
Lots of hardware holding my neck together
This is my neck. It doesn’t look pretty but with this amount of hardware holding it together it’s pretty strong. Quite how it got to be such a mess is a long and convoluted saga but it’s worth telling if only to warn just how badly wrong surgery can go.
In 1977, just before I was to start my compulsory military service, I went on holiday to South Africa with my sister and friend of hers and the friend’s brother. We met up in Pietermaritzburg where my sister was at university and made our way to the east coast of South Africa to a small town called Uvongo. We found the campsite and quickly pitched camp. I made my way to the beach whilst the others went shopping.
The surf on the South African coast can be big as there are no reefs offshore so it helps to be surf-wise. The tide was out and the body-surfers were making their way out to the bigger waves, diving under the breaking waves and surfacing once they’d passed.
A wave broke and tumbled towards me, I dived as stylishly as I could straight into the sand. My head hit the sand, swiveled to the left and bent backwards and I became a quadriplegic. Coughing seawater I somehow got my head back to the surface and legs and arms started to move again. I staggered a few steps then stumbled back to the shore.
That afternoon I went to see a local doctor. He was in an old cottage in a quiet part of the town and was totally bored. I explained what had happened.
“Squeeze my hands” he told me.
I did.
“Here’s a prescription for some pills that should ease the discomfort in your right shoulder”.
“So I’ve pinched some nerves in my neck?” I asked.
“Yes, something like that” came the reply.
And that was it.
20 years later and whiplashes to the neck in a military parachuting jump, a car accident and a mountain bike accident, I was in trouble. I’d had crippling migraines since leaving university. Now I had electrical like nerve pain in my shoulders to boot. It was time to see a neurosurgeon.
The same surgeon who’d fixed my spine after gunshot injury sustained during military service way back in 1979 put the MRI film of my neck up onto the light box. He’d done a good job then so I had a lot of faith in him.
“That’s giving you headaches” he said, pointing to a very distinct constriction in the spinal cord channel. Even to my untrained eye it didn’t look good.
I mentioned that on a recent trip to Cape Town a local neurosurgeon had fitted me in for a quick consult. He’d said that on the strength of the X-rays that I probably needed surgery although a MRI would be necessary to confirm it (I didn’t have the time for a MRI).
“Why didn’t you get it done in Cape Town?” the Zimbabwean surgeon asked.
“He only fitted me in as a favour” I replied.
I only realised years later that the Zimbabwean didn’t want to do the surgery. By the time the surgery was done some months later I’d discovered the surgeon was 74, certainly not in his prime but he assured me that it was routine. When I walked out of the hospital after 6 days I was convinced the problem was fixed.
After 3 months I had a final consult and all the adverse symptoms were gone.
“Thank goodness” the surgeon said with relief, “I don’t need to see you again”.
We discussed other things for a short while and I went on my way. No follow-up X-ray was mentioned.
By the end of 2009 I was dropping things and my left shoulder had become very weak. I was advised to go to Johannesburg in South Africa. I duly sent a stack of MRIs to the recommended surgeon and the reply was; “You need surgery!”.
Early 2010 found me in Milpark Hospital in central Jo’burg.
“These MRIs are terrible” the surgeon commented. “Do you mind if we do them again?”.
I was not surprised. The machine in Harare was old and the collar for the neck MRI was broken. A plan had to be made Zimbabwe style and the results were indistinct. So I agreed. Fortunately it was covered by my medical insurance.
The next day I was being prepped for sugery when the surgeon came past.
“Those MRIs, it’s a good thing we redid them”
“Why’s that?” I asked.
“Because it’s worse than I thought – it means we are doing the right thing!” came the response.
After 5 hours of surgery I woke up in agony. It went from bad to worse after that.
On the 4th night I woke up in the early hours and couldn’t get my right arm off the bed. My left arm was slightly better and I could just reach the handle on the chain over my bed. The nursing staff were puzzled and insisted it could not be swelling on the operation site as that only happened up to the third night. The surgeon was concerned and redid all the MRIs. He told me that he didn’t see anything he wasn’t expecting to see though the report that got back to the referring doctor in Zimbabwe clearly stated there was swelling, and pressure on the spinal cord, at the operation site. Evidently my body hadn’t read the text books.
The pain eventually subsided but I never got the full function back to my right arm and hand and now have had to become left-handed (with limited success). Weakness to my left shoulder resulted in surgery to it to decompress a pinched ligament but that was not wholly successful and I’ve had to give up swimming as a result.
In early 2014 I was in trouble yet again – falling over my own feet and eventually had to admit I needed two walking sticks instead of the one I’d used for the past 35 years. My GP referred me to Dr. V. He put the images up on the light box and could hardly contain his excitement (beware of surgeons who sense a challenge – they love challenges).
New MRIs were ordered and the news, once again, was bad.
