Contact Wounds is Jonathan Kaplan’s account of his education as a surgeon in South Africa and subsequent career treating the victims of modern warfare. He spoke recently with the California Literary Review.
- If there’s a hell on earth, it has to be Angola as described in your book. Would you tell us a little bit about its recent history and your experiences there?
- I arrived in Angola in its 26th year of war. The besieged town of Kuito, in the country’s central highlands, could only be reached on one of the UN food aid flights, which the surrounding UNITA rebel forces were trying to knock from the sky in order to starve out the inhabitants. The descent into Kuito involved a spiral dive from maximum altitude to throw off the aim of UNITA ground-to-air missiles, originally supplied by Ronald Reagan.The war had started in 1975 when Portugal decided to quit its overseas colonies. South Africa and the US, trying to stop an independent left-wing government taking over, backed UNITA, a tribal faction with a history of collaborating with the Portuguese colonial secret police. South African air power and armour and US-supplied munitions turned UNITA into a destabilizing force across the country. Kuito had twice been almost overrun by UNITA, and heavily shelled; now it lay in the center of a rough circle of government-held territory, home to around 160,000 civilian inhabitants plus a similar number of villagers displaced by the fighting.
- The small hospital run by the international medical relief organization Médecines sans Frontières provided the only care available for those suffering from disease, wounds or grave malnutrition – sometimes a combination of problems. The surgeon had been on duty day and night for months and my arrival allowed her to take a break. Before she flew off to the Angolan capital Luanda, we did a ward round together.
- Cases included gunshot wounds, neurological injuries and land-mine victims, intestinal perforations from typhoid, bladder damage following obstetric complications, infected fractures, and women with problem deliveries requiring Caesarian Section. These were all my patients, for the surgery department did all the operating in the place, and that included obstetric and orthopaedic cases.
- As a medical student in South Africa, you took an internship in the Seychelles that opened your eyes to some political realities and put you in great personal danger. Would you share that story with us?
- I arrived in the Seychelles a few months after its independence from British colonial rule. Beneath the appearance of tropical paradise, unrest simmered, with a political power-struggle underway against the country’s autocratic new head. Through a series of events whose piquant absurdity could only occur in so fantastic a place, I managed to attract the wrath of this individual and had to go on the run, hopping a trading schooner to one of the out-lying islands.There, aided by a sympathetic doctor, I lay low, hiding out for a whole on an even smaller island where the practice of voodoo – known there as grigri – had survived its suppression by the colonial authorities and now seemed to be flourishing in the jungle gloom.
- After the collapse of South Africa’s apartheid regime there were several gruesome murders of chemists and rumors of something called Red Mercury. What was happening and how did you get involved?
- Red Mercury was a mysterious compound rumoured to be a component of new-generation nuclear weapons, and changing hands on the international black market for large sums of money. I was making a TV documentary about a British transnational chemical company that had been attracted to South Africa during the time of sanctions. It manufactured mercury compounds, some with military uses, and its clients included Armscor, the South African government’s weapons manufacturer. My interest was medical; mercury contamination at their plant had killed one worker while others lay on hospital wards, slowly deteriorating.But a twist in the story involved the bizarre murder of one of the company’s directors, a chemical engineer whose body had been found painted neatly from collar-line to waist with a glistening layer of a mercury compound. The man’s death appeared to have the hallmarks of a gruesome warning, as though he’d been involved in a deal that went wrong. The detective handling the case revealed that it might be linked to a number of unexplained deaths of chemical engineers whom police suspected of trafficking in Red Mercury.
South Africa was in the grip of violent transition as the white government that had ruled the country for 45 years gave way to democracy. Ghostly hit-squads – some directed by the security forces, others operating autonomously – carried out massacres and assassinations. Mossad agents were said to be active, intent on preventing the sale of knowledge and material from South Africa’s military nuclear programme, which Israel had helped set up, to unfriendly regimes in the Middle East. Organised crime, perhaps the Russian Mafia, was being blamed for an explosion of murder and extortion. Once the first film had been completed the TV commissioning editor ordered me to investigate the Red Mercury story.
