Q&A: Dr. Paul Thistle

Dr. Paul Thistle, a Canadian,is the chief medical officer and only full-time doctor at theHoward Hospital in Glendale, northern Zimbabwe. The hospital, a Salvation Army institution and the only hospital left in the country not run by the government, serves a population of roughly 250,000. Dr. Thistle is a big reason why it continues to exist during the well-documented troubles of recent years.

Despite the turmoil, Dr. Thistle doesn't want to take sides in the current electoral crisis between President Robert Mugabe and the opposition. "The hospital is very apolitical," he says.

During his 13 years with the hospital, he married a Zimbabwean nurse, Pedrinah, and the couple have two sons, James and Alexander. He has returned to Canada to receive an honourary Doctor of Law from the University of Windsor, on June 11, and a humanitarian award from the Royal College of Physicians and Surgeons of Canada on June 19.

CBC News producer Jet Belgraver caught up with the doctor by telephone this week:

Q: What drew you to Zimbabwe to begin with?

The short answer is that I thought I was going to Mexico for a vacation and I got the wrong plane. But the longer answer is after medical school, I wanted to practise in an under-served part of the world.

I volunteered my services with the Salvation Army and they suggested an African country Zimbabwe in particular. I didn't know too much about it at the time, [except that it was] probably one of the more stable economies and stable countries in the region at the time. As it turned out, they were short of doctors and they had a rapidly growing HIV pandemic and health care was suffering. So I volunteered for one year that was the initial contract.

But I think my watch stopped and now I'm entering my 14th year at the Howard Hospital.

Q: Why have you stayed so long?

It is community. [The] longer you stay and you adopt the language and culture, the more you see beyond the four walls of a hospital, out into the community, and see the potential: education, income-generating projects, support for people living with HIV/AIDS. When the novelty's worn off, you've developed relationships with the community and you have a growing network of partners all around the world, including Canada, being my home-soil.

One thing leads to another and you continue to work, see development, even in the midst of the struggling economy in Zimbabwe now. Things are still happening, things are exciting and there are positive stories in the midst of a backdrop of sorrow and suffering and the unrest from the recent election.

Q: What has been the impact of the current economic crisis?

Inflation, they say, is at a million per cent a year. I don't know how they calculate that because my little pocket computer doesn't hold so many zeroes! It's astronomical. How can you run any business when you can't set your prices for more than five minutes? What exchange rate do you use?

So it's difficult to live in general, and when you're a district hospital serving 140,000 people every year with 140 beds, it's more difficult because you're dealing with more logistics not just medical supplies but foodstuffs for your patient. From the soap to wash your linen to the operating room, these day-to-day logistics are really unfathomable in a Canadian healthcare system.

Q: What has been your biggest medical challenge?

HIV/AIDS. Our incidence has declined from 27 per cent in 1999 to 15 per cent in 2008, but that still means that 15 per cent of the adult population [those in their] reproductive years, the bread winners are suffering what has been an incurable illness.

At some point, usually sooner than later, they will succumb to AIDS. Now, we've intervened with the ARVs [antiretroviral drugs] and [the] HIV cocktail, but the fact is they have to access treatment. [You] have to imagine what it's like for people in a rural area of Zimbabwe, with a poor transportation network, trying to access care at a hospital such as Howard. And being able to understand and continuing to live on treatment, having to take a pill at the same time every day, twice a day for rest of their life.

It's possible but it's another challenge a medical issue, a social issue .

Q: Are you at all concerned about what we hear as a growing political crisis in Zimbabwe? Are you scared?

Concerned, yes, for the welfare of the people. Scared, that's a sort a like a Halloween term to me and not so much frightened by it because the community and the hospital have a long-standing relationship.

We've been there since 1923. We've seen the comings and goings of unrest and political disturbances from the colonial government to Ian Smith's party, back in the '70s. We support the community and the community supports us. We're there to assist in any way possible and that's respected in the community with our medical and social programs. We've got a good relationship with the government of today and hope that will continue with who ever wins the election and whoever forms the government of tomorrow.

Q: So despite the current situation, there are still volunteers coming to the hospital?

Yes, because it's the network that we've established and its taken years.

Howard Hospital is safe, 100 per cent safe. We're smack in the middle of Africa, in the midst of the current situation of the country, in the midst of poverty and HIV/AIDS. It's not a Club Med, it's simply the Med and there are risks involved in travelling to this part of the world. Is it safer than the 401 in rush hour? I think it's safer based on my experience this morning driving out to Mississauga. But those are all perceptions. And perceptions are what rule the day, not the facts orthe risk of serious illness or injury.

Q: Many Canadians remember the story ofTinashe and Tinotenda, the conjoined twins from the village were who underwent separation surgery in Canada a few years ago. How are they doing?

The twins are great, they're four-year-old children making mischief all around Zimbabwe, at least all around the village. We see them on and off but seldom do I see them for medical concerns.

The younger one, Tinotenda, still has a mild curvature of the spine but that's even straightening out. He's the more talkative one. The other, Tinashe, is quieter but more physically fit of the two. The mother's doing well, getting some assistance from our Canadian well-wishers to start some income generating projects for the family. The kids are healthy and that's more than we had expected in 2004.