IN one of his letters quoted earlier in this book, Bishop Douglas McKenzie describes how he found Charles Johnson "tenderly nursing a sick baby." This incident is characteristic of the man's whole ministry. From his earliest days as a missionary he set himself to tend the sick and ailing. The days he spent in his own home at St. Augustine's were largely occupied with this work. The position was forced upon him. His knowledge of the healing art was empirical rather than exact. But as compared with that of the Zulus amongst whom he lived, it was advanced and profound. The system of medicine which the Zulus have evolved for themselves has some pretence of knowledge. There are various herbs and simples the healing virtue of which are known to them. They have discovered also some antitoxins in the use of which they are skilled. But all their knowledge is so confused with the practice of divination and of magic that it is actually of very slight use to them. Their methods of diagnosis are weird and wonderful. A pain is to them not a symptom of disease but the disease itself. Thus a headache is a headache, and must be treated by making a series of little incisions on the forehead, or wherever the pain is chiefly felt, and rubbing into them some acid preparation distilled from a root. As a counter-irritant this method is no doubt excel lent, causing the patient, as it does, to forget his headache in the greater pain of the acid injection. It is also successful in that it effectually keeps the patient from troubling the doctor again for some time. A pain in the eyes, again, must be due to the presence of some isilokazana, or beetle, in the affected parts. Incisions under the eyes, therefore, with more injections, will cause the eyes to water freely and so to eject the foreign body.
Chest complaints of all kinds, from bronchitis to pneumonia, are caused by holes inside the chest, a diagnosis which, in some cases, is pretty near the truth. The holes must be filled up. If the patient recovers after the filling process is complete his recovery proves the value of the treatment. If he dies it is because the holes were not sufficiently filled.
Surgery was almost unknown amongst them. Any Zulu would rather die than have a limb amputated, so that the need for that kind of surgery did not exist. Abdominal surgery was quite unknown. Dental surgery was practised whenever a victim was found who would rather face the brutalities of the tooth-extractor than go on for another single hour living with the offending tooth. In such cases he was tightly held prone on the ground while the tooth was removed at the point of an assegai. Let those of us who shrink from the skilled attentions of the knight of the forceps reflect upon what such a mode of extraction must have meant to the helpless victim!
The humane man living amidst all this ignorance and pain could only try to do his best for the wretched sufferers, conscious that even his worst was better than the best the native doctor could do. Common sense, eked out by Cassell's Family Doctor, could achieve much. Epsom salts, quinine, and ipecacuanha will carry a man far into the affections of a primitive people. Dental forceps, wielded however unskilfully, are infinitely to be preferred to the leverage of a sharp-pointed spear 3 feet long. The prestige of a white man invests even the mildest drug with magical properties. The unplumbed depths of the knowledge which he is known to possess inspire his patients with that faith which is the only potent ingredient in most of the nostrums swallowed by suffering humanity.
So Charles Johnson took up, figuratively speaking, the scalpel of the surgeon and the pestle and mortar of the physician, and spent a large part of his time wielding them.
During his earlier years there were no professional medical men in Zululand, his nearest missionary neighbour was many miles distant, and he had a large field to himself. During these years he acquired a good working knowledge of the various ills to which the African is subject, and his rule of thumb doctoring became very successful. His fame spread, and the number of people who came to him for treatment and advice was considerable. He made, of course, no charge for his services. Occasionally a grateful patient would bring a small gift in return for his help, but he maintained his practice largely from his own resources, with help from time to time from friends and supporters of his work. When more settled conditions prevailed in the country, and district medical officers were established in most of the magisterial districts, he was instrumental in persuading large numbers of Zulus to give up their own ignorant practitioners and go to the European doctors. By some of these medical men he was regarded as a rival who diverted from them patients who should have been treated by them. Several of the government doctors complained of his practices, as they did of the medical work of other missionaries in the country. But this was to take a very short-sighted view of what was happening. Apart from the considerable help which he, and other missionaries, gave to the people, they were instrumental in breaking down much of the prejudice which the black man feels against European methods of medicine. Without the help thus given the government doctor would have found it very difficult to induce natives to come to him for advice. The doctor's knowledge of medicine was, of course, scientific and professional, as against the empirical knowledge of the missionary. But his knowledge of the language and mentality of the Zulu was usually of the slightest, so that, while he himself possibly knew all about the particular disease he was asked to treat, he could not convince his patient that he knew. Confidence in his methods was therefore of slow growth. The missionary, on the other hand, knew how his patient's mind was working. He could explain clearly to him what was wrong, if he knew himself, and give him clear and understandable directions.