- You entered Iraq as an aid worker in April 2003 shortly after American troops had captured Baghdad. What were your duties and what did you observe during your time there?
- I was in Baghdad as a volunteer surgeon, but operating was difficult. The city’s hospitals had treated many wounded during the bombing, depleting emergency stores. Following the arrival of the Americans, much of the remainder had been looted, the pillage continuing even as staff tried to deal with arriving casualties. Operating rooms resembled charnel-houses, with discarded surgeons’ gloves, crusted dressings and bloody clothes caked underfoot. Fuel shortages meant the generators could light only small areas of the hospitals and were unable to power the elevators; injured were carried up the stairs to the operating tables, their wounds jetting. Water arrived in buckets, instruments could not be sterilised. Under these conditions the Iraqi surgeons – experienced, often with specialist qualifications obtained in England or the US – were operating only when it was entirely unavoidable, because of the risk of sepsis. I’d helped with some emergency cases, but most problems could not be solved with surgical skills.It seemed inconceivable that no strategy existed to restore order in Baghdad. Aid workers and journalists, even some of my Iraqi medical colleagues, suggested that the chaos was a sophisticated programme of destabilisation designed to shake up Iraqi society and encourage factions to promote their own agendas and leaders; as these emerged they could either be co-opted by the Coalition Provisional Authority (CPA) or destroyed. Yet the void continued, with different groups vying for control of medical facilities. A hospital director that I’d met in the morning might have been deposed by the candidate of a rival movement when I returned at noon – sometimes two or three pretenders would be holding court simultaneously in different offices – while the injured bled on the floor and desperate mothers roamed the corridors, collapsed babies in their arms, crying for medicine.
- Why do you think America invaded Iraq in the first place and what do you predict will be the end result?
- As a surgeon, my responsibility in a war zone is to its casualties; I leave the explanations for the war to others. A reasonably cogent analysis from an Iraqi doctor colleague was that this second Gulf War had been the First War of Globalisation, aimed at forcing open Iraq – and later Syria, Iran and the rest of the Middle East – to American markets, with a thoroughness that the World Trade Organisation could never achieve.Another justification for the invasion was provided by a US soldier, reflecting the viewpoint of his country’s government. I had gone to talk to troops at a roadblock after they’d fired on a car carrying an Iraqi family.
- ‘It’s they own fault,’ said the sergeant. ‘They shoulda stop a hundred metres away, like it says in the rules of engagement.’
- ‘They’re civilians,’ I objected, ‘they don’t understand about rules of engagement.’
- A soldier glared down at me from the nearest Bradley. ‘Civilians my ass,’ he growled. ‘These fuckin’ ragheads did Nine-Eleven.’
- The lamentable end results may be observed every day, while the global destabilisation that has ensued will probably provide work for volunteer surgeons for the next 50 years.
- You’ve purposely put yourself into dangerous situations throughout your life. Why do you do it?
- My skills have become suited towards crude extremes of suffering – war trauma, humanitarian crises. There is little other market for my abilities, or for the odd combination I suffer of imperfect clinical detachment, the vice of restlessness and some tarnished shreds of idealism. It is really only in the world’s darker corners that they have any chance to shine.
- You seem to have developed a deep cynicism for governments and their intentions, but not for individuals. Can you relate an instance or two that you witnessed of people behaving in a way that you found inspiring?
- I have been struck by how people in the worst circumstances transcend human limitations and show a generosity of spirit more selfless than any god. I’ve seen those in flight from a catastrophe trying to save the children of people they have never met, and observed them – exhausted, frozen, hungry – digging graves for the bodies of the unknown dead in order that they should be treated with appropriate respect. Often enough they’ve fed me when there’s been little food to share.