Hamilton Naki: 1926-2005

If you walked behind the Groote Schuur Hospital in Cape Town to the old cemetery any lunch time in the 1970s and 80s you would come across a fascinating gathering. A group of poor unemployed Africans, some of them alcoholics, and other HIV positive, were listening intently to another African reading to them from the Bible and then gently exhorting them about turning from their sinning to trust in Almighty God through his Son, Jesus Christ. The African preaching to them was Hamilton Naki a leading surgeon at the Groote Schuur Hospital who was using his lunch hour to say a word for his Saviour. He was also one of the most fascinating Christians in the whole African continent, yet unknown in the church, and in the world outside South Africa.

Caroline Richmond, writing his obituary in the British Medical Journal (25 June 2005), has captured the essence of his extraordinary life.

“When 26 year old Denise Darvall was knocked down by a car on her way to buy a cake in Cape Town, South Africa, in 1967, sustaining severe head injuries, she triggered an operation that made medical history. While she was considered brain dead when she reached hospital, her heart was healthy and kept pumping. Her body was placed in the hands of Hamilton Naki, who expertly removed her heart and gave it to Christiaan Barnard. He then transplanted it into 57 year old Louis Washkansky. Naki’s contribution was a criminal offence under the apartheid laws because he was black and the patient was white. Barnard could have been prosecuted for allowing him into a whites-only operating theatre and for allowing him to touch a white patient. Moreover, Naki was unqualified.

“Hamilton Naki had joined Cape Town University and Groote Schuur Hospital as a gardener, and was rolling the grass tennis courts when, in the 1950s, the professor of surgery, Robert Goetz, asked him to step into the laboratory and hold a giraffe on which he was operating. Goetz was trying to discover why giraffes did not faint when they lowered their heads to drink. He was so impressed with Naki that he invited him to work in the lab.

“Naki soon became skilled in a wide range of surgical procedures from Goetz, ranging from catheterisation and suturing to intubation and anaesthesia. He took over postoperative care of the animals. Before long, he could perform a liver transplant in a pig virtually single handed. There was little that the surgeons could do that he couldn’t. Naki credits Goetz with being his most important teacher. Goetz, who had fled Nazi Germany, may have empathised with Naki’s situation.

“When Goetz went to America, Christiaan Barnard arrived. Barnard recognised Naki’s abilities and used him firstly as his anaesthetist and later as his principal surgical assistant. In the 1950s Naki worked with Barnard while he was developing open heart surgical techniques experimentally He was prodigiously intelligent, had a formidable memory, and learnt by watching others. When Barnard developed arthritis in his hands, Naki’s contribution became even more important.

“He was promoted to technician and later to senior technician, the highest the university could take him under the apartheid laws. In an interview shortly before his death in 2001, Barnard called Naki “one of the great researchers of all time in the field of heart transplants,” adding that Naki “was a better craftsman than me, especially when it came to stitching.” When visitors flocked to see the man who had performed the world’s first heart transplant, Naki kept in the shadows, and was obliged to describe himself as gardener and cleaner. Barnard, who vigorously opposed apartheid, spoke in Naki’s praise whenever it was safe to do so, and entertained Naki at his home. Naki was a placid man who got on with the highly strung and media hungry Barnard. Naki had a major role in training the hundreds of trainee heart surgeons who flocked to Cape Town to study under Barnard. Naki cherished his role as educator, and taught three thousand surgeons.

“Hamilton Naki was born in Ngcingane, a village near Centani in Transkei, to a poor family and was educated to sixth grade. He left school when he was 14 and, because there was no work in Centani, hitchhiked to Cape Town. He remained there for the rest of his life, sending most of his wages home to support an extended family of 11 people. He lived in a tiny room in quarters for migrant workers in Langa, a black township on the Cape flats. He had no electricity or running water. Every morning he set out for work wearing a Homberg hat, suit, shirt, and tie, and with polished shoes. His family stayed in the village where he was born, and he supported them on his wages and later his pension, worth £70 (in UK sterling equivalent) a month. He could not afford to educate his children to follow in his footsteps.

“He would arrive at the lab every morning at 6 am, carrying umbrella, newspaper, and Bible, and work until 4.30 pm. He spent his lunch break reading the Bible to the down-and-outs in the cemetery behind the medical school, and warning them of the evils of alcohol and cannabis.

“After his retirement he raised money so that a mobile clinic visited his birth place, Centani, which was 50 miles from the nearest doctor or hospital. Every year he visited the surgeons who were his former trainees to raise money from them to maintain a rural school in the Eastern Cape.

“In later life he received the recognition he had long deserved and is now one of South Africa’s heroes. Cape Town University conferred an honorary MSc in surgery on him in 2002. In 2003 President Thabo Mbeki presented him with the order of Mapungubwe, one of South African’s most prestigious awards. Two years later, when Mbeki delivered his presidential address to the South African parliament, Naki was one of the “senior civil guard of honour’ who welcomed him.

“He leaves a wife, Joyce, and four children.”

CAROLINE RICHMOND

Hamilton Naki, gardener, animal technician, surgeon, and surgical tutor Groote Schuur Hospital, Cape Town, 1946-91 (b. Centani,Transkei, 1926, hon MSc in surgery Cape Town University 2002), died from a heart attack on 29 May 2005.