The story of a mission hospital

2010-06-16 00:00

JON Larsen’s book Kwabaka: A Search for Excellence in Caring tells the story of the Charles Johnson Memorial Hospital in Nqutu from 1930 to 2006. It’s a compelling mix of medical drama, social history and Christian witness.

Larsen’s initial reason for writing it was a pragmatic one: “I began to realise that the people who played a role in the history of that period were dying off. The sixties and seventies were critically important in South Africa — things happened that needed to be recorded.”

At the core of the story are two couples — the Johnsons and the Barkers. Charles Johnson was a teacher and Anglican lay catechist near Estcourt in the 1870s among the baTlokwa people — “a small, Sotho-speaking clan”, writes Larsen, “who had initially been displaced from the Nqutu district in King Shaka’s time”.

After the Anglo-Zulu War of 1879 the baTlokwa were invited to return to Zululand where their chief, Hlubi Molefe, headed up one of the 13 “king­lets” created in the post-war settlement. Charles and his wife Margaret went with the baTlokwa and set up a mission station near the battlefield of Isandlwana.

Johnson was ordained in 1887 and later moved to nearby Masotsheni from where, by the time of his death in 1927, he established 40 parishes, each with its own church.

The Anglican church decided to establish a hospital in his memory which began life as little more than a clinic in 1930. It was another pioneering couple, Anthony and Maggie Barker, who built up the clinic into a hospital, affectionately known as the “Charlie J” and to the wider community as Kwabaka — the place of the Barkers.

Larsen first met Anthony Barker in 1960 while he was a student doctor at the University of Cape Town and subsequently, with his wife Jackie, he joined the staff of the Charlie J in 1965. They now live in Howick and although technically retired after a long and distinguished career in obstetrics and gynaecology, Larsen still works a couple of days a week at the Celimpilo Clinic in Howick.

Larsen grew up in Zululand (as his surname suggests, he comes from Norwegian missionary stock) and in an early chapter of the book dealing with the Nqutu district in the thirties, he conjures up an evocative picture of a trading store of the period.

“My grandfather owned lots of stores in Zululand and in that store description I drew on my childhood memories.”

Larsen’s choice to become a medical missionary was an acknowledgement of his debt to the Zulu community. “My earliest playmates were Zulu children and I considered that I owed a debt to its people since I was enjoying the privilege of a medical education.”

Larsen also knew that medical help was in short supply. “Growing up you were always aware of the lack of medical facilities,” he says. “Only mission hospitals were doing the work.”

Eventually, the National Party government accepted that it had a responsibility to provide health care for all communities and proceeded to take over the mission hospitals such as the Charlie J. “I think the apartheid government made a mistake in taking them over — they should have funded them more fully and allowed them to run as independent institutions.”

With nationalisation something was lost. “The mission hospitals had their own ethos,” says Larsen. “It was the same as the mission schools — an ethos of caring and excellence that is difficult to achieve within a government institution.”

This ethos had been achieved at Charlie J thanks to a small, dedicated staff. “I have to emphasise the absolute excellence of the senior Zulu nurses who chose to work there, despite getting half the salary they would have got at a state hospital.

“They chose to be there because it was a healing community in apartheid South Africa,” says Larsen. “There were no racial barriers. We did everything together. It was so different from the apartheid world of the sixties and seventies. They reckoned it was worth the sacrifice to stay in this extraordinary community.

“They are now all grannies and retired. When I visited the hospital recently they said the biggest issue was to help young people discover that kind of service ethic. The book tries to explain that ethic.”

It was an ethic undoubtedly informed and epitomised by the Barkers. “They had this immense integrity,” recalls Larsen. For example, they refused to have a car. “They didn’t think it right to have a car that would put them above the community they had come to serve. They came to be part of a people, they identified with them and they were present among them. This was what made their Christian witness so powerful — it was more deeds than words.

“You sometimes encounter the idea that as missionaries come to save souls it doesn’t matter if the medicine is not that good. The Barkers never took that line — they reached for excellence.”

Larsen recalls Anthony Barker as a “flamboyant character and a brilliant communicator. He was widely read and always ready with a wonderfully apt quote. He was also a good surgical teacher and I learnt a lot of surgical techniques from him. Where Anthony was impulsive, Maggie was quiet but very strong. She was a steadying hand and she was a very good clinician.”

The nonracial ethos of Charlie J brought it to the attention of the apartheid authorities and the scrutiny of the security police. Anthony had become a well-known public speaker and outspoken critic of apartheid and there’s no doubt this played a role in the Barkers leaving South Africa for Britain in 1974.

They had decided to leave the hospital earlier in order to earn some money to fund their old age — they had been working for a pittance for 30 years and had no savings. Initially, Barker applied for the post of chair of community health at the then University of Natal Medical School. All involved approved his appointment, then the state health department and provincial health department backtracked and vetoed his appointment on a technicality.

“Clearly pressure had been applied,” says Larsen. “Someone had said ‘don’t let these people loose on black undergraduates’. Anthony also had legitimate worries about his own safety — he was really worried he would end up with an assegaai in his back.”

The Barkers maintained contact with the Charlie J from Britain, visiting it for a final time in 1987. They were tragically killed in 1993 while cycling in the Lake District when their tandem cycle was hit by a truck.

But the story of the Charlie J is not just the story of the Barkers, or the Johnsons. Although they might have the title roles, there are scores of other players, not least people such as Sister Monica Zulu, the first trained Zulu nurse employed at the hospital and who spent her entire professional life there, as well as many other doctors and nurses who provided compassionate care to a rural Zulu community.

Larsen left the hospital in 1977, two years after it had been nationalised. He became a registrar at King Edward VIII Hospital in Durban and was then appointed senior medical specialist in the community obstetric department at the medical school. He then returned to rural hospital practice and at Eshowe hospital established an integrated obstetric service involving five hospitals. “In five years, our team of advanced diploma midwives, clinic midwives and hospital medical officers reduced the perinatal mortality rate for that region from 43 per thousand to 25 per thousand.”

When Larsen was appointed regional obstetrician he extended this programme to all 14 hospitals in Zululand. The Charlie J was one of them.

Larsen concludes his book saying there is still a sense of pride about the hospital: “The vision of a health service in Nqutu fully managed by Zulu people has been fulfilled.” But does the Charlie J still have the empathetic spirit of its mission hospital days? “The older nurses to whom I spoke when I visited did not think so.”

On Larsen’s most recent visit, two weeks ago, he met the current staff and his former colleagues, the many retired nursing sisters. “We shared stories and laughter” —  and they responded excitedly to the book: “Hau! We have a story.” Thanks to Larsen, that story has now been told.

•  Kwabaka: A Search for Excellence in Caring by Jon Larsen is published by Cluster Publications

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