoyed to juggle in a erratic manner from one language to the other and back without speaking a short and meaningful sentence. His eloquence had the format of a barrel organ. People attending the morning meetings were confused and little later bored as well by the bilingual splits that he did not stop, and of the fact that they could not understand what he liked to say. So it became practice that the attendees looked at their watches, though the meeting was not far from the beginning or in the middle. The question was when would the superintendent stop his endless nonsense with the swinging empty shells and threadbare ingredients in a salad which was tasteless and meaningless. If somebody asked him a question, a torrent of words started again until the question had been crushed and chewed that nothing was left, but an answer did not come.

Meanwhile I had got a small flat allocated by the Bantu-administration. The flat had a small sitting room, a one-bed room, a very small kitchen with a semi-automatic washing machine, a veranda with a mosquito screen and a shower room with toilet. I did appreciate this improvement, especially that the sleeping room was spacious and not packed with cardboards from the bottom to the ceiling.

The first what the new superintendent in uniform of a major did, he let move the desk and swivel chair to the opposite site in the office. The old white painted asbestos board was hanged on the opposite wall where a telephone connection plug was put on as well. It was the side where the matrons and pharmacists took their seats when Dr Witthuhn was the civilian superintendent. That was the time when the lean white chief matron complained of the urine stench on the hospital square assisted by the short black matron who pulled the grimaces of disgust. It was also the time when the chief matron gave in one morning meeting an impressive speech regarding the team spirit by understanding each other and each other’s problem to work trustfully together in the very interest of the patients despite the many shortcomings under the poor hospital conditions in the critical circumstances of war. Her intention became a stillbirth by undermining and the false activities of Dr Hutman whom I soon recognized as the lieutenant of the devil.

Dr Witthuhn was moved down on the post of principal medical officer to the department of internal medicine. He took it cool without any effort of resistance, because he needed the regular income by the monthly salary. Above this, he was of the strong belief that the madness of the white arrogance and desperation would not last long. It also was no degradation salary-wise, since the white Bantu-administration had put him only as an acting superintendent on the previous chair and that for a short period of time. The military had mistrusted him as civilian superintendent because of his liberal, but ethically correct way of acting.

He made now the ward rounds as the other doctors did and was respected by the nursing staff as a friendly and understanding doctor with a human face, who made his notes with the big handwriting on the sheets in the patients’ files. Dr Witthuhn had a big heart and also big problems. It was part of his personality that he made big excursions when he was far away in his mind. He was a person, who was not simply to measure in the range of normal standard. He rejected the small-minded attitude of jealousy and malevolence, but was alert against people who were false and sly. He sat behind a small table in a small consulting room in ward 7 and examined the outpatients. A running ventilator stood on a chair opposite to him for some air circulation. It was a room of humbleness also in diagnostic terms as he sat back listening to the patient’s complaints and following the excursions in his mind. It was the case that he had to be touched for coming back to the world’s reality in this small consulting room with the smoothly running ventilator.

The health director sat in a flawless uniform of a colonel further and untouchable on the comfortable swivel chair behind his empty desk with the polished wooden plate in an air-conditioned office with the photo of the unyieldingly looking South African president in big format under glass on the wall. The director’s main concern were his teeth. His only work was to draw up decrees of what had to be done in the hospital and what not. So it was decreed and signed by this director that it was forbidden to treat Swapo-fighters and active Swapo-supporters. The Bantu-administration had no saying how the hospital had to be run. It was obvious that those white people remained indifferent about what was going on. They were not interested to look into the problems the hospital was confronted with.

It was the time when two officers of the SADF [South African Defence Force] occupied the chairs of the highest posts at the hospital administration. They controlled the medical work that had to be done under the most primitive conditions in using old and outdated facilities with the many missings. Nursing staff as patients and the population at large did not trust the military authority. The hospital got a strategic importance at the expense of being an open health institution for all the sick and injured people. Since the military had taken over the command in the hospital, the paramilitary koevoet patrolled the hospital ground in nightly raids with their armoured Casspirs searching with floodlight for hidden PLAN-fighters up into each angle and corner.

