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V. D. Ryndine


I found God in Africa:
Letters of a Russian Bush Surgeon




Illustrated by Evgeniy Perelygin

adaptation and editorial work

by Irene Connelly



This publication is a reduced and adapted English version of my book -


УДК 82.3
ББК 84(2Рос=Рус)-44
Р95

Я обрёл Бога в Африке: письма русского буш-хирурга
2012.-565 c.

ISBN 978-5-4253-0267-0

This book is available free of charge at the addresses below:

http://www.rulit.me/books/ya-obryol-boga-v-afrike-pisma-russkogo-bush-hirurga-download-free-366938.html

http://www.rulit.me/books/ya-obryol-boga-v-afrike-pisma-russkogo-bush-hirurga-download-free-366938.html





* * *
All names mentioned in the book are fictitious or modified


This book is a gift to my family.





To my wife, a heartfelt “Sorry, and thank you” for enduring the burdens that have
been collapsed, by me, onto her shoulders.









For my children, a simple parting wish: Love what you do.


FOREWORD

My lack of seriousness notwithstanding, I am in fact a very thorough person. Studying medicine, for example, took me nine years; my Candidate of Sciences dissertation took another five; and I worked on my Doctor of Medical Sciences degree for fifteen. I spent twenty years of my life writing this book.
It began as a handwritten manuscript in a plastic-covered notebook, which I worked on under the dim light of church candles in Voga, a crumbling Catholic missionary hospital near Quito, the capital of the Bié province. This was 1992, in the middle of a war-struck Angola. In recent years, many of these tales have appeared on my blog “Letters of Aibolit.” Aibolit is Russian doctor character, something like Dr. Doolittle, and as the first Russian doctor to settle in the Limpopo province, I rightfully claim that name.
I never intended to write history, or a novel; for that, I neither have the talent nor the education. My goal was merely to compile notes and snippets--stories by the old, for the young, whom I could then invite over as guests. In fact, this book might best be described as entertainment with a medical theme. Medical treatments as described here will lack any practical value, the field having changed drastically. Today’s medical education is a step above mine; young doctors confidently enter practice with spectacular technical ability given the available diagnostic and surgical equipment.


In his youth, Andrei Nekrasov changed professions many times. As a sailor and traveler he visited at least three corners of the Earth, writing down both stories of his own invention and those his comrades told him. I do not pretend to be a saint—think of this account of my medical adventures as the tales of Nekrasov’s Captain Vrungel








CHAPTER 1: Morning Prayers
(From the 7th of December 1992 until the 16th of March 1997 I was stationed
at the Raleigh Fitkin Memorial Hospital, part of the Church of the Nazarene
mission in Manzini, a town in the mountainous kingdom of Swaziland.)
The hospital is 200 meters from my home. Fifteen minutes before the start of the working day I shower, shave, put on a fresh shirt and lab coat, and unhurriedly make my way to the Male Surgery Ward. As I walk I respond to about twenty greetings and even more smiling faces. This lifts my mood, wiping away the serious “professional” expression I have assumed and sending me into the ward with a smile.
We all exchange greetings: Sana bonani! Yebo dokotela! and the medical staff halt their work in order to prepare for the morning prayer.
The Swazi are marvelous singers. I have noticed that my mood affects the level of enthusiasm in the staff’s hymn-singing, so I try to set a positive tone. “Who is today’s songbird?” I ask. “Dumisile Simelani? Dumi-Dumi, have you already cleared your little throat?” Dumisile begins to clap the beat and sings, with a powerful voice: Siya kudumisa, siya kudumisa, siya kudumisa, nkosi yamakosi! We praise You, we praise You, we praise You, O Lord of lords.
The simplicity of the words is compensated for by the strength and intricate harmonies of the performance. It seems to me that ancient Egyptians might have praised their Sun God, Ra, in a similar way. Perhaps this is how the Jews of the Old Testament praised God. The way the Swazi perform their choral hymns reminds me of Georgian choir singing. I have been listening to this singing every morning for three years and I never stop being amazed by it.



