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Place of Miracles
Salvation Army’s Captain (Dr.) Paul Thistle looks at differences between his work at Zimbabwe’s Howard Hospital and at Toronto’s Sick Kids.

Salvation Army’s Captain (Dr.) Paul Thistle made headlines three years ago in Canada when he facilitated the successful separation of conjoined twins Tinashe and Tinotenda at Toronto's Hospital for Sick Children. As the chief medical officer at Howard Hospital in Zimbabwe, he has spent the last 12 years quietly labouring to improve the lives of thousands of people. Salvationist recently caught up with Captain Thistle during one of his brief furloughs.

Ken Ramstead (KR): How many patients do you treat at Howard Hospital?

Some North American hospitals spend more money on their parking lots!

Paul Thistle (PT): Three doctors and 14 nurses look after 300 patients a day. That's approximately 115,000 visits, 22,000 surgeries and 2,500 babies born each year at the hospital. We serve a population base of more than 250,000, but people come from other parts of Zimbabwe because their hospitals are no longer functioning. People can't phone to make appointments, so they come as they are. By the grace of God and the support of our friends across the world, we are able to keep our doors open to provide a basic level of service.

KR: Your operating budget is $540,000, compared to $320 million at Toronto's Hospital for Sick Children.

PT:  It's a shoestring budget without shoes, belt-tightening without the belt. Some North American hospitals spend more money on their parking lots! An equivalent budget for a hospital comparable to Howard here would be $100-200 million. That being said, obviously $40,000 is not enough. We try to make up the shortfall through donor funding from various groups across Canada and around the world.

KR: I've been told the most sophisticated piece of equipment at Howard is an old ultrasound machine.

PT: We do have a CAT scan—literally, a feline that goes around the wards and scans everybody (laughs). But next to that would be the ultrasound machine, the same ultrasound machine that diagnosed the conjoined twins back in 2004. We do a lot with second-hand, refurbished equipment. We're not heavy into technology, we're heavy on the volume of patients we see. And all of those patients require medicine, surgery and all the costs associated with a large-volume hospital.

KR: Can you describe an average day?

PT: Our staff starts work at 7 a.m. with morning prayers. At 7:15, we get a ward report on what happened overnight—you know, the good, the bad and the ugly. Then we do ward rounds, where we see the in-patients. At 10:30, one of the doctors tackles the scheduled operations for that day while the other two handle the general clinic the queue of 150-200 outpatients who have now been screened by the nurses. This can last until 6 p.m. We don't have a cut-off, but we aim to finish around six because the patients may live 30 kilometres from the hospital by foot or have to come 70 kilometres by bus.

KR: What is the hospital's main strength?

PT: It's a one-stop shopping approach. Everything is located in the same area. At Howard, there isn't a lot of distance between the ultrasound, the lab and the X-ray machine. Within a day, a patient can arrive early—and they usually arrive at six or seven in the morning to wait in line—see a nurse and a doctor, get an X-ray, an ultrasound and a blood test, get treated and be home, as we say here, "before the sun licks the hills." At Howard Hospital, we try to provide a comprehensive service—medical, spiritual and social ministry all under one roof. You can get a lot accomplished in one day.

KR: Describe your most challenging case.

PT: The conjoined twins would probably be the most interesting case—interesting because of the underlying problem, fascinating because of the partnerships that came together to help these babies survive. Groups like the international Salvation Army and the Canadian Jewish Humanitarian Relief Committee coming together made it a true miracle. That's what we believe in—miracles. In fact, we rely on them at Howard Hospital.

KR: You have a tight budget, you're understaffed and overworked. What gets you up in the morning?

PT: It does sound like a country-and-western song, doesn't it? We do sing the blues some days. You wake up in the morning and expect the sky to fall on top of you. But the sky hasn't fallen yet, despite the challenges and the frustrations. There's always hope because the satisfaction is there. We make a difference in people's lives. We're not trying to save the world, we're not even trying to save Zimbabwe. We're saving individuals. And not just their bodies but their minds and their spirits are being restored through the services of Howard Hospital.

Ken Ramstead is the associate editor of Faith & Friends.

Originally published in the Salvationist,October 2007.




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