The replacement of the civilian superintendent by the young major has not brought any improvement. The Sekretaris had not kept his promise given one year ago to send a clerk to look into the critical matters and to list up the most urgent points for repair and replacement. The conditions remained miserable under which the huge workload had to be solved. The old central sterilization unit broke down from time to time what caused long delays in performing the operations. The outdated operating table ready for the scrapyard was not replaced and the old and defective surgical instruments had still to be used. The overcrowded wards were old. Some toilets were clogged or otherwise not usable. The doors of the wards were battered and the door handles and locks were broken off. Panes were broken in many windows. New bedsteads of the basic standard did not exist. The old, torn and smelling foam rubber mattresses were not replaced.

The hose against the urine stench on the square was the single improvement after some battles of the former civilian superintendent with the stubbornly stuttering Sekretaris. This was possible after Dr Witthuhn had convinced the Sekretaris by describing the urine stench as smelling so bad that he pulled the skin on his nasal bridge and got hit by the strong feeling of revulsion.

What the new superintendent in his dashing uniform of a major did achieve, were a new ambulance and two small Ford-buggies with open loading spaces. The major who was proud of this achievement after his few weeks in office reserved one buggy for his ‘official’ and private purposes. The administration followed without any criticism the military command what did not result in a single move in improving the condition at the hospital. It virtually ignored the responsibility of making one substantially constructive input into the miserable situation. It was the heavily disappointing fact that the functional standard of the hospital was brought down by the white-run Bantu-administration.

If the whites themselves had a health problem they were served by plane to bring them to the specialist in Windhoek or South Africa where they claimed the high First World standard in medicine. These privileged people recognized the medical standard at Oshakati hospital with the penetrating urine stench on the square and the primitive and defective ward facilities as obsolete. It was the hospital for blacks only. It was common practice that the whites used the quick and gratis transport by air for other things as well, when they had an appointment with the dentist or a medical doctor. Hairdressing and go shopping were included. Formal and informal communications with influential people in the floors of the central administration were of importance in the time of the increasing insecurity. One had to look forward to prepare the steps into the unknown future. What bothered white brains most it was the question how to maintain the high living standard when the apartheid system would collapse.

The morning meetings lasted longer by the bilingual jumps and countless repetitions of the new superintendent. The one black female colleague attended the meetings more often, but with a regular delay, who did not attend the meetings at the time of the civilian superintendent. She, who put the head in the civilian time through the open office door and back to make sure that the meeting was finished, took now part in the discussion in a more excited manner. She preferred her eloquence as the new superintendent did that the point to make got a smoke in the air. Dr Hutman had changed his cheeky and know-it-all behaviour, but kept covered with his intention to please the major. The outcome of the meetings remained poor and useless.

Dr Bernhard was a new colleague who was a specialist surgeon with a Swiss certificate. He had collected his experiences in traumatology on the hospital ship ‘Vietnam’ anchored in the harbour of former Saigon during the last year of the Vietnam war. Dr Bernhard came to Oshakati with his expertise and intention to help. He was a highly talented surgeon and took over the responsibility for orthopaedics, while I was kept responsible for general surgery. The new colleague was a relief from the huge burden. In the first year at Oshakati hospital I did circa one thousand six hundred operations. I felt sorry that the friendly cooperation with Dr van der Merwe came to an end, who asked the major superintendent to be transferred to the department of surgery for the last months of his military service. The major promised to accept his request after new young doctors from South Africa has arrived for their military service in the north.

Dr Bernhard could not believe that Medical & Dental Council in Pretoria did refuse his recognition as a Swiss specialist. Like me he was put as a senior medical officer and both felt the degrading as a box round the ears. The administration promised to upgrade the position of both doctors after one year into the category of chief medical officers. A probationary period was compulsory, and that in a time when specialists with experiences were needed most. The arrogance of the Council in Pretoria got combined with the blindness of a stubborn-short-sighted administration. It was the discrimination at the first place and the clerks and other white stooges were at the hands of the Boers. This anachronism had exceeded Bernhard’s tolerance limit. In his second week he already decided to ignore this nonsense and prepared his return to Switzerland in the first year. He told that he is neither a donkey nor prepared that idiots can dance on his nose.

