Project Canterbury

Within the Green Wall
The Story of Holy Cross Liberia Mission 1922-1957

By the Rt. Rev. Robert Erskine Campbell, O.H.C.
Formerly Prior of Bolahun and Bishop of Liberia

West Park, New York: Holy Cross Press, [1957]

Reproduced online by permission of the Superior of the Order of the Holy Cross, 2006.

Chapter 17. Medical Work

WORK IN hospital and dispensary seems always to carry a special appeal. The very thought of the thousands of helpless sufferers moves the deep sympathy and ready response of many to whom missionary effort as such makes no sense whatever. With no exaggeration whatever we can say that St. Joseph's Hospital at Bolahun has been a perfect godsend to this whole end of Liberia. Until quite recently this healing ministry extended over into Sierra Leone and up into French Guinea also, but that was in the years before the British and French governments respectively instituted medical services for their nationals in the area. We have no accurate records of how many surgical and medical cases we have had, but they run into the tens of thousands. What in the world these poor sick folk did before we came is anybody's guess. Native medicine men know of some simple remedies which may or may not be effective cures. But with no clear ideas of sanitation or of personal hygiene, it is a wonder that the people could last the 35 or 40 [186/187] years which seem to make their normal life span. That is of course if they survive the first year after birth. Here again there are no formal statistics, but a conservative estimate places the number of infants surviving at less than 50%. Even when they pass the hurdles of those first few months successfully, malaria, sleeping sickness, yaws, leprosy, tuberculosis and dysentery have to be met, not to mention the ailments common in Europe and America. Day by day all these sufferers arrive, brought sometimes in hammocks, sometimes hobbling along with a stick, or even crawling on all fours. Most of the patients are able to walk in by themselves to appeal to us for the gift they believe we have, the gift of health. Thus we try to conduct a work of mercy, the effort to cure otherwise incurable misery.

Just as a word of explanation, to the untutored native salei (or halei) means medicine all right, but also a potent something endued with supernatural powers. To Call it magic, or a charm, would be quite erroneous. They believe that a kindly spirit resides in that particular dose, and that when they rub it on or drink it or have it injected by a hypodermic syringe the friendly spirit enters their system also. There the good medicine drives out the demon of disease and makes them well again. Chemical reactions the patient has never heard of, but in picturesque fashion he thinks that the white doctor's friendly spirit inhabits the pills and will do battle with that devil of a headache and drive it out. Fantastic as this philosophy sounds to us, it is the settled belief of the people at large. Then, when they see that our drugs are really effective they proclaim loudly, "White-man medicine strong too much."

From the very day of his arrival in Masambalahun in 1922 Father Hawkins gave what first aid he could, dressing tropical ulcers too revolting to try to describe, giving epsom salts and similar harmless remedies to many of those appealing for relief. When a case arrived obviously beyond his skill, a couple of aspirin tablets or placebos would send the man away happy, [187/188] though of course not cured. We learned early that for these country Africans much larger doses than usual are needed, up to half as much again being required to produce the desired effect. It was really moving to realize the utter confidence people had in our medical skill, for frequently they would not believe us when we told them that we could do nothing for them. Sometimes they seemed to think that we were just holding back and looking for a large fee before giving relief. Then, if we persevered and refused their money they said we did not like them. Hence arose the custom of dispensing harmless little pills to make the people feel that we had really done something for them, something to help. Men obviously in need of surgery, such as hernia or hydrocele we had to dismiss with nothing to pacify them but a bit of vaseline or perhaps a couple of cascara pills. It came through experiences such as these that we appreciated ever more clearly the need for some sort of adequate means for ministering to the sick. We would not attempt to compete with Dr. Albert Schweitzer in Gaboon, but we sensed the need of this type of social and humanitarian service to a helpless people.

We have mentioned in another connection Father Allen's arrival in '23 and his training in tropical first aid. He spent three months at Livingstone College in London on his way to Liberia. Neither he nor anyone else pretended that he was a professional physician, but even then his skill and knowledge outshone anything ever seen at Bolahun. He brought with him quite a supply of salves, bandages and drugs, to say nothing of necessary books. How the news of all this leaked out we never did learn, but within days the monastery porch became so crowded with those silent, appealing patients that we decided to build a dispensary about 50 yards to the southeast, where the present St. Mary's Church stands. Here, most cheerfully Father Allen set up business as our first "general practitioner," bestowing generously his personal attention to all who came. [188/189] Of course anything like surgery was out of the picture, but he did extract teeth, and with no anesthetics either. Lean a chair back against the wall, set the patient in it. Put your left arm firmly about the head and tell him to open his mouth wide; and before the man Could say "Salika" out came the tooth, with never a whimper from the man. As we look back on these efforts they seem utterly fantastic, yet they had the immediate and lasting effect of breaking down the last vestiges of Opposition or of hostility. Since the natives have no timepieces, real emergencies might arise at any hour. Where was Father Allen? The ensuing search might locate him in the vegetable garden grubbing out weeds or in his cell writing, or, not infrequently lost in prayer kneeling before the Blessed Sacrament in chapel. Thank God for Father Allen's selfless life and work in those early days of the mission.