I remember my first visit to an African church, a Catholic church in Luanda. The Angolans clapped their hands while singing the hymns, and even danced a little! At first I was confused and a bit uncomfortable (“Dancing like this? In a church?”). And yet, why not? The Gospel says “Rejoice!” And so people rejoice, each in their own way.
At the time, though, I disapproved of the clapping and dancing of my friends: missionaries from Portugal, Spain, the Philippines, Latin America (I was inclined to grant them leniency, given their reputation), and Poland (northern people, so why on earth were they dancing?). Later, Padre Garcia gave a terse, clear reply to my ignorant comments: “When in Rome, do as the Romans do.”
And now I live like the Swazi—let us rejoice! I have already learnt to clap my hands to the beat and pronounce these words:

Akekho’ fana nawe, Akekho’ fana nawe, Nkosi yamakhosi!

Because there is no one like You,
There is no one like You,
There is no one like You,
O King of kings!

If they feel inspired, nurses and orderlies sing two and sometimes even three hymns. Then someone will recite a brief verse from the Old or New Testaments, after which they give their commentaries on the verse. Our short morning mass is always concluded with a prayer of thanks to the Lord. Any Swazi—man or woman, young or middle-aged—can perform this ritual with great enthusiasm, in one breath, and with no prior preparation.
And it’s not only the Swazi—it seems to me that many Africans have this gift for performing “professionally” in front of an audience. Often I see TV reports from the bazaar in Luanda, or from the streets in Maputo, Mbabane, and Johannesburg: the reporter asks the seller, worker, or student some topical question and the interviewee replies boldly, with no sign of embarrassment. (I think back to the shameless mumbling of highly ranking “comrades” from our government, prepared speeches notwithstanding.)
Today it is the turn of one unassuming fellow, Nurse Adam. He bows his head, closes his eyes, and recites, in a quiet voice, the words of his prayer:
Babe wetfu losezulwini,
Babe wenkhozi Jesu,
Mdoli welizulu nemhlaba,
Mnini mandla onkhe,
Wena lome kuze kube phakadze!

Our Father in heaven,
Father of our Lord, Jesus Christ,
Creator of heaven and earth,
Almighty Lord,
You live forever!

(Later, at home, I read over the text and realize that this is the Lord’s Prayer).
Siyakubonga Babe
Ngoba umuhle
Ngoba umusa wakho
Ume kuze kube Phakadze.



When in Rome…
Glen Gelheld, professor of endocrine surgery at George Washingtone University, prays with staff and patients.

Sometimes nurses ask me to pronounce the prayer. The first time this happened, I struggled to recall the prayers spoken by my dear mother and those uttered by various literary and film characters and managed to come up with something on the spot—perhaps a little artsy, but also sincere and suited to the occasion:
Lord, I thank Thee
For the opportunity I have been given
To see the sun on this beautiful earth--
The Kingdom of Swaziland!

At the beginning of this beautiful day,
Help us, Lord:

Heaven send strength to our patients to bear the sufferings;
Give them faith in healing;
And give us, doctors and nurses, wisdom.
Excite the sympathy in our hearts;
Make our hands skillful.
Lord, bless our labor.
Please, God, we beg you, in the name of Jesus Christ!
Amen!

At first I pronounced these words in Russian, which made the staff and patients laugh. Now, whenever necessity arises, I enthusiastically say the prayer in English.
My interest in missionaries in Africa, the Bible, and religion manages to pay off with an invitation. Roger Mpapane calls me somewhere around the end of the dry season in 1996 and invites me to give a brief talk to the congregation at Sharp Memorial Church, on the missionary station within about twenty meters of the hospital. I am to tell them about Moscow.
Apparently, I am being given the honor of speaking to the congregation of the oldest cathedral in Manzini, where services are conducted in SiSwati, the language of one of the kingdom’s national groups. Why me? I ask myself. Why not the other Russian, Dr. P., who is always up for this sort of thing?
Intrigued, I accept Roger’s invitation.It turns out that the Church of the Nazarene is being established in Moscow and the management of our mission have decided to celebrate the event with a speech by a Russian doctor.