Dr Hutman remained covered. He visited the major in the superintendent’s office on a daily basis. The other army doctors did not trust him with personal matters. Van der Merwe told this in a conversation in his caravan one year ago in connection with the fourteen-year-old boy, who passed away on the operating table in the delayed craniotomy when Hutman had rejected my advice and assistance. There was a hearing in the director’s office when Hutman accused me of having caused the death of the comatose patient by disturbance during the operation. The hearing revealed that the accusations were false and insidiously calculated that the colonel director gave this lieutenant only a verbal warning, since Hutman was his extended ear. Now he had become the extension of the major’s ear as well.

This egocentric doctor was son of a wealthy family in Johannesburg. He had his personal career in mind, but not the needs of the black people to whom he showed an emotional abstinence. The careerist pleased his superiors who occupied a big part in his corrupt thinking. The specialists came twice per week from the military hospital in Ondangwa. They were flown up from the central military airbase ‘Waterkloof’ [water gap] north of Pretoria to the north and were replaced at the military hospital after two weeks. These specialists in uniforms of high-ranking officers were lecturers and professors at the medical schools in South Africa. In their two-weeks-service they had to ensure the surgical care of the combat troops.

Why these specialists still visited Oshakati hospital was not fully understood, since the two civilian specialists, though downgraded to senior medical officers, worked in general and orthopaedic surgery. The army personnel got surgical treatment at the military hospital on the airbase in Ondangwa. It was thought that their visits had not only to do with medical support, but with the reconnaissance by searching for PLAN-fighters as well when they did the surgical ward rounds. This kind of intelligence service was easy for them by reading the history and evaluating the injury, since all the doors were open for the military authority which controlled the activities in the hospital. On the other hand it was true that Swapo enjoyed the broad support from the black population.

There was no illusion that any improvement in the working conditions would not come as long as the military and the whites ruled the regulations and mistrusted the hospital as an institution for hiding the enemies and Swapo-sympathizers. It was against the oath on the South African president and white apartheid flag to treat the enemy, whereas impartial and equal treatment was compulsory according to the Hippocratic oath. The gravity of the political schizophrenia became even more visible in the miserable conditions with the defective facilities. The many promises for repair and replacement from the white-run Bantu-administration and its stuttering Boer on top remained empty. It was an old and widespread political advice to keep up the white opportunism. The white stooges kept quiet when medical ethics became tortured and crippled. I thought of the psychological impact that should come on the young doctors after graduation from university with the ethical oath when they had become second lieutenants in the SADF and had to take the other oath on the South African president and the white apartheid flag. They stuck in the schizophrenic gap as they treat one patient and had to refuse treatment on the other patient. It was the excess after having lost reasonableness and humanity which caused the deep-going conflict between medical practice with medical ethics and its opposite by following the military order in regard to the political absurdity in the arrogant apartheid system.

The non-recognition of the specialist certificates of the two civilian surgeons and the languishing and depraved condition of the hospital were of great concern. The question was when would the hospital collapse due to the miserable conditions caused by mismanagement and white-political short-sightedness. The political formulas were implemented and administratively followed in an opportunistic and corrupt way against the majority what was the black population. Not much of nous was needed to understand the political baseness. The facts were visible and terrible enough without further proof of devastation. It was the time of the tensile tests in the conscience of each doctor and health worker, and this in the time when the big upheaval stood before the door.

In this difficult time Hutman kept himself camouflaged to play his insidious games against the civilian doctors, who worked hard and round the clock. His ambitions were selfish and traitorous without any sympathy for the black people. If there was an award for false denouncing of people, Hutman deserved it with the devil’s star for outstanding achievements as the opposite of bravery before he left for his family to Johannesburg. He was the only example compared with the other army doctors, who ruthlessly used the elbows and intrigue for his career. Since the privileged status had been taken away from him, Hutman put all his effort into the intention to harming me, who was responsible for the surgical department.

There were annoying word battles that I had to stand against Hutman who provoked the battles by arrogance and refusal to listen for reason. All the battles could be avoided, if basic education and respect against an older colleague were exercised and the rules of civilized thinking and speaking were practised. The first battle of this kind was in superintendent’s office when Dr Witthuhn called and confronted me with Dr Hutman. The superintendent sat behind piles of patients’ files on his desk and Hutman sat accompanied by two young army doctors on one of the upholstered chairs on the window front under the rattling air conditioners. One young army doctor sat right and the other young army doctor sat left of Dr Hutman.

