This is an edited extract from memoirs my father wrote while he was in his late-seventies describing some of the things that had happened in his life.

Introduction
In 1957 I got an opportunity to visit the renowned Albert Schweitzer at his "jungle" hospital at Lambarene in French Equatorial Africa in the then French colony of Gabon. Harry Oppenheimer, the son of Sir Ernest Oppenheimer, the founder of the Anglo-American Corporation controlling most of the gold and diamond mines of South Africa, had inherited his father's wealth and business interests and was well known in Johannesburg as a generous philanthropist. Jack Penn, a plastic surgeon and sculptor, had made bronze busts of both Harry Oppenheimer and Albert Schweitzer, and, I think, told the mining magnate of the difficulties under which Schweitzer was working and aroused his interest. Harry Oppenheimer used to send medical specialists periodically to Lambarene to help with difficult cases which the staff there were not competent to treat adequately. The doctors at Lambarene used to save up difficult cases and when they had a quorum of cases of one type, a team would go from Johannesburg to deal with them. I was asked if I would be prepared to go and give some anaesthetics and I agreed with alacrity.

Getting to Lambarene
Gabon lies more than 2,000 miles northwest of Johannesburg. Lambarene is on the Ogowe River about 50 miles south of the equator and 175 miles from the mouth of the river at Port Gentil on the shores of the Atlantic. There were no major airports in Gabon and I was given a ticket on a French airline from Johannesburg to Brazzaville, the capital of the adjacent French colony of Congo. The Congo River, now called the Zaire, is the frontier between the old French colony and the ex-Belgian Congo, now the country of Zaire. Brazzaville is on the north bank of the Congo and is just across the river from the old capital of the Belgian Congo, Leopoldville, now called Kinshasa. I had to spend the night at Brazzaville. I was booked into the largest hotel, which was very comfortable and there I met up with the surgeon with whom I was to work during the next week. He was Joel Cohen, one of the leading gynaecologists in Johannesburg, with whom I had not often worked but I did know him from meeting him at the various private hospitals in that city. He was a very able surgeon and I looked forward to some interesting operations. Joel Cohen had his wife with him, they were on their way back from a visit to Europe and they had with them an American couple, Larry and Kaye Gussman, whom they had met on their travels. Larry was the boss of a very large grain and cereal concern in New York and Kaye was a delightful ex-nurse. They were both keen to meet Schweitzer and Joel Cohen agreed to take them along. It turned out to be a very fortunate meeting for the Schweitzer hospital set-up because Larry became a very earnest aficionado and a very hard working and influential member of the Albert Schweitzer Foundation, and long after Schweitzer's death his only daughter was a frequent visitor to the home of the Gussmans. Larry was a very great help to the hospital in obtaining supplies of rice and in many other ways.

John Gunther, in his book Inside Africa which he wrote about 1955 and which I read before going to Lambarene, says "Nowadays it is easy enough to get to Schweitzer, if you do not mind old aeroplanes and eccentric flying", so I was prepared to some extent for the experience the next day. The five of us – the Cohens, the Gussmans, and I – boarded with some trepidation an old Dakota run by Air France (I had already heard of its nickname 'Air Chance'), for what turned out to be a roundabout tour of French Congo and Gabon.

An Air France Dakota. (Photo courtesy of Pierre at spottingaviation.forumactif.com)

At every stop people got in and out and the cargo was stored alongside the passengers and if it was bulky then some passenger seats would be removed to make room for the very varied freight, which included live goats and chickens, as well as machinery of all sorts. I remember at one stop a young white couple being very disappointed because the machinery they brought along for transportation could not be accommodated with the load we already had aboard and they would have to await the next flight of the so-called milk run. It was a regular scheduled flight but I do not know how frequently it went but certainly not more than daily and it may even have been only two or three times a week, We went right down to the coast at Pointe Noire and then doubled back inland and some of the places we stopped at were nothing more than clearings in a very dense jungle with no visible signs of human habitation in the vicinity.

