THE DONALD FRASER HOSPITAL

(CHURCH OF SCOTLAND)

Eeportand

balance ;%ljeetfor year endedJ

’ 31st DECEMBER, 1947

SIBASANORTHERN TRANSVAAL

% Me P. - 39541.

THE GROWTH o f t h e HOSPITAL- WORK FROM 1 5 3 3 TO 1947 -

Annual Admissions473

366 377

94- 168205 1 0

2J0

449

569

19 ~ 33 54 35 36 37 38 39 40 4-1 42 45 44-45 46 47

58658-8528

Daily Averages47.444 4-

34Z2»7

24-

IQ-7 '3 17.5116

6.1

56636.9

19-35 34- 35 36 37 58 39 40 41 42 43 4 4 45 46 47

181

Maternity Cases138

104

44 5o 54

18 18

f t f T 1 1 I

98106

•9 - 33 34-35 36 37 38 39 40 4-1 42. 43 44- 45 46 47

Medical Superintendent’s Report

For the first time in the history of this hospital the total num ber of the in-patients treated was over 1,000, the actual num ber being 1,068. as com pared with 960 the previous year. P art of this increase, unfortunately, was due to an outbreak of scurvy in two of the low veld locations served by the hospital. In the last two m onths of the year we adm itted 58 patients suffering from this condition. This is the first time in m y experience th a t there has been such an outbreak in this district, which is norm ally a very fertile one. In these two locations, however, there has been very little rain for the last three years, and by the end of 1947 the people were living on little else than mealie meal. Fruit, green vegetables and milk were practically unobtainable. Most of the patients affected were old people, and it was pathetic to see them hobbling along to the clinics and the roadside waiting to be brought to hospital. M any of them could not walk and were brought in donkey carts to the clinics, where they had to be lifted into the hospital van to be transported to hospital. It was encouraging to find, however, the readiness with which they agreed to come to hospital. Most of them indeed asked to be taken to hospital. A t one school which I visited where nearly 60 people were waiting to see me, I walked into the classroom where they had gathered and asked how m any wanted to go to hispital. A bout 20 im m ediately signified their desire to do so.

A t the same time this increase in the num ber of patients strained the resources of the hospital very considerably. There were m any occasions when all the beds were full and patients had to be placed on m attresses on the floor. M ore than once during the year I had to give instructions th a t only the most urgent cases could be adm itted, and wc had to refuse to take any others.

A part from this outbreak of scurvy we had the usual conditions th a t are always with us, m alaria, bilharzia, septic wounds, eye diseases, and so on. Two points are worthy of special m ention. The num ber of m aternity cases increased from 138 in 1946 to 181 in 1947. There seems little doubt, therefore, tha t the women appreciate the service given by the hospital, and th a t midwifery will play an ever larger part in its wTork.

PA TIEN TS :

W e seem also to have had a larger num ber than usual of very severe burns this year, m any of them in epileptics. T he incidence of epilepsy am ong the natives in this area seems to me to be high, and little, if

anything, is being done to assist the unfortunate sufferers. T he nursing of these cases makes heavy dem ands upon the tim e and patience of the nursing staff, and I m ust pay a special tribu te to all the nurses for the care and devotion they have shown in treating these patients.

STA FF :

T he difficulty of m aintain ing the hospital with insufficient staff has continued throughout the year, and constitutes the chief obstacle to fu rther development. Miss F. E. W ookey continued as Acting M atron until the end of October, and I cannot sufficiently express our gratitude for the service which she rendered.

Miss V. Bell joined our staff in July on transfer from our sister hospital a t Sulenkam a in the Transkei and took over as M atron from 1st Novem ber. W e also had the help of Miss D. Aves during Novem ber and December. U nfortunately she was unable to rem ain for a longer period. The appointm ent of another nursing sister is our m ost urgent im m ediate need.

Miss J. M acCallum came back as Secretary for four m onths from July to October, but, m uch to our regret, and hers, found th a t her health would not perm it her to rem ain any longer.