What was the point? Hutman accused me of not seeing the patients regularly in the intensive care unit, since there were no notes made on some days. The superintendent looked through the files and could not deny the accusation. He asked me, if that is true. I told that I have seen the patients every day, but in the early morning and had made notes in the files only, if something important has occurred in the patient’s condition. A reason of having done this was the time pressure, since I tried to see the patients in the other wards as well without delaying the operations.

The truth came out and Hutman’ face became pale. Instead of searching the files for missing notes I have seen the patients before the early shift of nurses has started. The superintendent has asked Hutman how he saw his responsibility when he camouflaged as a doctor to destroy what others have built with great effort to help the people, who are in need for medical treatment. And in the critical situation of war, only a few doctors were available. The superintendent understood the point. He said to Hutman, who turned his head to the companions on the right and on the left, that he should look after his patients and stop intriguing against me. After this ugly confrontation I called Hutman an insidious trapper and lieutenant of the devil following Carl Zuckmayer’s “The Devil’s General”.

The other battle was the disciplinary hearing that the director in colonel’s uniform held in his office when I had to defend myself against the false accusations of Hutman in connection with the death of a comatose fourteen-year-old boy on the operating table. This army doctor delayed the operation of putting burrholes for brain decompression from a haemorrhage. Instead of this he drank tea and chatted with some young army doctors in the theatre tea room. Also his operative performance was far from skilful and professional. At the end of the long hearing followed by the civilian superintendent, the director gave Dr Hutman a verbal warning, though he had deserved a strong written one which never came.

However, the lieutenant of the devil did not give up and continued his role as schemer of a low and corrupt character camouflaged as medical doctor. The devil sat on his neck and rode his bad character in a furious gallop. He was not interested in the damage he did by his traps and lies. His dark eyes remained restless. The immoderate arrogance expressed the psychological abnormality in a sense of a magnified ego in the mirror of an obsessional neurosis which was incalculable and unpredictable. The ego of Hutman and his restless agitation had stirred up the mistrust of the military against the civilian and had certainly contributed that Dr Witthuhn was removed from the superintendent’s chair and replaced by an eloquent but meaningless major-superintendent. The obsessed personality of Hutman was the main reason that the team spirit emphatically propagated by the dedicated chief matron had become a stillbirth.

The working climate became even more tense with the major on the superintendent’s chair and the dark machinations of the neurotic lieutenant of the devil as an extended military ear. The contra-productive activities inside the hospital gave the mirror image of a neurotic strategy combined with nervously shaking military and paramilitary activities in an exhausted apartheid system outside the hospital as well. The conditions were miserable and the medical facilities were defective. The wards were overcrowded and some funnel-shaped zinc toilets did not work or were clogged. The water pressure was weak and the old water pipes were rusty and furred up. There were hours and days that the hospital was without water when the pipes outside the hospital were broken and the repair took longer than told. Was the water pressure high, the water squirted through the holes of rusty water pipes. If not the water, the power was cut off with a negative impact on the operative work in the theatres, the central sterilization unit and the work at large. Excrements as diarrhoeal or piled were lying in the children’s ward and outside the wards marking the unhygienic state of emergency.

I criticized the indifferent behaviour of the people in charge, whether they were civilians or people in uniform who have neglected or ignored the problems of the toilet conditions and of the lacking hygiene in and around the wards. It was the academic status that these people did not put their noses over the badly smelling toilets or have looked into the filled-up funnels. But hygiene in general and in a hospital especially starts with the toilet conditions. If a doctor kept the hands clean by washing them after various procedures, he should understand the importance of cleanliness that includes the ward toilets as well. A medical doctor has not only to keep his hands clean, he also is responsible for the cleanliness in the wards where he does his daily round to see and examine the patients. It was one basic obligation that the doctor’s responsibility should not come to a halt without considering the smelling and otherwise malfunctioning toilets. The question is justified how patients should respect doctors who impose the unhygienic and smelling toilet conditions on them.