I am sitting here in a dark suit and tie among a group of similarly dressed Swazi. I am one of two white people in the church. The other is Dr. Hynd, son of the Church’s founder, English doctor Samuel Hynd.
When the moment arrives, I am invited up to the . . . what? I have no idea what they call the platform from which the pastor preaches in a Protestant church. I think it’s a “pulpit.” Roger stands next to me, ready to translate my speech from English into SiSwati.
Just then, children begin to march into the church holding posters bearing words like MOSCOW and RUSSIA. They are singing “Moscow! O, beautiful, beautiful city of Russia . . .”
When I figure out the lyrics I am overwhelmed; tears come to my eyes. Try to concentrate, Ryndine! I must keep it short, yet make it significant. I start with a phrase in Russian: “I’d like to greet you all in the name of Jesus Christ!” After a short pause, I repeat the greeting in English, Roger translating my words into SiSwati.
Then I continue to speak English to the best of my ability.
“I never imagined I would be given such an honor—an invitation to a church in this beautiful mountainous kingdom in the south of Africa, to tell you about my Motherland, Russia, Moscow . . .
“I’m grateful for the honor of being the first Russian to set foot here and the first man to pronounce words in Russian under the arched roof of the Church!
“Moscow is an ancient city on seven hills, the capital of an enormous country and a home to ten million citizens. It is a cultural melting pot with dozens of colleges and universities where many young people from all around the world, including students from Swaziland, study to receive their degrees. My friend Feligve Dlamini is one of them. He has brought home a Russian wife in addition to a University diploma.
“Russia’s history is not limited to the grave and bloody twentieth century. Not so long ago we celebrated the one thousand-year anniversary of the adoption of Christianity in Russia. And since the last century Moscow has been known all over Western Europe as a city of four hundred cathedrals.
“Before I came here tonight, it occurred to me that on a Russian Orthodox icon I have seen the head of the God crowned with precious stones, and I believe that one of the diamonds in that crown is your beautiful country, the kingdom of Swaziland.
“Now, you can imagine another country among the jewels in the Lord’s crown: My Russia!”


CHAPTER 2:
A Journey Across the South of Africa With Dr. Ryndine




Former Soviet doctors like me are often asked about the working conditions of African doctors; the local educational systems; the way surgeons’ associations work; how to pass the exams; and how to find a job in Africa in general or the South African Republic in particular. Oleg Blinnikov, an active “doctor without borders” (and well-known provocateur!), suggested in 2002 that I write about these aspects of my practice.
I have no idea what “Across America with Mikhail Klyatchkin” would look like, but my professional experience of survival abroad is a series of endless contrasts between two healthcare systems, two systems of medical training, and two styles of healthcare institution. These are aspects of medicine in which I was least interested, yet it was impossible for me not to note the differences and compare myself, an aggressive medical product of the Soviet system, with the needs and boundaries of the African cultures in which I lived.
It was clear to me that I trespassed the boundaries of my own system and didn’t meet the standards set by my employer. But I had to make a living somehow, and that is why I had to learn to bend, to remake myself, often recalling—with obscenities—my alma mater, my teachers, and the youth I wasted conquering false “peaks.”


The first eight years of my medical practice in Angola within the framework of Soviet contracts don’t count towards interaction with the local healthcare systems. The Communist Party of the Soviet Union had brought us up with a specific, Soviet, type of isolating arrogance and insolence which was considered sufficient when encountering unusual local pathologies or fantastic flora and fauna:
“Oh, leprosy-elephantiasis-Burkitt’s lymphoma? What’s an African human trypanosomiasis-malaria-bilharziasis? What do you mean, ‘crocodile/lion/hippopotamus bite’? Are you serious about ‘neck semi-severed with a machete,’ ‘child’s leg half-shot off by a Soviet antipersonnel mine,’ or ‘AK-47-induced open belly’?”
“What a moonlit landscape! Red hills from Čiurlionis’s paintings! Colubus monkeys, kudus, giraffes, and horned horses! All these red-blooded Cape Verdean and violet-colored Senegalese women . . . ”
Working in Angola, we were always aware of the colleague-compatriots at our elbows (sometimes pushing us in the ribs) and the close oversight of Soviet community members, including the “farm experts” who provided us in abundance with the poisonous spirit of the Motherland.