The air crew told us that at the penultimate stop before Lambarene we would stop for an hour-and-a-half for lunch which we would be able to get at the "airport" as they had a French chef there who would cater for our needs. When we arrived there we found the airport to consist of a landing strip in a clearing in the middle of a very dense forest and a thatched wooden hut in one room of which were tables set for a meal. Imagine our surprise and delight when we found that a very substantial meal was provided, I had a very tender rare buffalo steak followed by French cheese and complemented by half a bottle of Beaujolais. When the pasengers and aircrew came out of the hut prepared for the last leg of our journey to Lambarene we saw that the little wheel under the tail of the Dakota had a puncture. There was no spare wheel available so the crew had to go through the tedious process of taking the wheel off, taking out the inner tube and mending the puncture. Before they could start on that it was necessary to jack up the rear end of the plane and about a dozen of the interested audience of the black local residents of the tropical jungle were press-ganged into two groups and each group knelt down under the tail on either side of the wheel and then on a word of command they all stood up, lifting the tail high enough for the engineer to slip an empty oil drum under so that the wheel was clear of the ground. After about an hour’s delay the puncture was mended, the wheel back in position, and our human jack took the weight while the oil drum was removed.

Life in Lambarene
On our arrival at Lambarene we were honoured to be met by the great man himself. The airport at Lambarene was similar to the other clearings in the forest that we had stopped at on the way but an attempt had been made to have a small flower bed outside the wooden hut marked out with the metal tops of innumerable Coca-Cola bottles and some of the local beer bottle tops. The airport at Lambarene is on the opposite bank of the river Ogowe to Schweitzer's hospital and Schweitzer had come over in a small launch, but he had not known that the Gussmans were to be included among his guests and he did not have room for us all, so I volunteered to make the journey across in one of the native dugout canoes known as 'pirogues'.

Pirogues (i.e., dug-out canoes) on the banks of the Ogowe river. (A copyright photo from the Erica Anderson collection, courtesy of the Syracuse University Libraries.)

Schweitzer had a small fleet of these, normally pulled up on the river bank below the hospital buildings, and he employed some of the native Africans to ferry hospital personnel and visitors wherever they might want to go. The town of Lambarene is on an island in the middle of the river and was the headquarters of a very flourishing French timber industry. Schweitzer's hospital is not on the island but on the river bank about a mile or so away. Schweitzer always referred to the town as "le Grand Village", and he was generally known as "Le Grand Docteur".

Each of the visitors was given a room in a long single-storey building higher up the bank above the hospital. The length of the building ran parallel with the river and on the top side was a corridor giving access to the rooms, all of which were small, spartan but spotlesly clean, furnished with a bed, a chair, a desk and a washstand. Each of the rooms had a window at each end of the room, one in the door and the other overlooking the hospital and the river beyond. There was no glass in the windows but a fine mesh fly screen allowed ventilation and kept insects out. The window on the door had a blind on the inside for privacy.

Lambarene, circa 1957. (A copyright photo from the Kaye and Larry Gussman collection, courtesy of the Syracuse University Libraries.)

There was no running water or bathroom, but a jug of cold water stood on the washstand and hot water was brought each morning at 6.30 and again in the evening before the evening meal. The only electricity came from a generator which was turned on only when it was necessary to supply power for the operating theatre lighting, all the other lighting was by paraffin (kerosene) and heating (for cooking and sterilising hospital equipment) by wood burning stoves.

All meals for the white staff and visitors were taken in a communal dining room, breakfast at 7.30 am, lunch staggered to allow continuity of work, but at 6.30 pm all work finished and after an hour for freshening up almost a ritual dinner. The evening meal was presided over by Schweitzer who opened the ceremony by grace in French. We all sat at one long table covered with spotless linen and illuminated by a series of oil lamps, Schweitzer in the middle of one side flanked by the two senior nurses, Emma Haussknecht and Matilda Kottmann who had been with him at Lambarene for more than thirty years.

Dinner at Lambarene, circa 1957. (A copyright photo from the Erica Anderson collection, courtesy of the Syracuse University Libraries.)