Our first regular doctor was an Ex-Captain of the German army of World War I who had been captured and imprisoned in England. There, as the guest of King George V, he had improved his time by learning to speak and write the English language perfectly. So it was that Dr. Edgar Maass came to Bolahun on February 2nd, 1926 to remain with us for nearly five years. To him must be given full credit for organizing and opening St. Joseph's Hospital. By comparison it would offer dull, uninteresting reading should we relate Father Simmond's valiant efforts to bake bricks for the construction of wards and dispensary, or of the primitive theatre for surgery. The doctor instituted precise, almost military training for his dressers and other hospital helpers, and most efficiently at that. By July of '27 the new buildings, about a half mile south of the old monastery, were ready for occupancy. From the very day of opening they were filled with patients up to the point of saturation. So successful was Dr. Maass that he found himself nearly swamped with work, but thanks to the efficient manner in which the native assistants had been trained he [189/190] could leave to them most of the injections and dressings of sores and wounds. He nipped in the bud one of those time-honored African customs of petty thieving by employees and of their demanding from patients a small fee for services rendered. Cleanliness, order, prompt attention met all corners. For the overflow we had to build a native village called Kisitown nearby to house the relatives and the convalescents. Relatives and friends always brought the needed rice and extra clothing for those in the wards. The doctor instituted a small charge for surgery and medical services but, even so, grateful patients would "dash" him chickens, goats, and at times a bit of hard cash. Eventually Dr. Maass had to leave, but his medical skill and diligent attention to duty supply many pleasant memories to us all.

Another doctor who came primarily to write a book about the land and the people was Dr. Germann, but as he had time he gave great help to Dr. Maass. That was 1928-29. In our monastery library we have a copy of his "Die Volkerstamme im Norden von Liberia," profusely illustrated and with an accurate account of the Bandi people. It has never been translated into English.

It was fortunate that we could find another doctor quickly to succeed Dr. Maass. He was Dr. Werner Junge, who stayed for two years, '31-'33. His skill made it a busy time for him, and because of his wholehearted cooperation most beneficial to the mission. Unfortunate for us it was that because of the rigorous retrenchment forced on us by the depression we found it necessary to release him from his contract. Bishop Campbell was in search of a doctor for St. Timothy's Hospital, Cape Mount, and promptly transferred him thither with all speed. While at Cape Mount he and his wife were confirmed and became active church workers. Among other things, he opened and maintained the leper colony at Massateen, an island in Fisherman Lake. Due to the outbreak of the war [190/191] in '39 Dr. Junge returned to Germany. His book "Bolahun" translated into English and published just a few years ago, supplies a fascinating account of his work and adventures at our mission, giving as it does a physician's point of view.

In another connection we have mentioned Dr. Joachin Krueger, and his sudden departure after several years of diligent attention to his duties here. To succeed him we were able to obtain the services of Sister Dr. Joan Clatworthy, '36 to '37. She had worked for years in East Africa, and very soon after her arrival here it was evident that her health could not stand the strain. Be it said to her credit, she made a real effort to meet the medical demands, demands growing never less day by day. After a bit over a year she felt compelled to retire. Then we were fortunate to interest a young American doctor and his wife, Dr. Roger Fowler of Connecticut. But ill health plagued Mrs. Fowler also, and thus they remained on the mission just a year, May '38 to May '39. They were the first medical workers we had ever been able to get from the United States. By a piece of good fortune we found Dr. Joseph L. Selden of Kentucky almost at once. He and his family arrived in June '39 and remained for two years. These were all rapid changes, but the hospital and the medical work did continue. To us coming from abroad it gave great peace of mind just to know that a physician was in residence, especially after the scare we had over Dr. Krueger and Bishop Campbell early in '35.

The contribution of Dr. K P. Veatch, of Texas, has been related previously. After he left for home in '44 we had no doctor in residence for seven years. We simply could not compete with the $10,000 a year and all found, that was then being paid to physicians working out in foreign countries. Beside this, we felt that in our little hospital we must have a practicing Christian, Episcopalian preferred. Hence we owe the most profound gratitude to Sister Hilary from Malvern [191/192] Link, who assumed charge with remarkable tact and vigor. Father Kroll, Brother Sydney and others came down from the monastery to help as they could, but Sister was a trained nurse and quite able to attend to many of the medical cases. Then, strange as it may sound to some of our readers, no less a person than one of our first school boys, Patrick Siafa, proved himself quite competent to operate for hernias, hydroceles and amputations. He had for years been assisting various doctors in their surgery, had watched carefully and noted the techniques. If necessity is the mother of invention we see it here exemplified. And the remarkable part of the tale is that to this day he has never lost a case. Sister Hilary is still at Bolahun, though after more than 20 years service is no longer at the hospital, to the great distress of her many friends all up and down the country.