The regime’s constant oversight paralyzed all curiosity and independence: I didn’t have even the slightest notion of a contract; of what the rights and obligations of the involved parties might be. People employed by the Angolan healthcare ministry through the mediation of Soyuzzdravzagranpostavka (the Soviet Bank of Foreign Trade) hadn’t received their wages for years, yet they continued to work for fear of losing their invisible earned money and also to avoid going home to witness the chaos of socialism’s grand collapse.
The survival of around two hundred Soviet citizens was supported by a specialized shop that had Angolan government authorization to stock up with goods from neighboring Namibia and sell them to Soviet professionals. Few of us usually spent more than $200 on groceries each month, and as for the rest of our salaries, every month we carefully signed the journal that provided for a transfer of the remaining sum to corresponding accounts at the Bank of Foreign Trade. This was precisely the share of our wages which we had been unable to withdraw for years.
It looked like shady business to me—nobody knew where the money had been all that time. A simple calculation clearly shows what kind of sums got caught up at Soyuzzdravzagranpostavka: each of two hundred doctors entrusted zagranpostavka with transferring the equivalent of $500-600 to the corresponding account at the Bank of Foreign Trade. $100,0000-$120,000 per month; $1,200,000-$1,440,000 per year. Even if you place the sum at a meagre 3%, the split will be good enough. And if you deposit it at 10-15%, then the return will be beyond decent!
Funnily enough, as anyone could have learned from reading Soviet newspapers, the Soviet Bank of Foreign Trade had failed several months earlier. I still wonder where Soyuzzagranpostavka continued to wire our wages.

Instinctively, I sensed the danger of staying in Angola and waiting for the situation to resolve, and I began to look for an alternative. That’s how I came across Padre Manuel Garcia. Once a prominent figure in Angola, Garcia was the founder of the Catholic mission and two missionary hospitals, one of which he had been authorized to restore by two belligerent parties. Three ex-Soviet doctors entered into a gentleman’s agreement with the padre: the first (an obstetrician-gynecologist) went to Portugal for a three-month training course in anesthesiology; the second (a surgeon) was supposed to arrive at the hospital in 1992; and the third (a pediatrician) was waiting for a “call” in Luanda.
Looking back, I realize that our carelessness and ignorance of the law was stunning! Okay—the padre was a most honorable man, but who provided the financial support for our agreement with him? Garcia was nearly eighty years old. If he had suddenly passed away, who would have paid the tuition for our obstetrician-anesthesiologist in Lisbon?
Evidently Garcia had already bought a $1 million worth of hospital equipment, so what was next? Who was going to procure the equipment and medical supplies, pay wages to hospital employees, and finance even the minimal functioning of the hospital?
“Slava, I understand that wealthy people entrust padre with their donations to the hospital,” said our ob-gyn. “But how do they do it? Give it in cash, or write a cheque to the padre? Or does he have a separate account for the hospital’s needs?”
I was only able to answer him in part: “Padre Garcia is otherworldly! It’s beyond our understanding! For him, the mission/hospital and his personal life are the same thing.”
Well, that was our first mistake.
Padre was not “submissive” in his missionary work: all of his deeds did not follow the plans of his Order, so he had to finance his goals on his own. For years, construction projects and maintenance of the mission and the hospital had been supported by donations received through a subscription list of the wealthiest Portuguese of colonial Angola. Padre had no idea that the colonies had vanished and wealthy colonialists had become a thing of the past, as had the subscription list.
I learned this only after my arrival in the “past”—the once-famous Hospital Voga located some 30 kilometers from the beautiful town of Quito, the capital of Angolan province Bie.
Our second mistake was our readiness to work as physicians in a hospital with a staff of three people: Us. Who would provide general anesthesia? Soviet medical education does not include training that enables graduates to work as anesthesiologists the moment they leave school. What was our obstetrician-gynecologist thinking? He wrote from Lisbon: “My Portuguese colleagues are mocking me: ’We study anesthesiology for three years, and this Russian intends to master it in three months.’”




While preparing to go to Padre Manuel Garcia’s hospital to assist in its renovation, I imagined the joys of observing the pathologies about which I had read in David Christopher’s Companion to Surgery in Africa and Albert Schweitzer’s Letters from Lambarene. I tried to imagine myself as Albert Schweitzer. Or at least as Dr. Powderpill.