H O SPITA L BOARD :

D uring the year we learn t w ith m uch regret th a t Dr. N . M acvicar felt unable to continue his m em bership of the Board, of which he had been C hairm an since its inception in 1939. T hroughout these years Dr. M acvicar has been a wise counsellor and faith ful friend, and although no longer a m em ber of the Board we know th a t he continues to take a deep interest in our work. W e wish to record here our gratitude for all the help he has given to the hospital.

D uring the year the Board consisted of the following: T he N ative Commissioner, Sibasa (Mr. P. Liefeldt) representing the Native Affairs D epartm ent, Mr. J. G raham representing the Transvaal Provincial Council, and Rev. R. M. Fraser, Dr. R. L. Paterson, Dr. J. M. Stewart, Mrs. E. I. A itken and Dr. R. D. A itken representing the S.A. Mission Council of the C hurch of Scotland. Rev. R. M. Fraser was appointed C hairm an of the Board.

T he Board is also to have a representative from the Presbyterian C hurch of South Africa, and one 'from the B antu Presbyterian Church in future.

V IS IT OF COMMISSION FROM SCO TLA N D

D uring the year we were happy to have a visit from three Commissioners from the Foreign Mission Committee of the Church of Scotland. In the course of their tour of the South African mission stations they spent two days with us. W e were greatly heartened by their visit and this fu rther evidence of the deep interest the Church of Scotland has in our work.

BU ILD IN G S AND E Q U IP M E N T :

W e have not escaped the delays which are custom ary in building operations in these times, and we were disappointed th a t part a t least of our new buildings was not ready for use during 1947. T he new wards were, however, almost completed by the end of the year, and we hope to have them in use early in 1948. T he new surgical and out-patient block is also nearing completion, and we look forward eagerly to occupying it. The way will then be clear for work to begin on the very urgently needed new kitchen, laundry and storerooms, and also on the reconstruction of the older part of the hospital. W hen all this has been completed the hospital will have accom m odation for 150 patients. A nother urgent need is the provision of an increased and improved water supply, which m ust be undertaken as soon as sufficient piping can be obtained. The piping has been on order for over a year, and is beginning to arrive in small quantities from tim e to time. U nfortunately the funds required to pay for the completion of these plans are running low, and I estim ate that a further £10,000 will be needed this year for the purposes m entioned above.

D uring the year £2,717 was spent on fu rn itu re and equipm ent for the new buildings. This included a new X-ray plant, new beds and surgical equipm ent. Towards this the N ative Affairs D epartm ent m ade a special grant of £2,500, for which we express our appreciation.T H E S F EC IA L A PPEA L F U N D :

D uring the year donations were received am ounting to nearly £3,000. Acknowledgment of these is m ade later in this report. Included in this am ount is a donation of £2,500 from the B antu W elfare Trust, for which we are very grateful. In addition we received grants from the Transvaal Provincial Council of £5,000 and from the N ative Affairs D epartm ent of £7,447 (including part of the £2,500 m entioned above). These donations and grants brought the response to our appeal launched in 1944 to £29,617, and once again we express our heartfelt thanks to all who have contributed to this fund. Like the A frican people we m ust say, however, “ Please don’t be tired to-morrow.” T he needs are still great and growing, and we hope for continued generous assistance in m eeting them.

A R EV IEW OF FIFTEEN Y E A R S :

I write this report a t the conclusion of 15 years spent in building up this hospital, and as I hope shortly to proceed on leave overseas, this seems an appropriate time to review the work of those years. T he first medical m issionary actually began work here in 1930, bu t my wife and I did not arrive here until the beginning of 1933. W e were encouraged to undertake this work by the late Rev. Dr. D onald Fraser and the Rt. Hon. Lord M aclay whose vision and generosity m ade the inception and development of the medical work here possible. Its m aintenance throughout these years has been due to the continued support of the Foreign Mission Committee of the Church of Scotland. T hrough them the people of Scotland have carried on this m inistry of healing for the African people in spite of all the difficulties and hardships they them ­selves have had to face during the last ten years.

