Search Salon

- - - - - - - - - - - -

Recently in Salon Health & Body

A shot in the dark
Is a hospital the perfect place for a doctor to kill -- and kill again?
By Dawn MacKeen
[09/02/99]

Personal-space invaders
Research shows that we need room to stay sane.
By Jon Bowen
[09/01/99]

Urge
The gang's all here
Hope flickers at the World's Biggest Gangbang.
By Kevin Bisch
[08/31/99]

Urge
Through the hooking glass
Nancy plays her part -- but she can't decide what scene she's in.
By Tracy Quan
[08/30/99]

Urge
Teen transsexuals
When do children have a right to decide their gender?
By Maria Russo
[08/28/99]

Complete archives for Health & Body

- - - - - - - - - - - -

- - - - - - - - - - - -

Mnene -- a cluster of buildings -- can't be found on many maps. It lies in the region of Mberengwa in south-central Zimbabwe, in what in colonial times were known as the tribal lands of Belingwe, in the heart of the bush. Inhabitants identify themselves by the name of their tribal chief; the land is still owned communally, and the local people's life of subsistence farming has changed little for generations. There are no towns to speak of, scant electricity, almost no telephones. Most people live in extended family units in clusters of mud-walled buildings with thatched roofs. The landscape is often stunningly beautiful: verdant valleys give way to distant panoramas of mountain ranges. Drought and malaria are constant threats, in part because the lower elevation makes the climate more tropical than it is on the high plateau where most of the white population lives.

The region is served by three hospitals, one of them also called Mnene, all founded in the early part of the century by Evangelical Lutheran missionaries. Mnene Mission hospital, a cluster of one-story whitewashed buildings with corrugated metal roofs and wide verandahs, is set atop a hill with distant views and refreshing breezes. The buildings look much the same as they do in a photograph taken in 1927, when the hospital was built.

Also Today A shot in the dark Hospitals are perfect settings for serial killers -- there are drugs everywhere and doctors don't police doctors. "Blind Eye: How the Medical Establishment Let a Doctor Get Away With Murder" A throrough investigation tells a hair-raising story but doesn't go far enough in its indictment of the medical profession.

When Mpofu and Swango finally arrived, Dr. Christopher Zshiri, the hospital director, hurried out to greet them. He introduced Swango to Dr. Jan Larsson, a Swedish missionary doctor who was the other member of Mnene's medical staff, and showed Swango to his quarters, a spacious bungalow with a verandah, adjacent to the hospital. Zshiri is a native Zimbabwean. Under the country's system of socialized health care, he reported to the provincial medical administrator in Gweru and was paid by the government, even though nominally he worked for the Lutheran church. Even more than the others, Zshiri thought it was almost too good to be true that they had managed to recruit an American doctor to a place like Mnene.

Zshiri and Swango soon became friends. Zshiri couldn't get over how talkative Swango was, always eager for conversation and filled with curiosity. After his arrival, Swango had garnered glowing reports from patients and staff members. He was soon known to everyone as "Dr. Mike." It was true that he lacked experience in general surgery and obstetrics, two areas most in demand at Mnene. After a month at Mnene, Zshiri sent him to Mpilo Hospital in Bulawayo, where Swango spent the next five months gaining additional clinical experience. The doctors at Mpilo wrote glowing recommendations, and Swango was far more confident and proficient when he returned to Mnene in late May. He was seen as a nearly tireless worker, able to complete forty-eight-hour stints without sleep. He even worked extra shifts, giving up his free time. Of course, at Mnene, there was little else to do. Even the indefatigably cheerful Swango finally complained about the isolation, asking Zshiri if the church could possibly provide him with use of a car, since he couldn't afford one. Fearful that Swango might decide to leave, Zshiri wrote church officials a letter asking whether there wasn't some way they could accommodate him.

Swango often made extra rounds to check on his patients, sometimes at night or during afternoons when he was otherwise off-duty. So when Dr. Swango arrived in the surgery recovery room one May afternoon in 1995 to check on Keneas Mzezewa, the only patient there, no one thought it unusual, even though Swango had already completed his rounds that morning, and technically Mzezewa wasn't his patient.

Mzezewa had recently had his foot amputated by Dr. Larsson. A farmer in the Mberengwa area who was also a part-time laborer at the nearby Sandawana emerald mine, Mzezewa had come to the hospital the previous week complaining about severe pains in his leg. A tall, slender man with a wide smile, Mzezewa had reacted calmly to the news that his infected foot would be amputated. The doctor reassured him that he would be fitted with a prosthesis and should be able to lead a normal life once he returned to his farmstead. The operation had been uneventful, but Mzezewa had been kept in the recovery ward for close monitoring, which was routine in amputation cases. Dr. Larsson had been pleased with his progress, and mentioned to Zshiri how well Mzezewa was doing.

That afternoon Mzezewa was awakened from his nap by the new doctor, Dr. Mike. Before the doctor gave him the injection, Mzezewa noticed, he neglected to swab the skin with disinfectant. Mzezewa also noticed that when Dr. Mike put the used syringe in his jacket pocket, the needle's cover fell to the floor near his bed.

Still, it seemed a routine visit. Despite the large size of the needle, Mzezewa didn't mind the pain. He relaxed and lay back on his bed, prepared to resume his nap. But as the drug given him by the doctor spread through his body, he began to feel a strange loss of sensation in all his muscles. With mounting alarm, he realized that he couldn't turn over and couldn't move his arms or legs. He wanted to speak or cry out, but his jaws, tongue, and throat wouldn't respond. Then the room, brightly lit by the afternoon sun, grew dim. Soon all was darkness.

Mzezewa didn't know how much time passed while he lay there, alive and conscious but paralyzed and terrified. But then the darkness began to lift; he could see, though he still couldn't move his head. A nurse's aide entered the recovery ward and came over to his bedside. She held a thermometer and told him it was time to take his temperature. Mzezewa's mind was racing. His heart beat furiously. He wanted to cry out, but he couldn't make a sound. He could hear the aide, but he couldn't move; his muscles wouldn't respond. She asked him to move his arm so she could put the thermometer in his armpit. He lay motionless. She asked him again. Suddenly the aide looked alarmed, and ran from the ward.

Moments later, Mzezewa regained his voice. He screamed and began shouting to attract attention, though he still could not produce recognizable words. A nurse came rushing into the ward, followed by the aide. She came and stroked his hand, trying to calm him, asking him what had happened. But he was still unable to speak. Two more nurses arrived. Slowly Mzezewa regained his voice. "Dr. Mike gave me an injection," he finally gasped. The nurses were puzzled, for while Mzezewa was taking oral painkilling medication, he was not scheduled for any injections. In any event, injections were administered by the nursing staff, not by the doctors.

Then Swango himself came into the ward, coolly appraising the commotion. Mzezewa looked terrified. The nurses fell silent.

"Did you give him an injection?" a nurse finally asked. "What was it?" Swango seemed mystified. "He must be delirious," he said. "I didn't give him any injection."
salon.com | Sept. 2, 1999

© by James B. Stewart

- - - - - - - - - - - -

- - - - - - - - - - - -

  Get a printer-friendly version

  E-mail a friend about this article

  Backflip this article to find it again

- - - - - - - - - - - -

Search Salon