Albert Schweitzer’s living legacy

LAMBARENE, Gabon — The Ogooue River flows wide and unhurried, stretching across virtually all of Gabon through its tributaries.

At this river port of Lambarene (see map below), 175 miles inland from the Atlantic Ocean, a tall white man arrived in 1913, by pirogue, from Port Gentil on the coast. His name was Albert Schweitzer and the French doctor and his wife came to start a hospital in this tropical backwater.

Schweitzer was then 30 and had abandoned a promising career to pursue his quest to improve health care in Africa.

First he became known by the people of the area, who trekked for miles and for days to receive medical treatment. Over the years he became world famous, like Mother Teresa, for providing medical care to the poor deep in Africa’s tropical jungle. In 1952, a Nobel Peace prize crowned a lifetime of work as a doctor, theologian and ethicist. He was lionized in iconic photo spreads for Life Magazine. He died at 90, on Sept. 4, 1965, 44 years ago.

Schweitzer died where he wanted: in his narrow metal bed, under a white mosquito net, close to his beloved upright piano, his books, his pets — pelicans, dogs and monkeys — and his hospital.

A simple wooden cross marks his grave overlooking the Ogooue River, next to his wife, Helene, and their daughter Rhena, a biologist, who died aged 90 this year and was buried here in April.

Today, the Schweitzers’ personal quarters and the hospital built in the early 1920s are a fascinating museum.

Starting in 2001, the wood and tin roof buildings, damaged by termites, tornados and tropical humidity, were dissembled and rebuilt exactly as they were by a Swiss master carpenter. The renovation, including a recreation of Schweitzer’s kitchen garden, was completed in 2006.

Working from photos and memory, his old colleagues Jo and Walter Munz put back in place the original furniture and equipment. The effect is like boarding a time machine back into another medical era.

Its quaint, evocative, Spartan interior combines whitewashed woodwork, white cotton curtains and dark wood furniture. The charm lies in the details: his desk, glasses and letters (much tidier than in photographs, though); Helene’s reading chair, cane and nurse gown; the boxes with medical files of patients; the baby bassinet for newborns; the simple medical equipment of the early 20th century.

Unfiltered by spotlights or air conditioning, the rooms are filled with natural light, sound and the tropical air, screened by the latticed shutters.

In the operating room, frozen in time like body parts in formaldehyde, one hears birds and feels the heat or a cooling breeze, a blessing sent by the Ogooue — just as Schweitzer must have.

It is not hard to pixel in a crowd of Africans with their bundles and baskets of cloth, pots and food, bringing their disease and hope to be seen by Schweitzer.

Museum tour guide Chantal Nyangui describes how she was operated on here as a 3-month-old baby with an intestinal occlusion. She received care from Schweitzer’s disciple, Walter Munz.

Nyangui points out a framed quote from patients about having an operation under anaesthesia: “The doctor first kills the sick, cures them, and then resurrects them.”

The Ogooue River’s strong presence is everywhere: from the windows, from the walkways connecting buildings, and from Schweitzer’s grave next to the old landing where dugout canoes brought the sick from all over Gabon.

Schweitzer’s work continues in the modern hospital, built in 1981. It specializes in the tropical diseases seen in the old black-and-white photographs in the museum, such as the buruli ulcer, lymphatic filariasis or elephantiasis. In June, Phase 3 trials of a malaria vaccine started here.

Annually, the hospital provides 80,000 consultations, hospitalizes 6,000 patients and oversees 900 births.

The salaries of the staff, numbering about 250, are partly paid by the Gabonese government with the rest funded by the Schweitzer foundation and donors.

The hospital is run on Schweitzer’s ethical principles: everyone is treated. Pay later, if you can. Relatives can stay, with room to sleep, wash and cook.

“The staff is nicer than in public hospitals, the social dimension is a priority,” said Joel Boko, a computer technician who came from Libreville with an ulcerated thigh that requires a skin graft. His wife, Vyvette, took leave from her office job to cook hearty meals and sleep next to him.

“There is life in this hospital and its ethics attracts doctors,” said assistant director Valerie Pouget.

Nonetheless, funding is not enough. Relatives can be undisciplined, noisy or unhygienic.

The leprosaria Village Lumiere, built with the Nobel Prize money, is a conundrum. With leprosy no longer an infectious disease, there is no reason to keep 26 patients and their families in a ghetto. But the patients don’t want to leave the village or its free services — Gabon has no welfare system.

Liz Portnoy is a fourth-year medical student from the University of Massachusetts on a three-month internship through the Schweitzer Foundation in Boston.

“I have a new view of what is good medicine”, she said. ”In the U.S., we don’t see a person, we see a disease and we go at it with a battery of tests and technology in an academic routine. Here, it is about treating and healing an individual. And they have high standards of care without high-tech machines.” The museum prompts a visitor to revisit the Schweitzer myth. There are many readings, not mutually exclusive. In the 1960s, visitors, especially Americans, were revolted by the goats, noise and dirt of the hospital-cum-village. In the 1970s, Africans labelled him a colonialist who held African patients to an inferior standard of health care.

Was Schweitzer a white paternalistic male, unconsciously racist, who never employed African nurses or learned a local language? A rigid missionary who preached against polygamy and local religious beliefs? A recalcitrant colonialist who bellowed orders and wore a pith helmet until his death?

Or was he an intrepid doctor who worked for free in heat, solitude and austerity? A peacenik who, along with Albert Einstein, signed a petition against the atomic bomb in 1953 and condemned all violence? A green activist before biodiversity became a household word, who believed that the West is killing nature by trying to control it? An anti-colonialist who criticized European exploitation of Africans? An ethical pantheist, almost Buddhist, who revered all forms of life?

A 1952 movie with Jeanne Moreau, "It is midnight, Dr Schweitzer" (“Il est minuit, Dr. Schweitzer,”) gives him the hero treatment up to his internment as a prisoner of war during World War I. (He was born in Alsace when it was German.)

“Le Grand Blanc de Lambarene,” by Cameroonian director Bassek ba Kobhio (1995), is nuanced but critical: "The independence of the people has never been your concern. You only wanted to share their hell in the hope of reaching your heaven.”

In his last 15 years, Schweitzer became an anachronism. Isolated by a clique of strict European nurses, recalcitrant to change, as immutable as the Ogooue.

His legacy lives on. Bernard Kouchner, French foreign affairs minister and co-founder of Doctors without Borders, summed him up: “He was among the first to position health as the spear of a new world community, health as a common good for humanity.”

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