In 1933 there was no hospital here, the only accom m odation for patients being three or four wattle and daub huts. T he nearest other doctor available to the m ajority of the 150,000 people in this area was more than 50 miles away. T he nearest Provincial H ospital with accom­m odation for native patients was at Pietersburg, nearly 150 miles distant. To-day there is a reasonably well equipped hospital with 60 beds, soon to be increased to 150. The hospital has electric light, an X-ray plant and w aterborne sanitation. A ttached to the hospital are six small clinics with African nurses in charge, m ost of these having been trained in the hospital itself.

T ha t the hospital is m eeting a real need and is w inning the confidence of the people is shown by the steady increase in its work year by year. I have prepared three charts (see page 2) to show this increase diagram atically. Suffice it to say here th a t the num ber of patients adm itted to hospital has risen from 94 in 1933 to 1,028 in 1947, the daily average of patients in hospital has increased from 6 to 58-8, the num ber of m aternity cases from 6 to 181, and the num ber of out-patients from 1,285 to 6.555.

In 1933 no Government grants were available and the Church of Scotland carried the entire burden of starting and m aintain ing the work. T he first g ran t in aid of the train ing of nurses was m ade in 1935 by the N ative Affairs D epartm ent, which continued to m ake grants for this purpose until 1946, when the Provincial Council took over the respon­sibility of continuing them. In 1935 also the Provincial A dm inistration m ade its first g rant of £50 to the hospital. This has steadily been increased until in 1947 it am ounted to £2,950. T he Church of Scotland has continued to play its part and in 1947 was responsible for paying the salaries of the two doctors and one trained nurse employed at the hospital, a very vital contribution to the m aintenance of the work.

In 1934 the N ative Affairs D epartm ent gave a g ran t of £500 towards building a hospital and has since given fu rther am ounts of over £13,000 for this purpose. The Provincial A dm inistration has also m ade grants for capital expenditure of £11,684 while private donors have contributed £13,259.

In 1937 through the assistance of the Union D epartm ent of Public H ealth it became possible to institute regular periodical tours throughout the district. These have been steadily developed, and now the doctors regularly visit 11 centres, situated a t distances of 12 to 40 miles from the hospital. On these tours we frequently see anything from 30 to over 100 patients, and the hospital van comes back loaded to capacity with patients who could not otherwise reach the hospital. Bad roads and the absence of- bridges, unfortunately, m ake the carrying on of these tours very difficult and sometimes in the rainy season quite impossible.

The developm ent of the hospital to its present stage has been due- m ore than anything else to those who have worked loyally and devotedly w ith us to provide a reasonably efficient medical service for the people of this district. I cannot nam e them all bu t I think particularly of the small group of European and A frican trained nurses who, one after another, have filled the post of M atron and have grappled almost always single-handed with the difficulties of organisation, supervision and tra in ing necessary to the runn ing of such a hospital. I m ust pay tribu te also to our A frican probationer nurses, w ithout whose help and loyalty the hospital could not have been m aintained. W e owe a great deal also to the A frican Christians of our own and other churches who have supported our efforts to overcome the ignorance and superstition of the m uch more num erous heathen people, and have led the way in breaking down the fear of the hospital and of the white doctor’s m ethods of trea t­m ent. Finally, I m ust m ention the unfailing support and understanding which has been given to us by the various N ative Commissioners and officials of the Native Affairs D epartm ent. W ith the help and co-operation of all these we have been enabled under God to lay the foundations of a medical service for the people of this district, bu t they are only foundations. M uch yet rem ains to be done before we can claim th a t a reallv adequate curative service has been established.

W H A T OF TH E F U T U R E ? :

In a district such as this with a population of between 150,000 and 200,000, in which we . are providing the only organised m edical service, we clearly cannot rem ain content w ith what has so far been achieved. The response of the people themselves to the provision already m ade is a challenge to us to do m ore for them. Once the extensions and alterations to the hospital are completed we shall have a good central hospital, simply bu t adequately furnished and equipped, and capable of giving the usual general and m aternity services and tra in ing for nurses. A ttached to this we m ust have more clinics and district nurses. A t present we have three clinics, provided by the Berlin Mission, and three (Sibasa, Rem bander and Thengwe) which have been built by the hospital. A t least another five are needed. Along with this m ust go the develop­m ent of m aternity and child welfare services. Perhaps the greatest single service we can render this district is the provision of a midwifery training- school. From this we should be able to send a steady supply of trained midwives into the district around us.

