Kingfisher
Gretchen Roedde

CMAJ 2000;163(12):1616-7

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He is sleek in his finely cut suit, amusing us with tales of his business-class flight from London to Joburg (after the first hop from Dublin) and the stopover at the Victoria Falls Hotel: "Wonderful! The setting! The food! So beautifully refurbished! — and only US$230 a night!" We are discussing whether his well-paying employers (an affluent order of nuns) will buy, as a tax break, this debt-ridden hospital from its aging chief of staff, a German surgeon who anglicized her name and came out to Africa after the war, working tirelessly ever since — except for monthly trips into town for a perm.

"Actually, it's everything we need. You say it keeps losing money?"

Well, yes. It's hard to explain about the economic crisis in Zimbabwe, the cost of hospital care, the poor who can't be turned away, the heavy toll of AIDS and tuberculosis (causing 40% of illness and death in the country by last count). This is, after all, a Catholic mission hospital.

Our elegant friend is a priest. A priest vastly different from our short host with his rough sandals, small paunch under a burgundy T-shirt, enthusiasm for coaching football, thick Irish accent and heart of gold. He'd been in Africa for years as a brother and decided to study for the priesthood in Ireland and return. He'd almost brought our own faith back.

Our delegation of "development partners" had met him at a health conference, where his knowledgeable questions and utter frankness had impressed us. He knew health better than the district medical officers, knew the sleaze and politics, the inside scoop and the possibilities for change at a community level better than anyone there. When I'd heard him talk about the importance of distributing condoms to adolescent girls — "poor wee things, they have no rights whatsoever" — I had asked incredulously if he was really a priest. A Catholic priest?

"Surely to God girl you don't think we should just be letting them all die of AIDS?"

He had also mentioned, in passing, that the bishop was beginning to wonder about the marriages. "Why do you have more annulments in your parish than marriages?" he had been asked.

"Well, you know, once they tell me about the beatings — I won't stand for that in my parish! He either changes his ways or he's out! That's it! So I just annul the marriage. As for the marriages, the older men are just after the young ones — so they'll all die of AIDS. No, I ask too many questions and not many stand up to the answers."

We had asked to travel with him and visit the Catholic clinics in his diocese (all well-stocked with condoms). I asked the staff if they distributed them to unmarried people. They would look at our friend before answering, just in case we were some hierarchy visiting from one of the mission benefactors. "Oh to be sure, you can tell them the truth," he would say. He even had jokes. Like bringing cartons of condoms to one clinic where the Irish sister in charge, worrying about the crowded storeroom, asked, "Father, where am I to put these condoms?"

"Oh Sister, 'tis true you know nothing. 'Tis the man who puts on the condoms, not the woman."

As we travelled he pointed out the huge lands given by Mugabe to his cronies, safari lodges that provided no tax revenue to the cash-strapped regions we were in. This was land reform? And we saw the appalling lack of quality in the local clinics, where most of the staff had not been paid for months because the public treasury had been depleted to pay for the diamond-war protection racket in Congo. The mission clinics that managed to beg, borrow and steal were a little better off. Our priest friend had humiliated private mining hospitals into giving up all kinds of resources; he'd twisted arms, refused the sacraments, threatened to bring all the dead bodies accumulating in the malaria epidemic to the mine owner's house if he didn't free up the mine hospital morgue for them. He chuckled as he recalled these ruses.

Truly multipurpose. He had delivered babies (tying the cord with a rosary) — and given a ride to a hitch-hiking woman in labour, whose baby was brought into the world in the back of his pick-up truck at night by a blind old grandmother who needed no light for her task.

And we had travelled with him, miles in the dark over roads unencumbered by cars but whose stillness might be disturbed by a gazelle, chattering monkeys, a slow-moving elephant to the side of the road — all late at night when we knew we shouldn't be travelling, hurtling through the night with no seatbelts in the pickup, listening to tall tales and gazing at the bright stars overhead.

We are now at lunch, discussing the tax break. It turns out that our prospective benefactors, the order of nuns, had built hospitals on land that had proved highly profitable, once sold. And that even their operating hospitals were making money. "We have excellent quality of care, and people will pay for quality. In fact, we think we'll bring medical teams down here for a week or so."

"Medical teams? What sort?"

He thought plastic surgeons would be good. They had great ones. He described the fun it would be for the visiting doctors, the Vic Falls Hotel en route.

"Do you have TB specialists? AIDS?"

He didn't think so and wondered why we asked. Back to the kinds of illnesses seen here. No, he didn't think they had tropical medicine specialists, either.

We were feeling distinctly uncomfortable — even our cherubic host, who had been so sure this was the fairy godfather that would wipe off all the debts of the hospital so it could go on serving the poor.

"Well, actually, we don't really want to lose money, which we would if we paid those debts. It's a tax write-off, you see. It just looks like it loses us money." He tried to explain, in his carefully modulated accent. He had grown up in South Africa and gone as a priest to teach theology in Dublin. Our Irish priest friend had made the opposite migration.

Outside, it was hot with just a little breeze. Birds floated lazily on wisps of air. A kingfisher glinted against the sun as it swooped toward the water, its back blue, underbelly bright.

After the Flood, the Kingfisher flew too close to the sun. Its breast scorched red, its back took on the hues of the sky, blue.

Dr. Roedde is the Clinic Physician at the Well Woman Clinic, Temiskaming Hosppital, and at the Adolescent Sexual Health Clinic, Temiskaming Health Unit, New Liskeard, Ont., and travels for part of each year to work in international primary health care planning and training.

Copyright 2000 Canadian Medical Association or its licensors