“You need to make a decision soon. This degeneration is moving quickly” Dr. V. cautioned. Unfortunately I’d already booked to go to a bucket list event; a World Horticultural Congress in Brisbane Australia. By the time I got back I was in further trouble so hurried up and booked the surgery.
“This is to stop the rot” Dr. V. said from behind his surgical mask as I was wheeled into the operating theatre. “Anything else you get back will be a bonus”. The procedure went well with no complications and the rot was stopped but there were no bonuses. Dr. V. had been as good as his word.
Recently I went back to Dr. V. for a checkup on the neck and to asses a potential problem with my lower back which is starting to show signs of degradation below the original war injury that I sustained in the Rhodesian military in 1979 (this is accounted in https://gonexc.com/reflections-on-the-first-half-abridged-and-mostly-expurgated/). It was well treated by the standards of the day but now if you look at the X-ray on the left it’s possible to see where one disc has collapsed below the L4 vertebra and I felt that my gait and balance had suffered as a result. Dr. V. wasn’t so sure and sent me off to see a neurologist for nerve function testing.

My lower back. Look for the collapsed disc between the 2nd and 3rd vertebrae from the bottom.
I got chatting to the technician who did the actual tests and discovered that he’d tested my hands back in 2009 in the big government run Parirenyatwa hospital. I was curious to know if it was still running as it had closed in 2019 when all the junior doctors had gone on strike over pay so low that they could not afford to feed themselves and get to work. When the government had stone-walled the doctors the senior doctors had also gone on strike in support and they were fired too. A wealthy entrepreneur had offered to pay the junior doctors a useful wage but they replied that even if they could get to work there was nothing in the hospitals to work with – no bandages, syringes, gloves, medication etc.
“The junior doctors were reinstated – well those that hadn’t emigrated were – but the senior doctors weren’t and now there is no-one to run the departments” said the technician. So the hospital remains dysfunctional. Which applies to many hospitals around the country.
Fortunately for me I can afford the local private healthcare system which is adequate for most things. For the more technical I have an offshore policy that I have used in South Africa. The vast majority of Zimbabweans have no health cover at all and no way to pay for any.
I have been out of Zimbabwe for 10 days now, staying in the USA where my sister is very ill. In that time the unofficial exchange rate for the Zimbabwe dollar to the US dollar has plunged from 30:1 to 40:1. Nobody except the banks and government use the official rate (called the interbank rate) at 18:1. It is illegal to use anything but the interbank rate but even a fuel station chain, part owned by the government, is now openly charging US dollars for fuel. Just before I left Zimbabwe I was in a big hardware store in the industrial sites of Harare buying electrical cable for a borehole pump. The customer next to me asked if he could pay for a car battery in US dollars. The till operator nodded and printed out the relevant invoice. At the end of the counter the man operating the in-store bureau de change was asleep. The electronic notice board for the exchange rates on offer indicated the official interbank rates. Nobody was interested as the store was offering the black market rate. Yet the central Reserve Bank and the finance minister continue to trumpet that the economy is on course to de-dollarize i.e. go back to the Zimbabwe dollar.
I read somewhere that the death toll from the economic impact of the current COVID-19 coronavirus is likely to be higher than the direct death toll from the virus itself. Given the disastrous state of the government health system this is difficult to imagine. Large swaths of the population are malnourished and undernourished. Many are immune compromised with HIV and its effects. Should the virus get to Zimbabwe in any substantial force the impact is going to be massive because those most at risk are the old, infirm, malnourished and immune compromised. It won’t be pretty.
A letter to America
5 02 2023Hi Robin,
Our weather has become increasingly erratic over the last 15 years or so. I put it down to climate change. Right now we are in the middle of a relatively normal rainy season. That means that the ITCZ (Inter-Tropical Convergence Zone) moves over the country and it rains – quite a lot. Most of our rains happen from mid November to the end of March which in Harare means some 700 to 800mm. The rain can be quite intense – we had 75mm (3 inches) in several hours last week which meant all the rivers around town were up and one of the reservoirs that supplies town was spilling. As a country we’ve had good rain for the last 3 years due to the la Niña effect though it has been quite variable over the country and Harare, which is in a high rainfall area, received less than average. We are due for a drought and I see that there is a el Niño predicted later in the year which is a reliable indicator.
There’s rain around as I type this and yesterday afternoon we had quite a storm with high winds and hail and of course the power went off. It’s still off but we are geared for this eventuality and have solar panels and two lithium batteries to get us through the night. Power outages for other reasons, mainly incompetence and over-use of Lake Kariba as a hydro source, are common so everyone who can has a solar backup plan. Solar water heating makes a lot of sense in our climate so we have three solar heaters, one for us, one for the cottage tenants and one on the domestic employee’s rooms. In the cloudless, hot days of August and September the water can easily boil.
I see your weather has been erratic too. Mt Washington in the north-east of the USA hit a record -70C a few days back and Europe had an unseasonably warm Christmas. It seems that California has had some heavy rains too; the default weather app on my new iPad is set to the Apple headquarters in Cupertino and they had flood warnings out recently.
