A Canadian doctor's 13-year labour of love

The road to Howard Hospital is not paved with gold. It is not paved at all. In some places the dirt track is almost impassable. Holes that could swallow a small car kept our driver's eyes on the road. There were no street lights, no street signs, no cars, no houses.

The hospital is located just 80 kilometres north of the capital city of Harare, Zimbabwe. But for three friends and I, our journey felt much, much farther than just a few hours from our comfortable, modern existence. It was a trip into the heartland of an agricultural country in ruins, a land that at one time fed Africa but where its people are now starving.

We had been warned by family and friends not to go to Zimbabwe. In fact, just days before we left home the Canadian government issued travel warnings about the country. Instability from a still-disputed election was making it dangerous for everyone. But we were going under the protection of the Canadian missionary doctor Paul Thistle  and his staff at Howard Hospital.

We did not travel light. With us were five large suitcases filled with anti-retro viral drugs and other medical supplies, much of which was donated by Health Partners Canada for Howard. Skipping Zimbabwe on our African adventure was not an option.

That the name Howard Hospital sounds familiar to Canadians is probably because of the famous conjoined twins  who were born there in 2004. Thistle supervised their birth and helped get the boys to Toronto's Hospital for Sick Children. Tinotenda and Tinashe were successfully separated in March 2005. They were another reason for our trip to Zimbabwe.

Only full-time doctor

Thistle is the only full-time doctor working at Howard, and is the reason it continues to exist.

The hospital is a Salvation Army institution — the only hospital not run by the government that is left in the country — and serves a population of roughly 250,000 people. It looks  more like an army field hospital than any hospital that I had seen before. It is organized like a compound, with basic houses where the nurses and visiting doctors live, separate areas for the nursing school, maternity ward, operating theatre, women and men's ward and a pediatric rehabilitation area. Everything is open concept.

Walls are cracked and paint is peeling. There is no electricity for up to 12 hours each day. Operating equipment is several decades old — prehistoric by Western standards. Many windows in the hospital are broken. They are never fixed, because it is unthinkable to spend money to replace broken glass when there aren't enough Aspirins to go around. There are few sheets on the beds and supplies are rationed.

Yet there is no complaining among staff, who go about their jobs with pride and a determination to do the best job possible, despite a lack of medicine, modern equipment and in many cases, hope.

Because of the lack of doctors, nurses are crucial. Those we met are overworked, underpaid and spend most of their days dealing with death. Yet they are a strong bunch, always ready with a smile and hug to greet us, their Canadian guests. Seeing some of the conditions in the wards, it is just amazing they come to work each day.

Thistle, who is entering his 14th year at the hospital, is a quiet presence, but he commands enormous respect and deals with the lack of money, medicine and the unstable political situation with humour. But underneath the jokes lies a man who seems on the breaking point, as he cannot do this alone for much longer.

Nothing short of heroes

Those who dedicate their lives to this place are nothing short of heroes. They all do so much with nothing, and one cannot help but be inspired.

They rely on foreign doctors and nurses who come for two to six months at a time to volunteer. They are the lifeline, both for Thistle and for the hospital. Many are return visitors from across Canada. They do try to train Zimbabwean doctors, but the last two bolted to Botswana and Zambia soon after they were finished their residency. The wages in Zimbabwe are just too low to keep doctors there.

The patients ask for very little. Their nature is one of kindness and of gentleness. You'd think if anyone in the world was allowed to be bitter and angry, it would be the people of Zimbabwe. But they are not. We gave out pencils and Canadian pins to the children in the rehabilitation ward. So much happiness over a simple pencil. The children clap their hands together when you give them something. That is the Shona symbol for thank you. It melted our hearts.

Some walk for days to get to the hospital. Pregnant women sometimes spend days walking from their villages when they sense their due date is near. You see them outside the hospital's perimeter or sitting on the grounds, waiting for their delivery day to come. More than 2,300 babies are born there each year.

Thistle, who is from Scarborough, Ont., is known by everyone in this area. He is married to a Zimbabwean nurse and the couple have two young boys. It would be so easy for them to move back to Canada for a much better life. But it is not that simple. Deep down I think he fears that if he left, there would be no doctor to replace him. The hospital would have to close.

We spent the few days we had walking around the wards meeting people. It was all so desperate. Men and women, all so very sick. Most are infected with HIV-AIDS. The patients wait for Thistle to see them, for a nurse to give them something for the pain, for anyone just to look at them and tell them what is wrong.

But in the midst of such suffering and need, we did see firsthand the hope and possibility that Howard offers — the twins. Now almost four years old, Tinashe and Tinotenda are thriving. Their mother Elizabeth works hard to keep them fed and clothed, but they seem happy and healthy.

Inspiring to be around

Over dinner one night at Thistle's home he told us about the struggles he faces every day to run the hospital without money.

His sense of duty and respect for the people he cares for and operates on is simply remarkable. It is almost like a calling for him to be here. It is simply inspiring to be around him and to hear his tales — both good and bad. I found myself feeling guilty because I have no medical skills, and no way to offer what he so desperately needs — help.

Perhaps the saddest thing that we saw during our visit lies about a five-minute walk outside of the hospital. It is the new Howard hospital: about three times as large, bright, wide hallways, lots of windows with glass, a large operating theatre and much more space for patients. It is actually quite impressive.

The hospital was dedicated in 2003 — there is even a plaque telling us so — yet the hospital lies empty, crumbling slowly. There is just no money to finish it and no electricity, no plumbing. It is such a terrible shame. We all thought, if only the people of Canada could see what is becoming of this country, there would be more people coming over to help and businesses investing in it.

But Zimbabwe is too far away for most of us, with a political situation too rotten. And it's stories are simply not told.