The new superintendent neglected the hospital and its needs and imposed his unreasonableness with the state of dilapidation on the patients, the nursing staff and medical doctors. The Bantu-administration run by white clerks did nothing to correct the mismanagement that lasted too long. No single administrative ‘arse’ came to the hospital to look into the vast number of burning issues what the stuttering Sekretaris with the square face had promised several times and long ago. The people in the administration had given up their interest and responsibility to restore the hospital to a better condition. They sat back in their comfortable and air-conditioned offices and kept the faces of innocence when they took their coffee and tea breaks every day at the same time and of the same duration by following up their private interests that were substantially pleasant and profitable. The personal advantage lay in the centre of their thinking that they did not ‘waste’ their time on public issues like the anyway neglected hospital. If the phone line went through, administrative people consistently complained of work overload, though they finished office hours always in time and returned home, if no private business after hours were to handle. The doctors with their work-related small salaries without car and other allowances had still to work hard in seeing and treating patients waiting in huge numbers or to perform the unexpected emergency procedures.

One question remained: Where is the money allocated in the budget for maintenance, repair and replacement in the hospital? This question came periodically up, at least once in a year when the miserable conditions with the big number of lacks and shortcomings were pressing on the eyes and depressing the minds of those people who did the hard work with dedication on the patients. In which direction had the money disappeared? This question answered itself by observing the lasting situation of the critical conditions and by getting insight into the administrative mismanagement by measuring the scale of corruption. If book keeping were done in transparent ways, money could not simply disappear. Where were the pockets, bags and other containers that were filled with money what was allocated for the hospital? The question remained unanswered in all the years. But in wartime it is known that things went missing without coming back. The fire-reds of sunsets and sunrises indicated that something new was on the brink that could be expected very soon. The old time ran out and the whites met their measures, if things were not handled timely or would go wrong.

That unprotected black people suffered most, it did not bother much the apartheid-privileged people who kept focused on their lives and properties often with a collection through the years and that in contrast with the poverty of the black people, who were hoping for a better future by getting rid of the forced degradation and discrimination by the apartheid laws and regulations. So signalled the fire-red over the horizon for the ones the change with the hope for betterment by liberation and release from the white chains, and for the others the change was packed with worries and fears how the way would go into the uncertainty of an irrevocable future.

However, the white administration was still in place with the stuttering Sekretaris on top, who did not bother about the dilapidated condition of the hospital. All the written and reasoned requests of Dr Witthuhn when he was the civilian superintendent had remained unanswered. Urgent requests had never reached the practical phase of quotations or ordering. Piles of letters and requests lay on desks of the administration and were laid ‘ad acta’ without response. If a hospital person visited unexpectedly the administration to query why there was no response, no letters were found, but cups, glasses, bottles, teapots and sugar bowls were on the plates.

The visitor were pleased with excuses of work overload what was almost always the first shield of defence. There were other things to arrange which had little or nothing to do with the hospital and the numerous written requests, if not hospital-allocated money was already moved into non-hospital related channels. A clearly substantiated answer was never given that the visitor returned to the hospital without result. The visitor could make his own thoughts on the forty-five-kilometre-road back to Oshakati why he had achieved nothing by his visit. The fact of mismanagement and the suspicion of corruption lay on the hand.

Administrative people with greying hairs and the blink of harmlessness knew what they were doing. They were well-rested and motivated in their businesses when they sat the office hours comfortably on chairs behind empty desks with the little work to do in their air-conditioned offices. It was in their power in which direction the budgeted money had to go. Despite the shruggings of not knowing whereto the money has gone which was allocated for the hospital, these people knew of the slidings in which they were administratively or otherwise involved. The suspicion despite the miserable state of the hospital was evident that money had been shifted to anywhere under the hand of mutual confidentiality. The amounts were considered as quite substantial what was moved to other non-hospital related channels.

