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Outreach

“Why don’t you sit in the cockpit?” asks Dr Dawood. I look at her sharply.

“Can I?”

“Sure. Do you want to?”

“Do I ever!” I respond, sounding ever so slightly like an American teenager.

“Excuse me. Stefan,” she shouts at the pilot, “can he come up front with you?”

Stefan nods his agreement and I clamber over the seats to the co-pilot chair. Stefan is doing his checks, meticulously noting things down in a book as he points at instruments and switches with his pen, his lips moving silently in his pre-flight safety mantra.


I look out at the tarmac of Pietermaritzburg airstrip. The haze and mist that covered us when we arrived early this morning has lifted and it is safe to fly. Our destination is Dundee. That is Dundee, KwaZulu-Natal – a small farming and tourist town. I am joining Dr Dawood, the infectious disease consultant at Grey’s Hospital in Maritzburg for her “outreach visit” – a trip she makes monthly to support and teach at two rural hospitals. I met her at a conference and she agreed to let me come work for her for a couple of weeks.

Stefan fires up the engine of the small 8-seater aircraft. I look back at the main cabin. The seats are removable, allowing the cabin to become a temporary intensive care unit for retrieving crticial patients. Hooks are placed in the ceiling for attaching intravenous giving sets and other patient equipment.

We trundle to the end of the runway and then Stefan racks up the throttle before releasing us down the runway. In what seems an impossibly short distance we are in the air. And I am grinning like an idiot. He circles over the city and then sets the GPS and autopilot for Dundee. Within a few minutes the city has disappeared. I look below through the cloud and haze – we could be anywhere in Africa. A thin silver line marks the passage of a river through rolling wooded hills. The sun is baking – a thermometer confirms what I feel – it is bloody hot in the cabin. Stefan’s lips move as he mutters into his microphone to some air traffic controller – the engine noise drowns out whatever he might be saying.


Just 45 minutes later we start descending. Stefan gestures in front. A small town is materialising in front of us. I can see what must be the hospital and about half a mile from it a strip of tarmac beckons to us. We come lower, lower and with scarcely a bump Stefan touches down. He taxis to the end of the runway, parking next to a hideously deformed light aircraft that is presumably used for crop dusting. There is nothing else around, the airfield is deserted save for the yellow Department of Health vehicle awaiting us.

We are visiting two hospitals today. Dundee itself and that of another small town, Nqutu, in the heart of the Battlefield territory. The driver takes us at break neck speed the 60km to Nqutu first. We jabber all the way. He tells me about Nqutu’s famous Inyanga (traditional healer) – a man who got so wealthy he built himself an airstrip and bought a plane.

“Did you ever visit him?” I ask.

“Yes,” he grins, but does not elaborate.

The hospital at Nqutu has been rebuilt – its beautiful outpatient department has at least twice as many patients as Hlabisa. And half as many doctors. As we wander around it becomes clear that beautiful buildings help but are not everything. And however bad we thought things were Hlabisa they could have been worse – a lot worse.

Next back to Dundee Hospital. Dundee was built as the “white hospital” in the apartheid era and as such has wide corridors, a beautiful outpatients area, a dedicated casualty. All are deserted – Dundee is a small town. One of the doctors tells us it is the easiest job he has ever had. It is now of course multi-racial. The medical manger leads us through the building and out into the open. The main wards are in a separate wing. As we enter it is all very familiar – these wards feel identical to Hlabisa. The manger explains that these were originally built as the “black” wards. Low budget, low aesthetics, and strategically positioned far from the main entrance so no white people would have to see an unnecessary black person. In this post-apartheid era the old “white” wards now house paediatrics and surgery. But, as so often is the case, adult medicine has been pushed to the periphery.

As the round draws to a close we hear the throb of the plane overhead as it returns to collect us. We bid our goodbyes. By the time the transport gets us to the field the pilot has landed and is sitting at the bottom of the aircraft steps waiting.

I clamber into the co-pilot’s chair again.

And once again prepare to grin like an idiot.

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