Our forgotten surgical pioneer

By Tanya Jonker-Bryce

HAMILTON Naki, 76, is a soft-spoken, unassuming pensioner from Centani.

He is also one of the Eastern Cape's best-kept secrets.

Despite a low-key existence on a meagre gardener's pension, Hamilton is a giant in South African history -- a man who made an immeasurable but, until now, undervalued contribution to arguably one of our finest moments: the first human heart transplant.

While the credit for this momentous event rightfully belongs to Professor Chris Barnard, the famous surgeon himself always insisted the record-breaking transplant was a team effort.

And vital to the Barnard team was Hamilton Naki -- a man of incredible skill, entirely self-taught, who overcame a complete lack of education to be appointed Barnard's principal surgical assistant.

Since his retirement in 1991, Naki has all but faded from public view, choosing to return to the obscurity of his native Centani village.

But a new documentary by filmmaker Dirk de Villiers is bound to change all that.

Inspired by the enormous contribution Naki made, often without much credit, De Villiers is on a mission to "set the record straight".

"Professor Barnard admitted to me that if Hamilton Naki had been given the chance, he could have been the surgeon to do the first heart transplant," De Villiers says.

"The irony is that he never got the recognition for the exceptional skill he developed. Students from all over the world who were keen to get involved in heart surgery, flocked to Groote Schuur Hospital and the man who taught them was not the professors in the lecturing halls, but Hamilton Naki."

Naki himself remains modest about his achievements. "I was blessed by God who gave me his teachings from heaven," he says simply.

His message, more than anything, is one of encouragement.

"I want to appeal to the youth," he says. "The chance is yours. Education is very important if you want to survive anywhere on the globe, so stick to your books. We don't have enough black doctors."

Modest beginnings

HAMILTON'S amazing journey began in Ngcingane, a small village outside Centani in the Transkei interior, where he was born on June 26, 1926.

"I came from a very poor family and only went as far as Standard 6," he says, "but that was actually a very good education in my time."

Knowing that there were few if any opportunities in his hometown, Naki hitchhiked to Cape Town, where he eventually found a job as a gardener at Groote Schuur Hospital.

His main function was tending the residency tennis courts. However, a great affinity with animals soon led to Naki being invited into the lab of visiting professor Robert Goetz, an innovative researcher in the surgical laboratory.

It was to be a perfect partnership.

"There were limited funds and almost no experts to consult," recalls Associate Professor Rosemary Hickman.

"But Goetz was a remarkable innovator and inventor with ideas and abilities ahead of his time. Hamilton helped him in any way possible and absorbed his ability to make something out of nothing."

Naki credits Goetz as one of his most important
teachers.

"He taught me all about surgical work, but unfortunately his stay wasn't long as he had to return to Germany to pursue his research and I was left with the responsibility of teaching surgical research."

The arrival of Professor Chris Barnard in 1956 was Naki's second big break.

"Barnard began to introduce to South Africa the new techniques of open heart surgery and cardiopulmonary bypass surgery, which he had learned in the US," says Hickman.

Naki initially acted as Barnard's anaesthetist, where he impressed the heart surgeon with his enthusiasm and an incredible ability to learn, despite his lack of formal education.

Within months, he had been appointed Barnard's principal surgical assistant.

"Despite his limited education, he had an amazing ability to learn anatomical names and recognise anomalies," Hickman says.

"His skills ranged from assisting to operating and he frequently prepared the donor animal, sometimes singlehandedly, while another team worked on the recipient.

"He was also probably unique in once assisting with a delicate hepatic arterial anastomosis while gently rocking my baby's cradle."

Apart from a skilled assistant, Naki cherishes his role as an educator.

"In my so-called career as a surgical research lecturer, I taught more than three thousand professors," he says proudly.

Giving credit

"WHEN Hamilton retired in 1991, there was some question about the duration of his pension contributions," Hickman says.

"This was not helped by the fact that incomplete records were kept when he started working. In fact, the buildings that housed the financial department were not even in existence."

Hickman counts herself as one of Naki's biggest admirers.

"Hamilton is a truly remarkable man," she says. "His great influence and patient teaching skills will never be forgotten by any of the visiting or local surgical researchers, consultants or registrars," says Hickman.

Apart from just honouring Naki's accomplishment, filmmaker De Villiers hopes his project will bring about formal recognition.

"We sincerely hope that this documentary will give the man the recognition he deserves -- at least an honourary doctorate," he says.

"He is currently earning the pension of a gardener, and this has to be put right."

De Villiers has proposed two half-hour documentaries. "The emphasis," he says, "will fall on the injustice that prevailed during the apartheid era in the medical world.

"This is an important message to all black youths of South Africa."