A Yankee doctor in paradise

by S. M. Lambert

CHAPTER VII

HALF A LOAF AND A SLICE OFF

I should be sloppily sentimental and call the scene which is to follow “My Dream Come True.” The dream had backed in a little crookedly, knocking over a few ideals and dumping at my feet a short measure of fine gold. But who was I to complain? Something substantial had materialized out of six hard years of constant hammering for results. I think I was excited, for I could scarcely follow the earnest, dedicatory voice that rang through the new lecture hall, fragrant with fresh paint and plaster.

That was the morning of December 29, 1928. I sat on the platform with bigwigs of the Colony: Sir Maynard Hedstrom, U. S. Consul Roberts, the Secretary of Native Affairs, the Colonial Secretary and sundry others. His Excellency Sir Eyre Hutson, Governor General of the High Commission, was making a speech.

“It is fitting that there should be this meeting today to record the opening of the new Medical School in Suva, which has really been in being for some weeks, from November first, but officially as a Central Native Medical School in the Western Pacific will enter on its career, which we hope can be no other than a successful one, from January first, 1929 ... had its origin some years ago with Dr. Lambert, a member of the Medical Staff of the Rockefeller International Health Foundation ... whole-heartedly supported by Dr. Montague.... And the various Administrations in the Pacific, who have co-operated in the scheme, owe a deep debt of gratitude to Dr. Lambert for his strong faith, for his persistent advocacy of the proposal with the governing body of the Rockefeller Foundation ... without which we should not be in this building today....”

I looked over the upturned faces, brown and white. I counted the eight native boys of the graduating class, and thanked God that all the undergraduates wouldn’t have to sleep in the little firetrap of a dormitory, which would only accommodate twelve. The new dormitory could pack in twenty-eight, and there was room for forty in the dining room. The new main building, over which we were making such a fuss, would be fairly cramped quarters. It needed space for laboratories, pathological, bacteriological, biochemical. And the dissecting room wasn’t much bigger than my grandmother’s cupboard....

Just the same, my dream had come true, even with a string on it. The modest buildings we had achieved were modern-built and filled with students.

Now the Governor, his kindly, eupeptic face rather flushed with December heat, was addressing the student body:—

“... You are receiving opportunities with limitations, which are unavoidable, of becoming members of a very honorable profession, not only for your personal benefit but mainly for the good of those men, women and children to whom you will be called on to give medical and surgical aid and treatment to the best of your ability and knowledge....”

Then it was over, everybody had shaken hands, and I was being interviewed by the press. I told the reporters what I felt, that his Excellency had been too modest in disclaiming his own important share in bringing the School to life; how the project had been a partnership between Dr. Montague and myself, and how I might have given up early except for his quiet persistence; and how Queen Salote of Tonga and her Prince Consort had offered financial aid in my hour of deepest discouragement; how their loyalty to all the South Pacific had inspired other groups until at last they had touched the purse-strings of the Foundation....

Outside on the half-finished grounds I saw students filing into the classrooms. There was a score of dark-skinned Fijian boys with shocks of kinky black hair, sport shirts and sulus. They had the look I have always admired in their race, that of intellectual honesty and will to learn. The Polynesian boys were in lavalavas, and like the Melanesians they were bare-legged and unshod; some of them had the pale, even features and straight hair of Caucasians. There were a couple of boys from the Solomon Islands, wooly-haired and almost plum-black. The light-faced, worldly-looking ones were from the Cooks. There were a couple of well-dressed East Indians. The Condominium was sending us New Hebridean students, but they hadn’t come yet. The Fijians outnumbered the others, for there were twenty in all, and twelve of them were graduating from the old school, which had only accommodated sixteen students in all. Almost overnight the enrollment had increased to forty, and I was wondering how the boys from far-off groups would get on with the Fijians, when more of the outsiders came in. The fair-skinned boys from the Cooks and Samoa had one great advantage; they knew more English, whereas the Fijians were handicapped there and would have to learn hard lessons in a strange tongue. For the same reason all the Melanesian lads would have a tough time at first. New Zealand had been wise in giving her mother tongue to the Polynesians.... But I knew the Fijians, men like Malakai and Charley, who had mastered every hard subject that came their way.