After dinner two or three of the nurses handed round hymn books printed in German. Schweitzer announced which was the hymn for the day, and then he would go to an old piano that stood in the dining room and play the accompaniment and everyone sang the hymn. After that, Schweitzer read a short passage of his own choice from the bible, again in German. His selection was frequently from the Acts of the Apostles about St. Paul who seemed to be one of his favourite characters. I remember one evening when some of the other doctors tried to play on the old piano in the dining room but found it extraordinarily difficult because a number of the notes just didn't work at all. They decided that only Schweitzer could play that piano because he knew which notes not to play.

Dr Albert Schweitzer playing the piano. (A copyright photo
from the Erica Anderson collection, courtesy of the
Syracuse University Libraries.)

During my three weeks stay there Schweitzer made a point of asking each of his guests to visit him alone on one evening after dinner and asked them about their life. Although he could understand English very well he did not like to speak it because he knew that he was fluent in both French and German, as he would have to be being born in Alsace a province between the two countries and at the time of his birth under German rule as the result of the Franco-German war of 1871. Alsace was returned to France after the First World War but during that war, being technically a German citizen working in French colonial Africa he was interned in Africa and in 1917 taken back to France and interned there in what nowadays would be called a concentration camp. He did not want to speak English except to be polite to English speaking guests in case he should inadvertently say something which could be misconstrued to a different meaning from what he intended and that it might be quoted afterwards. Schweitzer asked if I could speak French or German and when he heard that I was at that time fairly fluent in French he conducted the whole of our after-dinner chat in that language. He thanked me for agreeing to give up three weeks of my time to come to Lambarene and asked about the advances in anaesthetics and asked that I should impart what knowledge I could in the short time that I was there to any of the nurses who might be available to benefit. He had a collection of cheap monochrome French picture postcards in sepia depicting the hospital and he wrote on two of those, in my presence, a few lines to say

To my friend, Dr. Roberts, with thanks for his help.

Sadly, both those cards and all the 16mm cine films I took during my stay were eventually destroyed when our house was burned down in the Tasmanian bushfires of February 1967.[1]

Medical challenges
After a weekend of getting to know our way about and being shown the patients they had saved up for Joel Cohen to treat and the facilities, or lack of them, with which we had to cope we embarked on four days of operations. There was no oxygen and no nitrous oxide, the logistics of maintaining an adequate supply of such heavy and bulky objects deep in the jungle made the lack understandable. There was an X-Ray machine of a very primitive kind but that was out of order and could not be expected to be repaired until some representative of the makers paid his next infrequent visit. I gathered that the rep would have made the journey specially had he been asked to to so by Schweitzer but the old doctor did not think it was really necessary. There was no blood available for transfusion, and the two young doctors who really ran the clinical side of the hospital were probably correct in thinking that as the only possible supply would have been from the local indigenous population it would not be possible to ensure that such a source would be safe as the majority of donors would be found to have at least five or six tropical diseases, malaria, bilharzia, yaws, etc.

Patients (and their families) outside Dr Albert Schweitzer's hospital in Lambarene. (A copyright photo from the Erica Anderson collection, courtesy of the Syracuse University Libraries.)

The anaesthetics were usually given by one of the more senior nurses who was a Dutch woman, in her fifties I would estimate, who gave the type of anaesthetic I had been at pains to eradicate from Holland ten years earlier, and which I had again encountered at the mission hospital near Johannesburg when I went with Denis Thompson and Phyllis Knocker which they had dubbed "Rag, bottle and prayer". She was pleasant and efficient enough in her way but very conservative and I am sure would never change her ways. There was also a much younger Dutch nurse there who had seen the change in anaesthetics in Holland before she went out to Gabon and who was eager to be taught whatever I could teach her, but I felt that the elder woman did not want to lose her position as the acknowledged anaesthetist of the establishment and she made sure that her superior status was not usurped.

