During a power outage in one wing of the hospital, 15 children died in a week. They were on support, and the back-up generator failed. "You just look at this and think, 'A mother carried this child for nine months, finally delivered him and the child dies because of power cuts?' It really doesn't make much sense."
This is an African medical reality that Godwin Godfrey knows well. But it is with soft-spoken and undramatic explanation that the 32-year-old doctor opens a window on this world that puts Canadians' concerns about wait times and medicare service into humbling context. Dressed in casual clothes and seated in a dutiful pose, hands on lap, posture upright in a wooden chair, he was recently in the Toronto office of Save a Child's Heart (SACH), an Israel-based not-for-profit humanitarian organization that provides free heart surgery for children from Third World countries and trains doctors who would otherwise not have access to such specialization.
Last year, the Canadian affiliate office of SACH raised more than $850,000, having enjoyed "infectious growth" since the chapter was started in 2001, says Karen Diamond, executive director of SACH Canada. SACH surgeons conduct 225 emergency heart operations each year, flying patients to Israel from all over the world.
Born in Tanzania, Dr. Godfrey is currently on a five-year postgraduate fellowship in pediatric cardiac surgery at the Wolfson Medical Center in Israel under the auspices of SACH. When he returns to Tanzania in two years, he will be his country's first and only pediatric cardiac surgeon. Almost half of the country's population of approximately 43 million are under the age of 14. Half a million patients remain on waiting lists for heart operations. They can be waiting for as long as six years.
"I went to Sick Kids [Hospital] yesterday, and I thought it was a five-star hotel," he says, shaking his head slightly. In Toronto to promote the SACH mission and tour the children's hospital, he has seen a lot of unnecessary death and nightmarish working conditions in his time at Bugando Medical Center in Mwanza, Tanzania, one of the country's largest referral hospitals, where he will return to practise.
Once, he had to perform a cesarean section when there was no electricity after torrential rains. Gowns could not be sterilized. The patient wasn't draped. All he had were short gloves, not the long ones designed for abdominal procedures. In the villages, conditions are worse. "Doctors have operated by flashlight. I have colleagues who go to villages and they operate on a wooden table by candlelight or kerosene lamp."
Dr. Godfrey had looked unsuccessfully for postgraduate opportunities in Africa after graduating from medical school in Uganda. It was in 2006 that a German pediatric colleague told him about SACH. The fellowship in Israel means that he sees his wife, also a doctor in Tanzania, and infant son only a few times a year.
Born in a small town called Moshi, he grew up in a family of four children, all of whom have acquired postsecondary education. Their father is a general surgeon. Clearly, a highly educated family, I comment. "I would say we are trying our best," he replies in his understated way. There's a sense of a bemused outsider about him, someone who is always looking back and forward, caught between boundaries, having transcended the limitations of his own country but not exactly at home outside Tanzania, either.
Good intentions in the African medical profession constantly fall victim to the pressing reality of AIDS. The epidemic has shortchanged other medical disciplines. "At the end of the day, it's not forecasting on lives but forecasting on where the funding is. …You are leaving children dying and you're closing your eyes."
Still, the deployment of doctors from SACH last year to the Bugando Medical Center gave him hope. "For one week, they set up clinics, and we operated on 14 children that week. It was a big success. Since then, about 20 patients have made their way to Israel. And at least this showed how this can be done there, even with limited facilities. It's human power."
Dr. Godfrey is an exemplar of hope. He is not brash, not overly confident, steamrolling his vision for how things will change through every room, to every possible donor. Hope that is tentative and fragile is paradoxically the most powerful; a finger of light against the darkness you know exists. Many doctors in Africa are aware of the corruption that plays a part in the power shortages at their hospitals and in the medical supply chain, but they cannot report it, as their careers would be over, he explains.
His hands remain in his lap – strong, clean, still. Throughout the interview, his voice never rises in alarm or exclamation. And he looks out from behind his glasses with a steady, calm gaze. "You enter medical school, expecting to play like God, to be the saviour, and then you get broken down in pieces," he says. "But you don't need a lot of effort to make a lot of change in Africa, and this is what attracts me back."