Auditors from the central administration investigated a case of a Ford mini-loader of which the engine was replaced twice in one year, though the first engine had driven less than twenty thousand kilometres. The four tyres on this car were replaced several times in the same year. The investigation led to the suspicion that something was not in order. The auditors went to the office of the Sekretaris to get more insight into the mysterious story. However, the Sekretaris leant back with an innocent blink and shrugged his shoulders. The auditors showed him the entries in the book, but the Sekretaris continued shrugging his shoulders and blinking his innocence. He as the auditors sat up on the chairs and were looking in the opened book. The auditors waited for an explanation what the Sekretaris was unable to give. He put up the phone and ordered stutteringly the person responsible for the car pool to his office. The stocky gentleman in the middle of his age entered the office with a face of the total innocence. The Sekretaris explained to him the problem in connection with the Ford mini-loader in the language of the Boers, but the gentleman from the car pool kept quiet with an innocent face as he could not understand the point. The auditors became annoyed. They pulled out the invoices and receipts of payment for the replaced engine and tyre sets and put them on the desk of the Sekretaris, who pulled his face with grimaces of ignorance and unwillingness to understand.

The investigation proved that the mini-loader had an accident and was written off and scrapped two years ago. The number plate had been removed, but the number on the plate was written on the various invoices. The auditors asked where the two engines and the four tyre sets were, which had been invoiced and paid for. The determination of questioning brought the Sekretaris and his clerk responsible for the car pool into the embarrassment of the lack of evidence and credibility. Their faces became ash-grey and their eyes lost the blinks of innocence. The fact was that the engines and tyre sets had disappeared as they had been dissolved into thin air, though the records were on the polished wooden plate of the desk. Those kept quiet, who knew about this kind of business. None gave an explanation to resolve the discrepancy. The auditors insisted. “Nobody will buy this from you”, one auditor said looking at the grimacing face of the Sekretaris, while the other auditor made a note on his notepad. The Sekretaris did not back his clerk. He let him fall like a hot potato, though the clerk had several times fulfilled wishes of his superior for free. Now the clerk should see how he could come out of the steam of lies what he in his smaller capacity was unable to achieve. Disciplinary measures were predicted. In the end and after some other topics in the same conversation and after a braai in the private atmosphere in the spacious garden with a spacious house of the Sekretaris, the auditors nevertheless gave their approval for the correctness in keeping the books and left the Bantu-administration and the north back for Windhoek.

It was guessed that the auditors’ report with the grey zone in regard to the purchase of the second engine and the four tyre sets for the already scrapped Ford mini-loader had got the okay by countersigning of the person in charge of the next higher instance and were laid as finished and approved to the other approved and countersigned reports in one of the filings and drawers or were put straight-away into the voracious jaws of the oblivious abyss. Disciplinary measures as predicted took never place, since the culture of corruption was widespread in the various branches of the administration up to the top floors. ‘Pretorianic’ mince-hymn by linking Gregorian expression of Greek pentatonic melancholy with manic-depressive hip hop and side jumps came along with the dilemma of rejection of responsibility that the culture of corruption was open, if the camouflage was appropriate. It was similar to the cackle hymns of a group of geese with in between and irregularly chopped lasting slogans. Things had exaggerated that affected the situation. It was like a walk on a tower-high tightrope with the balancing pole, but without net and return. Neglects and dissipations in the final stage violated coarsely the remainders of law and order. I kept eyes and ears open, while others preferred blindness and deafness to enjoy the higher degree of comfort. The story had many faces on the eve, but the whites feared the imminence of a sudden change.

Heavy thunderstorms and fierce lightnings

It was the night from Saturday to Sunday of the second week in February when a heavy cloudburst occurred. Series of lightning flashed through the night and the thunderstorms rushed most powerfully hammering rock-hard blows in ear-splitting and rolling staccatos down followed by trembling counter-tremolos over the ground. The walls shook and the doors rattled, the cups, plates and pots clattered and the asbestos plates in the ceiling grinded. A torrential downpour struck the corrugated roof and splashed against the panes. Down-flashing lightning glared like ghosts in acute windings over the swimming ground sponge. One lightning tore off a big branch from an old tree. Storms raged heavily and the glaring of the lightning were accompanied with hiss sounds of the power of thousand pythons. Hit waves rolled powerfully out like big cannons gave sharp shots that heavily detonated up to far for a stretch of some seconds.