Planned, and I use that word loosely, power outages are called “load shedding” in this part of the world. Towards the end of last year it was announced that Lake Kariba, which is our major source of hydro power, had got to it’s minimum level permitted for generation due to over-use by the Zimbabwe power authority and load shedding would become a daily occurrence. We have another major thermal power station at Hwange in the west of the country but it has become a byword for mismanagement and cannot take up the shortfall. We also import a lot of power from Mozambique and South Africa but have managed to get into a lot of debt so the aforementioned countries are fed-up and restricting our supply. South Africa has its own power supply issues (again due to mismanagement by the state-run utility) and is also imposing load shedding but at least it sticks to a schedule. In Zimbabwe the power generally goes off in the suburbs about 6.30 a.m. and comes back on around 10 p.m. Businesses are not exempt either and incur heavy costs due to diesel generators. It’s not unusual for some to run just on night shifts.
Our swimming pool was an early casualty of the power cuts. It’s essential to keep the filter running which the solar panels can do on a sunny day but those are rare in the rainy season so it’s more green than clear these days. Marianne was muttering about the cost of more chemicals to try and clear it. I pointed out that we could always fill it in but it wouldn’t be a cheap procedure and then we’d lose some 70,000 litres of stored water that would be very useful in a drought. We have decided to live with it being more green than not (it is covered over in winter when not in use).
The book you asked about is, I think, “The Shackled Continent” by Robert Guest who was an Africa correspondent for The Economist for a number of years. I found it fascinating and very insightful. Maybe I should read it again.
My business muddles along. I have a lot of outstanding debtors and it’s not so simple as insisting that they pay up front for their orders. I hate having to get nasty but it may eventually come to getting professional debt collectors in as I need to get the money to pay for imports of the coir “peat” raw material that we use to grow the seedlings. I obviously cannot use Zimbabwe dollars but fortunately I did invoice in US dollars which once again is becoming the currency du jour. The government is still trying desperately to keep the local dollar alive but with an official exchange rate of 740 to the US dollar compared with a “parallel”, i.e. street, rate of 1,100 to the dollar, it doesn’t have much of a chance. The local currency is still used, and has to be offered, as a payment method but most outlets make it very attractive to use the US$ by offering massive discounts . Government departments don’t do this so get paid almost entirely in local currency which means they are perpetually in financial difficulties – hence the disastrous state of the power supply, roads, rail links and anything else they are involved in. Am I making sense?
The government is also trying to stifle speculation on the currency markets by lending money at vast interest rates, 110% in November 2022, which makes doing business very difficult and one of the reasons that I use to explain why my business is so flat. The other is the proliferation of competition, often informal, which cut lots of corners allowing them to undercut my prices. Their quality is dismal but people either don’t care or see it as an acceptable consequence of the cheap prices. My prices haven’t changed in four years despite the rising costs of inputs in real (US dollar) terms. It doesn’t make for attractive business. Curiously the construction business is booming with cluster homes (small, single level apartments – several to a property) and other developments being built throughout the suburbs. Quite where the money is coming from I cannot ascertain – but in an economy as moribund as ours it’s almost certainly dirty.
Yes, us Zimbabweans are a resourceful lot and I guess in that respect Diana remained true to her heritage. My workroom/office is full of junk that I cannot throw away just in case I find a use for it in years to come. It must be a hold-over from the days when Zimbabwe was Rhodesia and under sanctions so nearly everything that could be was recycled. It’s probably an attitude of my generation rather than today’s “youngsters” – I drive past a municipal rubbish tip on the way to work and there’s never a shortage of trucks pulling in to offload. I suppose people do make a living out of recycling here though it’s not as fashionable as in the developed world. An elution plant (recycling gold from electronics) has recently been constructed at the former rubbish dump. It’s also not unusual to see carts being pushed around the suburbs and having one’s gate bell being rung by the owners looking for scrap metal.
I guess our “big” news for this year is that we’re going over to the UK in May to attend a rock concert! I’ve never been to one as standing for a long time in rowdy crowds is obviously not possible for me but this is Mike & The Mechanics who are not as popular as they used to be so seating is an option. Time to tick off the bucket list.
Then we are going to stay on the Cote d’Azur with an old girlfriend and her husband for four days. Apparently we’ll be quite close to St Tropez. Marianne is keen to go and see how the ultra-rich live but I may give it a miss. Really looking forward to it and we’re brushing up our rudimentary French in anticipation.
Well, on that positive note I’ll sign off and wish you all the best for this year. Forget the snow shoveling, go skiing and may it be exceptional.
Ciao
Andrew
Note: this is a genuine reply to a friend in Washington State U.S.A. who was a good friend to my sister Diana, and helped look after her in the terminal stage of her cancer three years ago.
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Tags: el Nino, load shedding, power cuts, solar power, Zimbabwe, zimbabwe dollar
Categories : Business, Economics, Social commentary