One hot Luandan afternoon, walking my Welsh terrier Luke in the yard of the University hospital named after the tragically deceased Américo Boavida, I peeped into a nearly destroyed building of the hospital library.
On the floors of its many rooms, old medical journals lay in formless piles mixed up with human and cat feces. On the shelves, covered by thick layers of dust, were old medical volumes in Portuguese, French, English, and Spanish, some of which had been published decades ago.
Murmuring “God forgive us, it’s for the sake of the missionary hospital,” I picked some four dozen books in primary medical sciences, which I moved with the help of a neurosurgeon, Boris Polyakov, to the Catholic priest’s house where Padre Garcia used to stay.
A few weeks later, I managed to book a ticket and put myself at the disposal of Padre, 80, who was supervising the continuous delivery of cargo for the hospital’s needs in a company of a Portuguese pharmacist, Señor Nunesh, 76.





Our trio of doctors had been waiting carefully for three months, but the rebirth of the Hospital Voga never occurred.


Padre Manuel Garcia, Hospital Voga, Kuito, Provincia Bie, Angola - 1992



I managed to flee from this Angolan hotbed of tension, arriving in Windhoek, the capital of Namibia, with $20 in my wallet.
There was no need for doctors in Namibia. Not for Russian doctors, anyway. I decided to go to the South African Republic, though I had no idea how they trained doctors or what the healthcare system was like, and tried to picture my future, imagining myself supervising interns in a remote hospital.
The few bits of information I had acquired, like “Private medicine is quite good”; “Public medicine is not bad for a Soviet immigrant”; “Doctors in the South African Republic get a government-funded mortgage”; “Expat doctors in the SAR are sent to work with AIDS-infected patients” transformed within my ignorant mind into ugly manifestations of a wretched Soviet world view: “Private medicine is when you get, say, $1,000 for every operation or even more”; “A good doctor’s salary in a public hospital is when you have a car”; “Who provides the housing? The government, I guess”; “Working with AIDS-infected patients? But I dreamt of working in a leprosarium!”
At the time my mind couldn’t process the information about the need to pass some sort of an exam; had I seriously considered it for even a second, I would have headed back home immediately. How was I going to take medical exams in English, in my fifties?
The first reliable source of information about medical examinations in South Africa was an elderly couple of African missionaries, whom I met on the airfield of the Lobitu airport, the last Angolan town where our six-seater landed for a fuel top-up. These agents of God provided me with the phone numbers of their children, who had helped a Russian doctor with English so that he could pass the Medical Council exam. “Now his family lives happily in Swaziland!” the missionaries informed me.
It was desperation that gave me courage. The situation in Russia after 1991’s attempted Soviet coup d’état; one year of work in Luanda; three months at Hospital Voga; and, finally, three weeks of travel from Angolan Huambo through Windhoek of Namibia to Cape Town, the capital of the world’s edge, made me desperate.


From Pretoria I called Dr. Manell, an author of publications on esophageal cancer surgery with whom I had been corresponding. As esophageal cancer surgery was perhaps the only medical area of expertise I could claim, it seemed to me that I could be useful at her department in a third-rate role.
It turned out that Dr. Manell had left academia and gone into private practice. She told me that to work as doctors in South Africa, foreign medical professionals had to pass a specialized exam offered twice a year by the Medical Council. She was willing to help me while I waited to take the exam, offering me a job as a lab technician job at a salary of $500 per month. The chance to work as a lab technician caught the breath of this Doctor of Sciences. I was also excited about meeting this woman, an expert in esophageal cancer surgery. She invited me to visit her office, in a fashionable district of Johannesburg, as soon as I settled things in Pretoria. But after a conversation with Mrs. von Reinsberg, head of the Exam and Registration Department of the South African Medical Council, my hopes faded. I realized that despite my knowledge of medicine I couldn’t overcome the obstacle posed by my English skills.
Fortunately, I still had the phone numbers of those missionary children, who guided me to Swaziland. I reached out to Igor Pegov, the first Russian doctor in the tiny mountainous kingdom of Swazi. The kind doctor, whose adventures deserve a separate account, introduced me to Dr. Hynd, president of the Nazarene Church missionary hospital’s Board of Trustees in Manzini. I was invited to the hospital for an interview.
Before heading to Swaziland, I visited Dr. Manell’s office at the private Rosebank Clinic in Johannesburg. The visit served to puncture my Soviet sense of superiority: the clinic, the office, the secretaries, and the doctor and her Australian accent all impressed me, to put it mildly. At this point in my search for a future I was just an exhausted Russian mumbling incoherently through the decayed teeth in his mouth; a Russian whose only thought was about how to wind up the visit quickly and decently. Why did I even come here?



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