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My early days as a surgeon at Aga Khan Hospital

Sunday December 8 2019


Tom Mboya delivers a speech in Machakos after the release of Paul Ngei from detention. ILLUSTRATION | JOHN NYAGAH | NATION MEDIA GROUP 

Yusuf K. Dawood
By Yusuf K. Dawood
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Once I started working in the hospital, I discovered that the top brass was all white, the browns filled the middle cadre and the blacks were in menial and subordinate positions.

This was not necessarily racial but was borne out of necessity. The country had been developing in racial compartments at a different pace and the hospital had to establish a hierarchy from what was available in each category.

As in Apartheid regime, the races were set not only apart but also unequal. But all this was going to change soon because 'uhuru' (freedom) was round the corner as was evident by gradual release of the famous “Kapenguria Six”.


We witnessed the celebration in Machakos which followed the release of Paul Ngei, the fiery Akamba leader, where the guest of honour was the young, charismatic Tom Mboya, who proved to be the centre of attraction.

We were taken there by Mr Janmohamed, a budding local Asian politician.


At the rally we met Paul Ngei, who wore a cap with “1951-1961” inscribed on it.

Our host, Janmohamed, explained to Marie and me that it signified the years of his detention.

Tom wore an elegant western suit but for theatrical effect, he emerged wearing a robe, reminding me of Mark Antony deriding Brutus as the body of slain Caesar lay at his feet.

A big crowd had gathered to listen to this legendary figure and sat in the open air under the brilliant sun of a clear African sky.

As usual, slogans of "uhuru na Kanu", "uhuru pamoja" and "uhuru sasa" rang through the fields and forests.


There were prolonged cheers by men and loud ululations by women, all dressed in brilliantly coloured tribal clothes as Mboya made an appearance on the podium to deliver his speech.

He stood like a monarch who was surveying his subjects. In the course of his motivational speech, he pointed at a rotten fruit precariously hanging from a tree, eroded by woodworm.

“Colonialism is like that fruit, rotten through and through.” He said and took a tactical pause until his audience went agog with suspense when he added:

“Like that rotten fruit, it must fall and be buried in the good African soil for good.” His listeners were stirred into frenzy.

In my first year in Kenya, the hospital was visited by the Aga Khan in May, who graciously congratulated me for improving the general atmosphere in the hospital and raising the morale of the staff, both verbally at a board meeting and in a letter he sent me soon after his visit.

Finally, the historic visit by Jomo Kenyatta on October 5, 1961 after his release from detention, alluded in detail earlier on.

The other historical incident, recorded in low key by the media at the time was the admission of Mama to the maternity ward and the birth of Uhuru, who followed his illustrious father to State House, making Mama the wife of Kenya’s first President and the mother of the Fourth!


Undaunted by the racial incidents, undeterred by horrifying forecast by the estate agent and refusing to be discouraged by lack of surgical work, Marie and I decided to plod on, regardless.

The only factor that I could influence was the low-bed occupancy.

In that respect, I set three aims for myself — to start on a clean slate throwing all past politics to the wind; work tirelessly to make the surgical unit a centre of excellence, and to improve the standard of service beyond what was available in other hospitals.

The last one was necessitated by the public perception in 1961 that only a white surgeon could carry out a surgical operation!

To change this mindset, I thought it better not to decry it but to provide a superior standard to change the racial bias.

I promulgated the superior standard of service in the surgical unit and to practise what I preached and set a personal example, I used to see my operated patients at least twice a day once when my operating list was over and again before the patient and I retired at night.

That made the patient feel very secure and impressed upon him that he was being closely monitored by the surgeon himself.

It proved a comforting thought for the patient because I found in my survey that it was what he dreaded most.


In connection with caring for patients and carrying out their wishes, I have an amusing incident to narrate.

I was having a leisurely breakfast on a Sunday morning when Dr Paes rang.

He was a busy GP whom I had assiduously cultivated, among others, to refer his surgical work to me in the hospital.

“I have a Mr Patel with me who wants to consult you about his hernia,” he said.

“On a Sunday morning?” I asked. “Yes,” he replied. “I suggest that you see him today and book him for surgery on your next list.”

I rang Sister Taylor in the Casualty because outpatient clinics were locked on Sundays and arranged to see Mr Patel there.

I took a brief history from him, asked him to undress and saw a large hernia in his groin. "How long have you had it?” I enquired.

“Thirty-seven years,” he replied. “Why did you wait so long?”

“I was waiting for a surgeon like you to be born and be trained,” replied the patient cheekily.

“My operation list is on Tuesday and I am booking you for it.”

“Oh,” Patel sighed. ”As you can see, I have shaved, put a little Dettol in the bath, took a purgative last night and have starved since last evening; I am ready for operation right now.”


The empty beds in my unit were haunting me and I rang the Theatre Sister.

Luckily it happened to be Sister Robinson, who had drastically abbreviated my unpronounceable surname to Mr K!

I acquainted her with my problem. She replied: “You can’t operate on a 37-year-old hernia on a Sunday.”

“What if it was strangulated?” I asked. “That would be different,” she conceded.

“Take it from me, while you have been arguing with me, it has strangulated!” It appealed to her Irish sense of humour and we won the day.