«There are two difficulties to be overcome. W e m ust have more

trained missionary nursing staff, willing to undertake the train ing of A frican girls as nurses, and we m ust have m ore support from the Governm ent and people of South Africa. T he Church of Scotland has given a lead in establishing this medical mission and will continue to support it in the future, bu t we m ust look to the people of this country also to continue and increase the support they have already given.

The question m ay be raised whether the entire responsibility for such work should not be handed over to the Government. T h a t raises large issues, and this is not the place to discuss it fully. I would simply point out th a t even now there is no Governm ent Hospital with accommodation for native patients in the whole of the Zoutpansberg District. Missions certainly cannot, and ought not to, be expected to carry on m edical work unaided, b u t I would affirm m y belief tha t the m inistry of healing is an integral part of the Christian mission, and th a t for people whose whole conception of disease is deeply coloured by superstition and the belief in witchcraft, a mission hospital can more effectively m eet the needs than any Governm ent institution. It ought also to be able to give to its nurses in train ing a foundation of Christian character th a t will enable them to serve their people more devotedly. As I look back over these fifteen years, I am conscious of how m uch m ore we m ight have attem pted in these directions, bu t these are the ideals for which we have striven.

A .— In-Patients : STA TIST ICS

In hospital on 1st January , 1947 .. 40

A dm itted during 1947 1,028Total under treatm ent 1,068

Discharged :Cured ........................... 755Im proved ................... 117No c h a n g e ................... 99

Died ................................... 48In hospital on 31st Decem­

ber, 1947 ................... 491.068

Daily average of in-patients 58-1Total daily units ........... 21,211Average days’ stay per

patient ................... 19-9

Surgical :M ajor operations ... 32 M inor operations .. 247

279Obstetrical :

Confinements in hos­pital ........................... 181

N orm al ........... 170Instrum ental ... 5 Caesarian s e c ­

tions ........... 6IS]

B.— Out-Patients :

Individuals AttendancesAt the hospital ......... 2.323 5,377A t detached c lin ic s ................ 1.325 2.476On tour 2,807 4,251

6,455 12.104

C .—-Patients Treated by District Nurses :Station Individuals Attendances Confinements

B e u s te r ................... 436 1.347 12Georgenholtz 576 2,457 1G raham Dispensary, Sibasa ... 862 1,932 7R e m b a n d e r ........... 658 5.203 13Thengwe (1.1.47 to 31.3.47 onlv) 179 486 3Tshakom a ........... 1,322 6,980 15

T o t a l 4,033 18,405 51

D.— Combined Total for Hospital and Clinics :Individual Out-patients ................................... 10.488Attendances ........................................................... 30,509Confinements ... ................................. 232

The Donald Fraser Hospital,SIB ASA,

B A LA N C E SH EET A T

L IA B IL IT IE SChurch of Scotland ..........................................................N ative Affairs D epartm ent:

A t C red it 1st J a n u a ry , 1947 ..............................Add: B uild ing an d E q u ip m e n t G r a n t s ...........Transvaal Provincial Adm inistration:

A t C red it 1st J a n u a ry , 1947 ...............................Add: B uild ing G ra n t ..................................................N ative Recruiting Corporation L td . Deferred Pay

Board ..............................................................................Sundry D onations:

A t C redit 1st J a n u a ry , 1947 ...............................Add: R eceived d u r in g y ea r ...............................Sundry Creditors for Capital E xpenditure

Sundry C r e d ito r s ...............................On O pen A ccoun t.

Revenue and E xpenditure Account

£42,092 13 9

W e hav e ex am ined th e boo ks a n d v ouchers o f th e D o n a ld F ra se r H o sp ita l an d th e B alance S heet is p ro p e rly d raw n u p so as to show a tru e an d co rrec t v iew o f th e e x p lan a tio n s g iven to us an d as show n b y th e boo ks of th e H o sp ita l a t 31st D ecem ber,P ie te rsb u rg ,

1st M arch, 194S.

