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V. Ryndine—I Found God in Africa.1.2 - Ch 3: Swaziland and Good Fortune

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

Ch 1: Morning Prayers - Pblished in my blog on 06.12.2018

Ch 2: A Journey Across the South of Africa With Dr. Ryndine - Pblished in my blog on 06.12.2018

Ch 3: Swaziland and Good Fortune - Pblished in my blog on 14.12.2018



Ch 4: Taking Exams at the Medical Council of the South African Republic / Surviving Abroad

Ch 5: Niamey, Niger

INTERLUDE: Pornographic Surgery

Ch 6: My First Fall

Ch 7: Khrushchev’s Thaw

Ch 8: Shulamit

Ch 9: The Academy

Ch 10: In the Land of the Bear

Ch 11: Ten Years From Russia

Ch 12: Sixty-Two

Ch 13: My Life in Food

Ch 14: Family and Practice (Private and Public)

Ch 15: Private Practice: My One Thousandth Patient

INTERLUDE: The Internet

INTERLUDE: Love

Ch 3: Swaziland and Good Fortune

The job interview in the hospital of the Nazarene Church went off without a hitch: “You will serve as a Medical Officer in the surgical wards. As you don’t have your diplomas at the moment, you will work under the supervision of your American colleague Dr. Pollard until they arrive. You may live in the intern’s room, and you will earn a standard intern’s salary of $500 per month. Starting the day we receive your diplomas, you will be paid a full $1,300 per month.”

Few people in Russia could understand how lucky I was, and I could hardly understand it myself back then.

First, there is not a single civilized country where a foreigner with a travel visa has the right to employment. A foreigner can get a job only if he or she has an employment visa. Violators are severely punished: the employer is fined, and the employees are deported. When they offered me a contract to work in the hospital in Manzini, Swaziland, I had a travel visa.

You could only submit an application for an employment visa from abroad—in my case, I would have had to turn around and leave Swaziland to arrange my lawful stay there as a hospital doctor. My work application needed an “offer of employment” from the hospital attached to it, an offer certified by the immigration control authorities of the country. This offer from my employer must prove that he had failed to find a specialist fit for this position in Swaziland. Given the bureaucratic framework of the mountainous kingdom the offer’s certification might also take many weeks. It could take three months to process an application for an employment visa at Swaziland’s embassy in Pretoria (and sometimes they were rejected). You can easily imagine how much time the completion of the hospital’s paperwork might take.

Second, in order to manage the quality of services, many English-speaking countries have professional councils for oversight of many specialties and certification by these councils is essential if a specialist wants to work in those countries. I was employed in Manzini without any certification from Swaziland’s Medical Council.



Raleigh Fitkin Memorial Hospital - international medical staff 1993

I was unspeakably glad, as I was living on charity and being fed by kind people some 12,000 kilometers from the Motherland. How many people can understand this?

After this extended free-floating period I took on my new job with enthusiasm.

The intern’s room provided for me was located on the second floor, next to a library comprising several hundred ten-to-twenty-year-old books on the primary medical specialties—which were just the thing I craved at the moment.


There were a lot of jobs to be done in Mazini: There were around forty beds in the men’s ward; twenty-five in the women’s; fifteen in the children’s ward; and anywhere from one to three patients in the private ward on a given day. There were three operations per week. Once a week we saw our surgical patients—between fifty and seventy of them. My duty shifts were every third day (but sometimes every other day): I was summoned to stitch the head of every beaten drunkard and to perform caesarean sections or endometrectomies—do you mean “D&C” or “hysterectomy”?—amid hemorrhage. And naturally, I was supposed to provide aid to patients with fractures.

As I had learned after five years of work abroad, a Medical Officer was among the lowest ranking health workers in English-speaking countries. I was able to survive and support my family on such a small salary only because of an enormous number of paid shifts and the free accommodation, water, electricity, and so on. Yet I managed to receive compensation from the hospital for the flight from Luanda to Swaziland, and the Moscow-Mbabane tickets for my wife and two kids were purchased at the hospital’s expense.

My contract with the hospital was drafted for two years. Every two years the contract would be renewed, and I would be paid the sum of my would-be pension fund accumulated over the previous two-year period. Every two years my family were entitled to roundtrip airline tickets to Moscow (under the condition of the contract’s renewal), and I was fortunate to be able to collude with the airline company to get a full refund on the tickets pre-paid by the hospital. These “pension” and “travel” payments allowed me to buy a secondhand car, pay the university tuition for my son, and pay for my daughter’s school in South Africa.

My employer, the American Nazarene Church, covered neither health insurance nor professional insurance. God had been protecting my family’s health as a reward for my dedicated service—for five years I hadn’t needed medical insurance in this part of the world. Although with my apparent lack of skills and knowledge in the context of the mission hospital’s extreme conditions, even God’s favors couldn’t save me from troubles: one of my patients, a child, died and the broken-hearted father filed a lawsuit against the hospital upon the recommendation of his lawyer.

When the Chief Medical Officer Jack Hickle, a native Alaskan, showed me the letter from the lawyer, I said: “I can theoretically assume that the cause of the child’s death was my misconduct. But whatever I say in my defense, we’re going to lose the legal action after just one question: ’Doctor, have you been registered with the Medical Council of Swaziland?’”

Had this occurred a year earlier, another question would have been the killer: “Do you have an employment visa?” But by this time I had managed to obtain an employment visa by taking advantage of the immigration office’s new boss, one of the hundreds of Dlamini princes, who had no idea how to do his job.

The hospital paid $10,000 to the father of the deceased child, which was an enormous sum of money for a poor Swazi. After this, Dr. Hickle insisted on the necessity of professional registration for all the doctors in the hospital, with $1,000 per year per employee allocated to the cause.

The registration process was delayed by the Medical Council Registrar’s stubbornness; Dr. Shongwe declared that “not a single Russian doctor would ever be registered in Swaziland.” Dr. Hickle finally managed to persuade him to change his mind, and the three Russian doctors (already working in the missionary hospital) were registered.

After another six months, I managed to convince Dr. Shongwe to examine my documents from Angola, certifying that I had worked as a “Consultant in Surgery,” and eventually I received a certificate from the Medical Council of Swaziland proving my registration as a “Specialist in General Surgery.” I brought the certificate to show it to Dr. Hickle.

“Jack, can I count on a pay raise now?”

“Dr. Slava, we don’t have a surgeon’s position for you at the moment.”

The only surgeon’s position at the hospital was occupied by Dr. Degene. A young Ethiopian doctor, Degene came to work at the hospital two years after I arrived. I was slightly depressed over the fiasco with my pay grade, but it didn’t make me hate Degene who, to be honest, had better training in surgery—nothing like my fragmentary knowledge, acquired through obsolete techniques and crude practice.

Taking into account all the favors and good deeds that the Americans had done for me since I arrived at the hospital, it would have been silly to hold a grudge against Jack.


Comments

С нескучной пятницей, однако!))
Николай, привет!
Спасибо за коммент...

Напомнило мне стаАААарый абстрактный анекдот...

Летят по небу четыре зелёных крокодила.
Один:
- Что за херня: пятый день летим и всё пятница??

Так вот я только сейчас понял смысл: Они же были на пенсии! А для них, как и у меня сейчас, все дни пятницы...
Браво! Пусть так и будет)) Доброго здоровья!