A group OF Canadians visiting Dr Patricia Horne in Zambia before Christmas were mesmerised by a procession of small children bearing gifts. "They brought live chickens, eggs and maize," Patricia explained. "They give you their hearts. And they have nothing."
Patricia Horne, at 71, is the only doctor in the Monze Mission Hospital's busy children's ward, where the mothers stay with their children. "They're very ill, but they never complain. They're just so grateful. I don't think of the work as rewarding. I'm just happy," says this extraordinary woman who spends her pension on goats, pigs, and maize for the families.
"There's no point in getting the children well in the nutrition centre and sending them home," she explains. "What are they going to eat? If they have no money for seed maize, they're going to starve the next year."
Dr Horne was home recently for two months' leave at the Dublin house she shares with Margaret, her twin, a retired social worker. "I couldn't manage without Margaret to keep the home fires burning," says Patricia. They were excited when I visited, because their recent bring-and-buy sale had raised £2,800 for the hospital.
"I rang the nuns. They are overjoyed," says Patricia, showing me albums of photographs of the children in her care. They are beautiful, with shining eyes, but some resemble famine victims, with stick limbs and distended stomachs. Others are bloated due to protein deficiency.
Patricia's words pour out in a torrent, so eager is she to explain the poverty, the drought, and the appalling diseases that kill. "We mainly deal with malaria, and the resulting gastroenteritis," she says. "And with malnutrition, pneumonia and bronchitis. I used to be so upset when a baby died. Now, after four years, I've seen what they have to face. We do our best for them; we use expensive drugs when we have them, but sometimes I say, `Please, Lord, let this baby die.' Your eyes fill with tears, but you have to go on."
Varied career
A graduate from UCD in 1955, Dr Horne enjoyed a varied career, working in many hospitals, including the Children's Hospital, Temple Street. She holds diplomas in child health, public health, psychological medicine, and tropical medicine. She spent two happy years working in Nsukka, Nigeria, before stints as a registrar in surgery, medicine, and anaesthetics. Turning to psychiatry, Dr Horne eventually settled as consultant psychiatrist in St David's Hospital, Monaghan.
Her retirement, late in 1992, lasted two years. "It suddenly struck me: I have medical qualifications; what am I sitting here for? " she says, stressing that she wasn't bored. "I was going full tilt." She rejected a job in the Turkana region of Kenya, because in a remote area she wouldn't have enough to do. But the chance to work in the busy Zambian hospital run by the Missionary Sisters of the Holy Rosary, alongside a friend from UCD days, Dr Lucy O'Brien, was too good to miss.
12-hour days
Dr Horne works 12-hour days in the malaria season, when 200 children fill a ward designed for 100. "You'd never refuse somebody just because you didn't have a bed. If you haven't a bed, you put them on the floor, or they share. We have no alternative."
Dr Horne is full of praise for the Zambian enrolled nurses, who do the work that would be done by a houseman over here. "The nurses see admissions white and convulsing, and even before I see them they will have them up on a drip, and they'll have the blood up to the lab for cross-matching. They really are wonderful. It's full-scale co-operation."
Dr is "not supposed" to work at weekends. "I try to be finished in two hours on Sundays," she says, "but what can I do? The doctor on duty would only see the new admissions." On Saturdays, Patricia fits in a visit to the market to buy warm clothes for the children in the nutrition centre. These protect them from pneumonia, which is so prevalent in malnourished areas. And due to the appalling economic situation in Zambia, there is a constant battle to find drugs and surgical equipment. "I send back SOS's to Margaret. We rely on contributions [gratefully accepted by the Missionary Sisters of the Holy Rosary, Glankeen, 9 Richmond Avenue South, Dublin 6.]. And I send the hospital driver to Lusaka to buy drugs." Whole families are dying of AIDS-related TB, which spreads because malnourished people have no immunity. With no cure for AIDS, Patricia emphasises the need for a change of lifestyle.
Spread of AIDS
"We tell them to stick to marriage and have one partner, and that would prevent the spread of AIDS tomorrow," she says. "And you come back to Ireland, and look at the newspapers, and realise that we're starting to do the opposite."
Close to tears, Patricia shows me a photo of "Jack", a little boy admitted to with TB, whose entire family died while he was in hospital. "He used to visit my house. At night-time I'd ask him what he'd like, and he always wanted chips. Before he died, the Father confirmed him, and went out to buy him chips. He could hardly eat them. And he died at three that morning. And when I came down the next morning all the children were there to greet me. They knew I'd be sad about little Jack. But what would have happened to him when I was on leave? At least we made him happy."