More boys would be eligible for the school. We would have to refuse some for lack of space, and look very carefully into the mental qualifications of every applicant.... There would be a tendency on the home islands, I knew, to play favorites for political reasons. Some of the officials would promote candidates because they were “good batmen”—meaning that they had served them well personally.

All that must be straightened out, for we would never have room for slackers.... I wondered how soon we could promote a decent school for native nurses; that was a part of my plan for enlargement. Now they were living in a crazy shack where they did their own cooking, and in the hospital they scrubbed and emptied slops for dainty British nurses. Samoa was giving her native girls an adequate training. We could do no better than follow her lead.... I wondered if students would ever come from Papua and New Guinea, where N.M.P.’s were dreadfully needed. The Canberra Government was standing pat on White Man’s Australia, and the “blackfellow” was not supposed to have a head on his shoulders. Papuan and New Guinea natives, they said, were not adequately prepared for higher education. I knew better, for I had seen those boys, and worked with them.... According to Australia’s yardstick students from the New Hebrides and the Solomons were also inadequately prepared; but they were entering our first class. Australia forgot that her Territories had been missionized by Fijians, Tongans and Samoans.... Dr. Strong, the progressive C.M.O. at Port Moresby, had offered to pay the expenses of Papuan students, if Canberra would consent.... But why argue the point? Australia was jealous of little Fiji’s rise as a medical center, and had decided not to send a student or to permit an N.M.P. to work in her possessions.... I wondered if she would ever change her mind.

******

Up to the day I retired the Foundation was always a little nervous about what I was going to do next. They were usually asking, by inference, “Where is Lambert going to pop up now?” Dr. Heiser’s immediate reaction to whatever I put up to him was a simple, “No,” and I had to pound away at him until he gave up. As I have said before, he was very careful with Mr. Rockefeller’s silver dimes, and his honest stubbornness deserves great credit. Dr. Sawyer, who bossed me during my early days in the Pacific, was a strong advocate of the Central Medical School, for he knew the needs of the islands. Sawyer is now the Foundation’s Director of the International Health Division, and still a little nervous about me. He wants me settled on a Californian farm where I’ll be out of mischief. Sawyer is one of the most brilliant research scientists of our time. Considering his environmental background he is extremely broad-minded—he comes of a family of clergymen. I shall never forget the time I led him up to a North Queensland bar where the Australians were sneering “Wowser!” at every prohibitionist. Sawyer ordered ginger ale, drank it and made them like him. With the same puritanical gusto he backed me up in the Medical School. I shall always be grateful to him.

I had estimated that it could be financed by a contribution of £1,500 each from seven island groups. Fiji’s sudden decision that she could start a School of her own on a one-horse scale had given more point to my argument when I went back to the States and put it up to the Foundation. I had talked pretty steadily for half a year, informing the unsympathetic ones that Fiji’s stingy plan would set the School back about twenty years.

In 1927 I had come back to Suva with the Board’s promise in my pocket. They would fund half the expense of the larger plan. This was economical still, and hardly adequate for what we needed; but we had enough now to get things going. I had wrestled with the Foundation’s Department of Medical Sciences, to whom I had to appeal for the sort of funds required. To give out money to the very finest medical schools and raise their already high standards was the Department’s end and aim. To finance a little idea like ours gave them an almost physical nausea. I didn’t get anything out of them, except to make them admit that some lower grade of medical education might be useful, until their high-flown notions had time to turn out crack specialists to serve the teeming millions who lacked anything but witch doctors to care for them.

The Department of Medical Sciences remained adamant. I finally got the money from the International Health Board itself. This was the first time they had given financial support to the building of medical schools. Up to then it had always been in the hands of the Department of Medical Sciences.

The time would come when we would need more buildings and equipment, that was obvious. The time might also come when some jealous local politician would attempt to wreck the School, or drain it white. A little man can do big mischief, as we found later when a domestic colonial secretary worked his political best to destroy our planned Unified Health Commission, for the petty reason that Fiji’s Chief Medical Officer would head it with a few pounds larger salary than his own. He was of the old anti-American type, which has done so much to promote ill feeling both between England and her colonies and England and America. His kind, I hope, is passing. This little man was not quite able to interfere with co-operation in the Mokogai Leper Colony, which we started back in 1923 and saw built into one of the finest leprosaria in the world.

