Two days ago I met Paulo Manuel Mande. I had the opportunity to watch him fix some fractures, wash out open wounds, and – together – we delivered two healthy baby girls (twins!) by cesarean section. Working with Paolo was not unlike working with some of the other surgeons I have met: he works briskly, anticipates his next move, and exudes a silent confidence. However, unlike other surgeons, Paolo has not gone to medical school, has not even gone to college, and until last year had not gotten past the sixth grade.
Paulo Manuel Mande
His story is, in a way, shared by many of his colleagues at Kalukembe Hospital (below). The 200 bed facility in the middle of the Angolan bush is run entirely by nurses. Various doctors came and went through Kalukembe just as the hospital wound in and out of a war that dominated most of Angola’s 36 years of independence.
In 1990, when violence in the region peaked, the foreign medical staff was forced to flee the country. The Angolan nurses also fled the region; they scattered amongst the surrounding municipalities and provinces. Travelling only when their safety was relatively guaranteed, they gradually returned to find a ransacked hospital; nevertheless, they started to piece it back together. It was at that time – with bomb blasts as a soundtrack and lanterns for OR lights – that Paolo and a few other technicos started to implement (or “imitate,” as they describe it) the skills that they had learned over years of serving as assistants.
Improved OR lighting now
… (part 2)