A PPRO PRIATIO N A C C O U N T FOR

T o E xcess Expenditure for Year ............................................................ £139 10 2Funds Appropriated from Revenue for Capital E xpenditure ... 14 6 4

,, B alance to Balance S h e e t .............................................................................. 424 14 6£578 11 0

£6,200 0 07,447 4 1

6,6S4 0 05,000 0 0

10,322 7 62,936 12 10

£1,263 10 0

13,647 4 1

11.6S4 0 0400 0 0

13,259 0 41,082 18 7

£41,336 13 0331 6 3424 14 6

Church of Scotland TrustNO RTHERN T R A N S V A A L

31st DECEMBER, 1947

ASSETSBuildings:

A t D eb it 1st J a n u a ry , 1947 ............................... £15 ,223 19 6Add: A dd itio ns d u r in g y ea r ... ...................... 14,010 11 1

£29,234 10 7Furniture and Equipm ent:

A t D eb it 1st J a n u a ry , 1947 ................... 3,157 8 2Add: A dd itio ns d u r in g y ea r ................................ 2,717 14 7

5,875 2 9Motor Lorry .......................................................... 328 0 0

D eprec ia ted v alue.Cash, Capital Account:

A t B arc lays B a n k (D . C. & O .) , L ouisT ric h a rd t ... .................................................. 5,824 3 4

O n H an d an d D e p o s i t .................................................. 42 IS 65.S67 1 10

Revenue and E xpenditure Appropriation Account:A t D eb it 1st J a n u a ry , 1947 ................................ 46 4 2L ess: F u n d s A pp ro p ria ted from R ev en u e fo r

C ap ita l E x p e n d itu re ................................ 14 6 431 17 10

£41,336 13 0Motor Vehicles, L ive and Rolling Stock ............. 495 0 0

D ep recia ted values.Stores and Stocks on H and— E stim ate ...................... 100 0 0Sundry Debtors ..................................................................... 54 2 7

P er Ledger.Cash:

A t B arc lays B an k (D . C. & O .) , L ou isT ric h a rd t ................................, ........................ 67 0 11

O n H a n d an d D e p o s i t .................................................. 39 17 3106 18 2

£42 ,092 13 9

hav e o b ta in ed all th e in fo rm a tio n an d ex p lan a tio n s we h av e requ ired . In o u r opin ions ta te of th e affa irs o f th e H o sp ita l acco rd in g to th e b e s t o f ou r know ledge an d th e1947.

N E ST , D E N T O N & CO.,C hartered A cc o u n tan ts (S .A .) .

Y E A R ENDED 31st D ECEM BER, 1947

B y Balance at 1st January, 1947 ..................................................................... £578 11 0

£578 11 O

The Donald Fraser Hospital,SIBASA,

R EV EN U E A N D EX P E N D IT U R E A C C O U N T

E X P E N D IT U R ET o Provisions .................................................. ...................

G roceries, E ggs, M ilk, M eat, F ru i t an d V egetables.

Surgery and Dispensary:D ru gs an d D ressings ..................................................In s tru m en ts an d A ppliances ...............................

Dom estic:B edd ing an d L inen H ard w a re an d C rockeryC lean ing ................................R ep airs an d R enew als,

m e n t ......................F u e l an d L ig h tin g

F u r itu re an d E q u ip -

Establishm ent:R ep a irs to P la n t an d B uild in gs In te re s t, In su ra n c e an d R e n t G rounds, G ardens an d R oads

Adm inistrative:S alaries ........................................................P r in tin g , S ta tio n e ry an d A d v ertisin g P o s ts , T eleg ram s an d T elephonesT rav e lling an d T ra n sp o rt ...................A ud it Fees, 1946 an d 1947R ailages ..................................................B ank C harges .....................................D ep recia tion — M o to r V ehicles, 20%

Salaries and W ages:M edical an d N ursing ......................N a tiv e W ages ......................................F u rlo u g h R elief C o n trib u tio n C ost of L iv in g A llo w a n c e s .............

