Dr Paul Thistle lives
and works in rural Zimbabwe with his wife Pedrinah
(both are wearing their Salvation Army uniforms)
and their two children, Alexander (left) and James
Photo credit: Glen Simmons |
Dr Paul Thistle is almost certainly
one of the highest paid doctors in the world: at last
count, his salary had grown to about a billion dollars
a month.
But his take-home pay is woefully
low and his hospital's budget is only about 1% of what
a comparable community hospital in Canada receives.
"A shoestring budget," he says. "Without the shoes."
That's because Howard Hospital
is in Zimbabwe, where the ongoing political crisis instigated
by President Robert Mugabe has incited widespread civil
unrest, violence, food and fuel shortages, and the sky-rocketing
inflation that's responsible for adding at least four
or five zeros to the end of Dr Thistle's salary, which
is paid in near-worthless Zimbabwean dollars. Despite
the deteriorating political situation, however, Dr Thistle
isn't thinking of leaving the country. After all, he
says — his sense of humour as biting as ever —
he's earning a billion dollars a month.
ZIMBABWE'S
DECLINE
The difficult situation at Howard Hospital, which is
a couple of hours outside the capital Harare, is a microcosm
of the dire straits all of Zimbabwe — and its medical
infrastructure — is now going through.
Involvement in the Congolese civil
wars over the past decade sunk the economy deep into
debt, and recent radical land reforms have created nationwide
food shortages and led to riots, which have in turn
led to government repression of the poor and the hungry.
Memories of the country's once-successful agricultural
sector throw the current troubles into sharp contrast.
The Economist summed up the situation in 2002:
"From breadbasket to basket case."
That was around the same time Rachel
Spitzer, then a resident in obstetrics and gynecology
at the University of Toronto, first visited Zimbabwe
to work with Toronto-native Dr Thistle.
"The situation in the country has
deteriorated over the last seven years," says Dr Spitzer,
who's now working towards a Master of Public Health
degree at Harvard. "In 2001 it was one US dollar to
300 Zim [shorthand for Zimbabwean dollars] on the black
market — officially one to 65. In 2004 it was one
to 7,000. Then, last summer, it was one to 180,000 —
but really 180 million because they dropped three zeros."
The official rate of inflation is now somewhere above
100,000%; last month, the Reserve Bank of Zimbabwe began
issuing $25 million and $50 million bank notes. A $50
million bill reportedly buys three loaves of bread.
The country's hyperinflation has
led to major social upheaval. "It's hard for the hospital,"
Dr Spitzer says. "Cell phone reception at the hospital
has gotten worse. Land lines have gotten worse. The
land connection to the hospital was reliable in 2001,
rare in 2004 and last summer even rarer. Buying commodities
is getting harder and harder. Cooking oil is not available,
and gas is hard to find."
National elections in March have
done little to quell the ongoing crisis. President Mugabe's
ruling ZANU-PF party lost their majority in parliamentary
elections and a presidential election run-off is scheduled
for later this month. Opposition leader Morgan Tsvangirai
had claimed victory, but was beaten by police and hospitalized
with serious injuries and is now in exile. The situation
is bad and, by most accounts, it's getting worse.
MEDICAL
RELIEF
NRM managed to reach Dr Thistle by email last month
("It may be impossible to get a clear telephone connection
at a fixed time," he pointed out) to talk about his
work at Howard Hospital and what's going on in Zimbabwe.
Dr Thistle's official titles at
the Salvation Army-run Howard Hospital are chief medical
officer and chief of staff. "Chief of staff is an exaggeration,"
he says. "We've never have had more than three or four
permanent doctors at Howard." In fact, at the moment
he's the only doctor at a hospital that serves about
250,000 patients. Zimbabwean junior doctors come and
go — but mostly, they go. "The greener pastures
look very green, especially when you cannot afford to
feed your family."
The route from Toronto to Zimbabwe
wasn't planned: after Dr Thistle finished his ob/gyn
residency at the U of T in 1994, he volunteered with
the Salvation Army. Initially, he was to be sent to
Zambia, but his assignment was switched to Zimbabwe
before he left. "It was my first time in Africa, so
I didn't notice the difference. Like a lesson off of
Sesame Street, they all began with the letter
Z."
Then he found another reason to
stay: at Howard Hospital, Dr Thistle met a nurse named
Pedrinah. They married and now have two children, James
and Alexander.
Dr Thistle's work, which has always
been underpinned by his religious convictions, involves
seeing patients with all sorts of conditions and needs,
regardless of their political backgrounds; overseeing
administrative tasks at Howard; and conducting research
into HIV transmission and treatment. His work has earned
him some attention. The University of Windsor will give
him an honorary doctorate in June and another major
Canadian award, the details of which are being kept
under wraps for the moment, is set to be given to him
in June.
STRIFE
AND UNREST
The news out of Zimbabwe this year hasn't been encouraging,
though Howard Hospital remains safe from the limited
violence. "It is difficult," says Dr Thistle. "We try
to keep our doors open and our shelves stocked when
other healthcare institutions have shut down, victims
of the political and economic crises."
Dr Thistle points out that the
limited violence has not spread far outside Harare —
a "small miracle," he says, which Dr Spitzer attributes
to Zimbabweans' pacifism — but he says he has treated
three people who said they were hurt in political attacks.
It remains unclear what will become
of Zimbabwe in the coming months. "Despite the fact
that things are getting more difficult and the NGOs
are departing, [Paul] seems more committed than ever,
because the need is greater than ever," says Dr Spitzer.
"At this moment in Howard's history,"
wrote Dr Thistle in last month's edition of his Zimbabwe
Bulletin, published by the Salvation Army, "we see
the byproducts of the past: the malnourished children,
the hypertensive widow with stroke unable to afford
the escalating costs of transport to hospital. People
are hungry and tired. Everyday is Lent in Zimbabwe."
And, in spite of all he's seen,
he still manages a smile. "Business at my liposuction
clinic has been sagging."
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