CHAPTER XX

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.