Having had previous warning of the meagre facilities that would be available, I had begged from the manufacturers a donation to Lambarene hospital of an EMO apparatus and taken it with me. This machine devised by Epstein, an assistant of Sir Robert Macintosh at Oxford (E=Epstein, M=Macintosh and O=Oxford), contains ether kept at a constant temperature by a simple chemical thermostat, and a known concentration of ether vapour can be given very simply. This either can be breathed spontaneously or, if respiration is deliberately stopped by the use of a muscle relaxant, can be given by Intermittent Positive Pressure by the hand use of a concertina bellows (IPPR). Macintosh had preached from his earliest days as Nuffield Professor at Oxford that the safest anaesthetic agent in the hands of unskilled anaesthetists was ether and this simple portable apparatus simplified the administration by delivering a known concentration. I took with me also a supply of Pentothal for induction and gallamine triethiodide (Flaxedil) as a muscle relaxant, some endotracheal tubes and a laryngoscope mainly for my own use in the difficult cases I knew I could expect to do with Joel Cohen.

Doctors and nurses operating in the hospital at Lambarene. (A copyright photo from the Erica Anderson collection, courtesy of the Syracuse University Libraries.)

We worked hard during those four days of gynaecological surgery from about 8.am until 6.30 pm. with about an hour's lunch break. I well remember two operations out of the 20 or 30 we must have done. One was a colpo-perineorraphy for a very severe case of vaginal prolapse and the other a Wertheim's Hysterectomy, a very radical removal of the entire internal female genital system, for advanced cancer of the cervix. The latter woman lost too much blood which we were not able to rectify and she died post-operatively.

Deterding and other things
An interesting person staying at the hospital while we were there was Olga Deterding, the heiress, we were given to believe, of the famous oil magnate, Sir Henri Deterding who was the head of the Royal Dutch Shell business. She had apparently been one of a group of what were known as the "Bright Young Things" who had set out more or less as the result of a whim or even a wager to cross the Sahara, or so the story went. Olga had had either an accident or an acute attack of appendicitis, I forget which, which had enforced a stay in hospital and she had been left behind the rest of the expedition but was expected to be able to catch up with them later. Before she did so she had been told about Albert Schweitzer and decided to forego the Saharan jaunt and made her way to Lambarene. She was so impressed with him that she wanted to stay on and help. She became what John Gunther in his book, Inside Africa calls a Schweitzer addict. She helped in various ways about the place, I remember that she was put in charge of organising the stock of medicinal drugs in the hospital dispensary and one day when there was no surgery being performed I sat at a table with her in the open air and we opened innumerable packets of “free samples” of drugs which had been unused by their recipients, or never even sent out, and then had been collected and sent on to Schweitzer. we then transferred them into large glass jars with the generic name of the drug on it for use in the hospital. Olga had been at Lambarene for nearly a year. During the second week when I was the only short-stay guest there, in the evenings Olga used to ask me to go and talk to her, or listen to her gramophone records which she had managed to have sent out. At the end of the first week of my stay, Schweitzer organised a motor launch trip on the Ogowe for the visitors and any of the rest of the white staff who were not on duty or could be spared. We had a picnic on one of the small islands and then went off in a number of pirogues exploring various narrow channels in a sort of marshy backwater until the launch was ready for the return trip.

Joel and Mrs Cohen and Larry and Kaye Gussman left after the first week and as the normal hospital routine only called for operating sessions on three mornings a week I had a lot of spare time. During the surgical sessions I attempted to teach the two Dutch nurses to use the simple EMO machine. The younger girl was very keen but I detected a tendency for the older woman to take most of the cases and prevent the dissemination of knowledge where it could have done most good.

On one occasion, Dr Schweitzer asked me if I would like to make a day's expedition to “le Grand Village”, the town of Lambarene and so I armed myself with my 16mm movie camera and wearing the inevitable solar topi I sat in a pirogue paddled by an African who had orders to take me over to the island and wait there until I should want to return.

Leaving the site of Schweitzer's hospital in a pirogue (i.e., in a dug-out canoe) in order to cross the Ogowe river to go to "le Grand Village", the town of Lambarene. (A copyright photo from the Erica Anderson collection, courtesy of the Syracuse University Libraries.)