But the School was open, and we were down to the realism of immediate figures. We could admit forty, and the cost per student would be ninety pounds. There was a wooden dormitory, a main building seventy-six by thirty feet, and the Principal’s house. We were well staffed with the Chief Medical Officer, the pick of the government physicians and local practitioners. We also had the Government’s pharmacist, a dentist, the Government’s bacteriologist and chemist, and the Rockefeller Foundation’s modest representative. We had plenty of textbooks and scientific instruments. In fact we had about everything but room to turn around in.

******

I wasn’t dissatisfied that afternoon in 1928 when I made another inspection of the buildings. Our feet were on the ladder, we were going up. The other things would come, though there was plenty of fighting ahead.

I had to reflect on the slow and painful beginnings of the Native Practitioner system, some forty-two years before. In 1875 the Colony was frightened by the measles epidemic which burned the Fijians down, and with only the puniest attempt at medical aid. Thirteen years later the British residents were appalled by the danger of smallpox, brought in by the East Indian invasion. The Government well knew that the most important medical need was vaccination, but the expense of European vaccinators in this work seemed overwhelming. Health in those days was in the charge of Dr. Corney, Fiji’s second great Medical Officer. Sir William Macgregor, later Governor of Papua, was the first, and Dr. Montague was the third of the great ones. In Corney’s day the Colony, in desperate need, was sending out natives to administer vaccine to an endangered population.

Corney saw how dextrous these men could be with instruments and how quickly they won the confidence of half-wild villagers. Perhaps the Colony’s financial embarrassment was what touched off his imagination. At any event, in the late eighties, after the Government had voted small sums for vaccination purposes, Corney surprised them all by suggesting that the native boys be given some systematic medical education. In January, 1889, eight Fijians passed the examination and were given certificates.

These early students got only the bare bones of a living. They were huddled together in a bure in the old Colonial Hospital grounds, and spent a good deal of their time working their gardens for enough vegetables to keep going. They had no lecture room, no models or diagrams; postmortem examinations were not easily obtained and almost the only apparatus for anatomical study was a set of bones. When medical officials had time to teach these boys they casually handed them some practical work in the Hospital. Most of the nursing duties fell on their shoulders, as the Matron was the only trained nurse in Fiji. There was some improvement in 1900, when a lecture room was built. Somewhat later improvements advanced as far as a wooden students’ quarters.

In 1898 the students went on strike, which resulted in the improvements of 1900. As a body they called upon the officials and announced that they wanted the whole-time services of a cook, otherwise they were going back home. The authorities concluded that they were probably human beings, so the point was carried. After several years the eight-student school had turned out approximately twenty Native Medical Practitioners. These men were working for something like seven pounds a year, all told, but they were given free gardens to cultivate for themselves. They earned two pounds ten as Provincial Vaccinators, and in 1905 their salaries jumped to between eighteen pounds and fifty pounds. Seven years later their usefulness was recognized by another increase in salary; this time they were divided into first, second and third class. A first-class N.M.P. was getting as much as one hundred pounds a year. When the new School was opened, they were making around one hundred and fifty pounds.

The products of this low-paid, rough-and-ready education won their spurs early. In the devastating influenza epidemic of 1918 three of the old students died at their posts as dispensers in the Colonial Hospital. Eight in all died, out of a total of forty-eight. In no case was there any complaint that an N.M.P. had failed in his duty so long as he was able to lift a hand.

In December, 1928, a new order was coming to pass, I hoped. The door was open, not too wide, but young men were passing through with a keen desire to get the best that modern methods could give. That door would have to swing wider. It mustn’t close again. Neither politics nor prejudice nor indifference must slam it shut in the faces of those who had come so earnestly to learn. I was canny enough to suspect that there would be the same percentage of failures you will find in any college anywhere—ten following years of experience taught me that the average was less. They had something more than the desire to get on in the world, which inspires so many European professional students. That December evening I talked with several of the incoming class, the boys who were not too shy to speak out. Why did they want to go into medicine? The answer I got from them was usually the same: “Because I want to do something for my own people.”

It was about then that I pulled in my belt and promised myself that so long as I was alive and in Fiji I wouldn’t let them down.

PART THREE