An apocalyptic dream could not be more eery and horrific. It could be the dream of the shipwrecked man in the forlorn endlessness on the storm-foamy ocean between crashing-down wave mountains and the tearing-away wave valleys. The feeling of tininess and helplessness of the human against the powerful natural forces was present with the big trouble to save the soul in front of the drowning rift. Each time I felt the relief when the hitting waves rolled away and were fading down afar with the dull roars of the night. Forceful thunderclaps had torn the night’s sky like a gigantic sheet lightning flashing in wild zigzags across the sky behind and through the cut-off cloud banks. The optimism was unfounded in understanding the sheet lightning after the heaviest thunderstorm I ever have experienced as a message of peace, since the blood-red in the colour scale could be seen as the infernal hellfire as well.

I looked through the window at the raged-through sky and was waiting for further signs what the sheet lightning had to say, if there was the message of a peace angel or rather the devil’s message with a white-hot iron forged in the smithy of the hell to a huge killing sword of destruction. It were the flash pictures of nocturnal illuminations when it became still outside and the moon shone through the widening cloud banks and mirrored itself in the lake in the front garden. During this natural spectacle the question arose of defining life with the poor hospital conditions and the meaning what could be achieved in peace and with a right management what the war and associated mismanagement with the various kinds of corruption made impossible. I got tired and went to bed, but could not find the sleep.

It was after a long ‘walk’ that he gave up parts of his consciousness when the phone rang. It was three o’clock in the morning. I was on duty call. A nurse of outpatient department told that a girl had been brought, which was hit from the lightning. I put on shirt and shorts and went barefoot with sandals in my hand to the hospital that was approximately seven hundred metres away. I had no car and a hospital car for the doctors on call was not available. I walked through the darkness. The cloud banks were closed and prevented the moon to come through. The gravel road was soggy and covered with lakes that I trudged in deep potholes that the mud splashed up on legs and shorts. I tried to keep the walk in the middle of the road to avoid slippings into the side ditches that were filled of muddy water. I reached the unshielded dim road light at the checkpoint of the exit of the village where I showed the permit to the guard who stood back-leant against the small control room. No car was driving to give light to the road marking the huges lakes after the heavy rainl. I continued walking in the middle of the road what was difficult in the darkness, and stepped many times into the water-filled potholes that the mud splashed up on me. I passed the hospital gate and left the right wing open and crossed the square in front of the outpatient department building by trudging through puddles that covered the place.

I reached the entrance of the building and was full of mud spots up to the white shirt and arms. I washed off the mud in the scanty light under an outside tap and put the sandals on. Water dripped from arms and legs when he entered the outpatient waiting hall. The wet feet made squelch sounds on the cork of the sandals. The nurses on night shift made big eyes as they saw me with mud spots on shirt and shorts, but they did not say a word that the doctor had walked through the mud in deep darkness. I approached the trolley where a girl lay covered with a sheet. The girl’s face was burnt and she groaned with pain. She did not speak.

I pulled slowly the sheet from the chest down to the toes when I got shocked. A lightning had severely hit the girl. She had deep burns on the right lower leg from the knee down to the ankle. The soft tissue coat had partly burnt off on the frontal and lateral aspect that a large part of the shin bone was uncovered and charred. Other burns were on the left arm and left leg. Shock treatment has started by putting on an intravenous drip to a vein on the right elbow. I felt very sorry for the girl whose eyes already signalled that she could not keep up her life.

The girl was brought to the intensive care unit to control the basic parameters as pulse rate and blood pressure in short intervals. The girl was laid in a bed next to the window in the first two-bedroom. The wounds were dressed and an old bed frame was put over the lower leg that the sheet didn’t touch it. The resuscitation was combined with injections against pain. It was out of question that the girl would lose her right leg, if she would survive. I took a seat on a stool in front of the bed and measured blood pressure and pulse rate and made the first notes on the observation sheet. The girl was in a very critical condition, since inner organs were affected by the high voltage as well. I connected an old ECG-machine which was the only one in the hospital, and fixed the electrodes on the girl’s chest with small plaster stripes and read the oscillogram of the heart action on the moving paper stripe. The ECG showed the tachycardia with irregular extrasystoles. The oscillogram confirmed the pulse rush as palpated on the wrist artery. The pain killer became effective and the girl closed her eyes.