I used the word “inevitable” because Schweitzer had a “thing” about his staff and guests always wearing a hat and he was known to have a decided preference for the old pith helmet. I had bought a cheap imitation one in Johannesburg, and both the Cohens and the Gussmans came similarly prepared. Schweitzer was convinced that they prevented sunstroke, but medical opinion at that time was throwing doubt on the existence of such a disorder and most people at the hospital only wore it to please the old gentleman. Later medical knowledge shows that whether or not sunstroke is a medical entity, the use of a protective hat is of great value, in light skinned people at any rate, in the prevention of skin cancers. I wandered around the town and entered the de-luxe hotel, but only for a cold beer on the verandah. I was too overcome by the price of that to think about having lunch there. There was, however, another smaller hotel, where I had an excellent meal with genuine French cuisine and I made sure I had some meat.

We only once had meat at Schweitzer's hospital and that was for a special occasion, somebody on the staff had a birthday. Normally the diet was, in the main, vegetarian but we got fish fairly frequently and eggs every day. Although he had his famous "Reverence for Life" and that was one reason for a mainly vegetarian diet, Schweitzer did not totally ban the killing of animals for food. On this birthday occasion he had personally given orders that a goat should be killed and served. He was very worried that the average African native in the district was not getting enough protein in their diet and urged them to go out in boats and fish. It was, he explained to us, a vicious circle in that they got fruit and other food too easily and that left them deficient in protein and this deficiency made them too lazy to go to the effort of going out in a pirogue on the river to fish. He told us that the local natives were so lazy, mainly due to malnutrition, that in the town of Lambarene the French timber people found that it was worth their while to import African labour all the way from Nigeria because the natives from there were strong and energetic. He told us that on the 14th July, the French National Day, Bastille Day, they had a great celebration in Lambarene organised entirely by the Nigerian ex-patriates, and they were not even from a French Colony but a British one, but the locals were too apathetic to try and organise anything so onerous. Schweitzer told me that he would have been willing even to organise an elephant hunt to supply the Africans with protein, so I realised his reverence for life had reasonable limits. While I am sure he would be distressed to see someone needlessly kill an insect he had no objection to the use of anti-mosquito sprays. He would not have endeared himself to anti-racist advocates because his attitude towards the black people was summed up in a remark I heard him make that "The black man is my brother, therefore I must love him as a brother, but he is my younger brother and he must do as I tell him!"

Dr Albert Schweitzer and a group of African men and women at the hospital in Lambarene. (A copyright photo from the Erica Anderson collection, courtesy of the Syracuse University Libraries.)

Return to Johannesburg
During the third week Teddy Epstein, no relation to the Epstein who worked with Macintosh at the Radcliffe at Oxford, but an eye surgeon from Johannesburg, with whom I used to work fairly regularly, came up to Lambarene and I had some more specialist work to do, but after that I was due back in Johannesburg, so I bade farewell to the great man and to all the staff and caught the "milk-run" Dakota for the rest of its circuit and arrived back in Brazzaville. There I transferred to a cross-river ferry to Leopoldville, the capital of the Belgian Congo.

Dr Albert Schweitzer and members of his staff farewell visitors to the Lambarene hospital, circa 1957. (A copyright photo from the Kaye and Larry Gussman collection, courtesy of the Syracuse University Libraries.)

I hired a taxi to take me round to see the sights of the city and to the falls on the River Congo to the west of Leopoldville which render the river unnavigable between the city and the sea. The Congo is a huge river, it must have been over a mile wide at the point where the ferry plied between Brazzaville and the southern (Belgian) bank, and up-stream from there it is navigable for about 2,000 miles and is, of course, or was in those days, one of the main traffic arteries for the Congo. My flight from Leopoldville to Johannesburg was at about 2 am so it was not worth while booking into a hotel so I just had to sit around in some bar spinning out a few beers until the time for departure to the airport.

Endnote
[1] Because all the photographs and cine films that my father took during his 1957 visit to Lambarene were destroyed when his house was burnt down nearly ten years later, I have supplemented my father's account of his work with Dr Schweitzer with photographs taken at the same time in Lambarene by Erica Anderson and by Kaye and Larry Gussman. The copyright photographs were kindly made available to me by the Syracuse University Libraries when I visited the university in December 2010.

**********