£561 11 S278 0 2

441 12 750 0 <>47 16 9

3 19 3174 3 4

S3 1 1 1151 5 524 IS 1

136 1 6133 2 225 9 8

314 14 1163 0 0

107 4 69 10

91 0 0

1,573 0 7239 14 11100 0 0528 7 3

i63Q 19 8

839 11 10

717 12 1

159 15

871

,441 2 9£5 .660 4 4

P ie te rsb u rg ,1st M arch, 1948.

Church of Scotland TrustNO RTH ERN T R A N S V A A L

FOR TH E Y E A R ENDED 31st DECEM BER, 1947

R E V EN U EB y P atien ts’ Fees ..................................................................... £966 5 6

Gr?.nts and D onations:P ub lic H e a lth D e p a r tm e n t ................................ £574 8 8

F o r In fec tiou s D iseases.Transvaal Provincial Adm inistration:

G eneral R ev en u e G ra n t ............................... 2,500 0 0N ativ e N urses .................................................. 450 0 0

N ative Affairs Departm ent:M edicines fo r T hengw e, R em b an d er an d

G raham D is p e n s a r ie s ................................... 150 0 0Church of Scotland .................................................. 629 10 0N ative Recruiting Corporation L td .— Deferred Pay

Board ..................................................................... 250 0 0Sundry D o n a t io n s ......................................... 10 0

4,554 8 8 £5,520 14 2

Excess Expenditure— C arried fo rw ard ............. 139 10 2

£ 5 ,660 4 4

N E S T , D E N T O N & CO.,C hartered A cco u n tan ts (S .A .).

DO N A TIO N S TO SP ECIA L A PPEA L FUN D

T he Hospital Board gratefully acknowledges the following donations received during 1947: —

T he B antu W elfare T rust ................................................... £2.500 0 0

St. Jam es’ Presbyterian C hurch Y.P.A............................... 1 1 0

Rev. I. B. M acCalm an ........................................................... 1 0 0

Miss H. Slater .................................................................. 5 n 0

Cam phill Queen’s Park W orking Party ........................... 2 0 0

Gooldville Congregation, B antu Presbyterian C hurch ... 15 0 0

N orth M orningside Church, E dinburgh ................... 41 16 9Mr. N. Pollock ................................................... i 2 0

Mr. and Mrs. C. R. Bristow 2 0 0

A nonym ous ........................................................................... 7 10 0

Mr. M. S. Geen ................................................................... 1 1 6Miss F. Brown ........................................................... 1 0 0

Mr. D. K. Adams ................................................................... 5 0 0

Mrs. J. W. Noble ................................................................... 2 2 0

A nonym ous ........................................................................... 300 0 0

M r. S. J. Dinwoodie ........................................................... 5 5 0

Rev. P. G. G o rd o n ................................................................... 1 1 0

Anonymous ........................................................................... 42 8 7St. Andrew’s Presbyterian Church W om en’s Associa­

tion, Pretoria ................................................................... J 3 0

A nonym ous ........................................................................... 1 0 0

Mr. and Mrs. Koker ........................................................... i 2 0

£2,936 12 10

Previously acknowledged:1943 ' ............. £250 12 61944 1,832 6 11945 . . ................ ... 3,533 19 111946 2,395 16 8

----------------- 8,012 15 2

T o t a l £10,949 8 0

TH E DONALD FRASER HOSPITAL, C H U R C H OF SCOTLAN D TRUST,

SIBASA, NORTHERN TRAN SVAAL

P A TIEN TS ' DAY STATISTICS FOR YEA R ENDED 31st DECEMBER, 1947

TOTAL PATIENT DAYS ............................................. 21.211NUMBER OF PATIENTS .............................................. 1,068AVERAGE DAYS STAY PER PATIENT 10-f)DAILY AVERAGE IN HOSPITAL -.8INCLUSIVE COST PER PATIENT PER DAY 5/4-044

Pietersburg,1st March, 1948.

NEST, DENTON & CO.,Chartered Accountants (S .A .).

Collection Number: AD1715

SOUTH AFRICAN INSTITUTE OF RACE RELATIONS (SAIRR), 1892-1974

PUBLISHER: Collection Funder:- Atlantic Philanthropies Foundation

Publisher:- Historical Papers Research Archive

Location:- Johannesburg

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