No unprejudiced person would deny that the treatment by missionaries of ailing Zulus has done much good, both in the direction of effecting cures, and also in that of breaking down prejudice so that the European doctor might have the opportunity of helping the people. But obviously, such quack doctoring ought not to go unchecked in these days when the provision of roads and motor transport has made possible easy communication between a doctor and his patients. It is more than time that missionaries gave up the practice of treating sick people. But until more medical men and more hospitals are provided, either by the government or by missionary enterprise, the people will still flock to the missionary who will continue to feel constrained to do what he can for them.
The present position in Zululand is most unsatisfactory. There are ten or eleven--the number varies from year to year--professional European medical men in the whole country which has a scattered population of some 12,000 Europeans and 350,000 Zulus. There are two government hospitals for natives and three missionary ones. On the other hand, there are some 1200 native herbalists and medicine men licensed by the government to practise their wiles upon their fellow countrymen, not one of whom has any kind of training for his work or possesses any qualifications for it beyond a slight knowledge of a few drugs. It would be impossible fully to relate the amount of mischief for which many of these men are responsible. Every missionary knows what they do, and constantly complains of them. It will be sufficient here to say that, in the opinion of many of the Zulus themselves, no practising Christian can be an inyanga (doctor). The question will be asked, Why does the government license these men if they are so bad as this statement would make them appear to be? The answer to this question is simple. Government did not establish these men in their work. It found them already at work and instituted the licence system in order to try to control their activities rather than to encourage them. Whether licensed or not they will practise so long as the credulity and ignorance of their people tolerate them. The only way to lessen their number and their influence is to provide a better medical service in the country which will, in the course of time, command the confidence of the people and attract them to itself. It would be stupid to assume that the Minister of Public Health (or Minister of the Interior, as he is so fittingly called in South Africa) is ignorant of the facts here stated. It would be cynical to believe that nothing is being done about it by responsible officials. But no one, not even a cabinet minister, can create an efficient medical service in a few years in a new country like the Union of South Africa. Of late years signs have not been wanting which show that a large scheme of medical and hospital service in native areas is being thought out. Under the new methods of taxing the natives, introduced in 1927, a part of the proceeds of the taxes is to go to form a Native Welfare Fund, and one of the charges against this fund will be the establishment and maintenance of hospitals in native areas. This fund, however, cannot be available for financing any large scheme for some years to come. Meanwhile missionaries are doing their utmost to establish hospitals in their larger centres of work so that, when the Welfare Fund is available, it may be used to support institutions already at work, rather than to establish new places.
Charles Johnson fought a vigorous and, on the whole, a successful battle against the influence of the native izinyanga amongst his people. That he did not succeed in banishing them altogether from his sphere of influence is due to the length of time which it takes for superstition and ignorance to be dissipated in the minds of human beings, whether they be African or European. The racial and tribal instincts which play so large a part in the mental outlook of primitive folk kept many of his people on the border-line of doubt as to their final choice between submitting their ailments to the attention of a European doctor or calling in one of their own izinyanga. It was, and is, natural that these mixed feelings should persist. The untutored African regards the white man from much the same angle as that from which any European child would regard a man with a black skin, that is as something hardly human, something altogether alien, something to be feared at close quarters and derided from a safe distance. A person who is regarded with mixed feelings of fear, astonishment, and amusement would not command the confidence of the ordinary individual. There is always present, it must also be borne in mind, the temptation to believe that African diseases can only properly be understood by African people, a temptation which has been strengthened by the scepticism of many otherwise intelligent Europeans regarding the possibility of possession by demons, of the power of spiritual forces over material things. The African who regards disease as being due much more to spiritual and mental causes than to purely physical--and who shall say that he is altogether wrong?--finds it impossible to believe in the fitness of a sceptic in these matters to cure him of his ills. A hospital has been established at St. Augustine's since the death of Archdeacon Johnson, in order both to commemorate his memory and to carry on the medical work which he did for so many years. The hospital is small, but already it has more than justified its existence. There is little doubt that it will grow in size as well as in usefulness because it is a necessity. Those responsible for its establishment find the struggle to keep it going a heavy one. Until it can qualify for Government aid it is supported entirely by voluntary gifts, by the fees paid by patients, and by a grant from the Diocesan Finance Board of Zululand.