It was Sunday morning five o’clock when I set off for the way back to the flat. I was extremely tired and looked for a rest. Kristofina was the girl’s namel. I took her name in my mind on the walk barefoot through the mud with my sandals in the hand. I passed the checkpoint and the guard looked at me with big eyes, since he could not believe that I was a doctor coming back from work with all the mud spots on legs, shorts and shirt. I removed the spots from the legs under the tap water outside the flat and entered the small veranda and put the sandals down. I went through the small sitting room to the kitchen for a cup of instant coffee with the chicory supplement. I stirred two teaspoons of sugar in and put the cup on the small table in the sitting room and started reading in Martin Buber’s ‘The Book of the Praises’, so the fifth psalm: “Give ear to my words, O Lord, consider my meditation. / Recognize the voice of my cry, my King, and my God: what I will pray to you. / My voice you should hear in the morning when I direct my prayer to you and look up to you. / Since you are not a God that has pleasure in the wickedness neither shall the evil dwell with you. / The foolish shall not stand in your sight, since you hate all workers of iniquity. / You will destroy them that speak leasing: the Lord will abhor the bloody and deceitful man.”

I saw with the inner eye how Kristofina bent her body in pain and final agony. I tried to console the suffering girl by reading the verses of the sixth psalm and sending her the verses with my deepest sympathy: “Lord, do not rebuke me, neither chasten me in the heat of your anger. / Have mercy on me, You, because I am weak and my bones are as my soul is. / But You, my Lord, till when I have to wait ?! Return and untie my soul, rescue me for the sake of your mercy ! / Because in death there will be no remembrance of you. Who can thank you from the grave ?!” I felt exhausted when I cleaned my mind trying to encourage Kristofina to go her last way given from the fate after lightning had hit her so severely. I had her burnt face in mind when her eyes ‘told’ that she cannot keep up her life. Now Kristofina should go her way even when she must do it alone, but bravely and with confidence in her soul.

The phone rang close to ten o’clock. The nurse from the intensive care unit told that Kristofina had passed away five minutes ago. I became tears in my eyes and wished this young girl the great peace by crossing the last bridge. I felt deeply sorry for her that she had to cross the bridge alone without taken on her mother’s hand. I was shaken by the fact that life on this planet could be so short and unfulfilled. After I had put down the receiver, I opened the ‘The Book of the Praises’ and sent her the following verses of the last psalm afterwards: “O praise him ! / Praise God in his sanctuary, praise him at the vault of his power./ Praise him in regard to his mighty, praise him according to the fulness of his greatness !”

I had fallen asleep when Mr. T. knocked at the door around eleven o’clock. He came from the Sunday service in the white painted church with the short and small bell tower over the main entrance where the pigeons sit in front of the small bell chair and shit the churchgoers on their heads and Sunday clothes. Pigeons could shit into the face, if the churchgoer looked up to the forth and back swinging bell with its small rings or was looking up for something else. Mr. T. had dropped his wife and the three sons at his house to have a chat with me. He took a seat in one of the two outseated armchairs and lit up a ‘Camel’-cigarette, while I went under the shower. When I came back barefoot with a clean short-sleeved shirt and shorts, Mr. T. leafed in the book ‘The great philosophers’ of the historical philosopher Karl Jaspers, who had taught this subject at Basel university.

It was the lack of understanding German language that he put the book aside and said that he had a great interest in philosophical books, when he was at school. He recently had read some essays of Martin Buber. I asked Mr. T. about the core of Buber’s philosophy. He said that the core of his philosophy is the I-You-relationship or the dialogue between the ‘I’ and the ‘You’ reflecting on man and mankind. I said that each philosophy should go about the personality in its cultural diversity from man to man to understand each other more and comprehensively and to control together the ‘it’ by examining the social aspects which go beyond the analytic scientific thinking what had led to the manipulation of minds by setting the materialistic priorities that had caused spiritual impoverishment and ignorance. People of the day do question the existence of God or any supernatural power. They ask, if such an existence could accord with the principles of natural or other sciences and with human reason and reasonableness. With the ‘disappearance’ of God, the values of ethics and humanity had dramatically declined.