The seven-year drought of doctors was broken in 'i by the arrival of an energetic, highly trained young man and his family from Memphis, Tennessee. It was Dr. William B. Rogers Beasley. Before leaving home, Dr. Beasley had taken special work in tropical medicine at Tulane in New Orleans and had made a thorough study of the U. S. Government leper colony at Carrville, La. Thus equipped with the latest scientific skills and discoveries in tropical medicine, he quite literally "whirled in." Not only did sleeping sickness receive his serious attention, but also the lepers. So many were these last that, in consultation with Father Parsell within a few months of his arrival Dr. Beasley established Mbalatahun for them, not only to obtain more effective isolation but to speed up their treatments and check on the results. Twice a week a doctor and attendants make the trip thither not merely to dispense the necessary drugs but for religious instruction and sanitary inspection.

Still another of Dr. Beasley's practical moves was the establishing of a special village for convalescents just across the Wawo [192/193] on the road to Masambalahun. The hospital proper had become so dreadfully crowded again that something had to be done to make room for the stream of fresh arrivals. For a number of years up until '35 we had had Kisitown for this purpose, but it had filled up with such a mob of loafers and ne'er-do-wells that we realized the only solution to the problem would be to tear it down. This new settlement we named Hilarylahun after the good Sister Hilary, and instituted a strict check at least once a week as to who might be in residence. We want to stop abuses now before they have a chance to start.

For tubercular patients Dr. Beasley opened an isolation ward, and in an effort to stem the high mortality among infants opened a well-baby clinic every Wednesday morning. This last was a sight to behold when ion or so anxious mothers would arrive at the crack of dawn and with their precious offspring tied to their backs by the generous folds of a lappa, which is a long, wide strip of country cloth. As an immediate result of this clinic, many a child today enjoys normal good health who otherwise might easily be in his grave.

After service here for two and a half years Dr. Beasley and his family returned to the States, and was succeeded by the Rev. Dr. Joseph H. Smyth, who is still the physician in charge. In June of '56 Sister Una, one under junior vows in the Community of the Holy Name in England, came out to help, especially with the work among women and with the surgical cases. At present writing, the wards are always full (o beds), surgical attention given to those who need it, and blood tests made in the laboratory under the direction of Mr. Sterling Sorenson. The dispensary for outpatients is crowded to suffocation every day. All this development presents a rather startling contrast to out modest beginnings, but if through physical healing men and women are brought to God, the trouble and expense are all worth while. Just talking to people and [193/194] preaching to them is not enough, as Dr. Albert Schweitzer realized as a young minister years ago in his native land. When they realize that our interest in their welfare is both for this world and that yet to come, the natives listen to our message with profound respect and attention. Exactly how many have been brought to Christ through hospital ministrations we have no record, though we know that conversions have been numerous. It has happened at times that some man has been unable to make up his mind and the medical relief given at St. Joseph's has supplied the little push needed to settle his determination to heed the Christian call.

Let no one visualize St. Joseph's as comparable in any way with the material magnificence of our modern American hospitals. We can show nothing more than rambling one-story brick buildings covered with corrugated iron roofs and scattered about the compound. Yet, under even such primitive conditions, with no running water at our command, and until quite recently with nothing like electricity, and with equipment only too often improvised we are bringing health and happiness to thousands year by year.

For those interested in the figures, the following is a resumé of the latest complete year we have, namely '55:

Treatments 42,309

Outpatients 28,145

Inpatients 496

Laboratory exams 14,355

Surgical cases, attended to by Sister Una, were 580 in '56, the year she arrived.

In closing this summary of the medical part of the mission it is but right that we should express gratitude to the hundreds who have helped maintain it, for without their assistance and interest there would be no hospital, no laboratory, no leper colony, no dispensary. It would be quite impossible for us [194/195] to carry the work by ourselves. Over the years literally tons of bandages, sutures, equipment and medicines have been sent for the use of the various physicians and surgeons. In particular we appreciate the numerous boxes of "samples" sent by American doctors. We have been told that at home every doctor receives annually more of these than lie knows what to do with. To St. Joseph's Hospital they have always been welcome, and over the years have saved many thousands of dollars which would have been spent for drugs. The Auxiliaries and other groups who have donated bandages and the like will never know what a blessing they have sent along with their handiwork. Small through the parcel may seem to the person mailing it out to Bolahun, when added to the hundreds of similar little packages it makes the difference between health and death for many a helpless sufferer. Both they and we feel under obligation to express our thanks.

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