‘It smelled like BBQ so he lay back and enjoyed it’
LIKE my father, I developed an interest in skin diseases after qualifying. Dad wanted to study dermatology but with the Depression in the 1930s and the precarious economics of family doctors prior to the NHS, he never did. Dr Andrew McWhan, who taught me a lot about the effect of bad housing and bad politics in the depressed mining areas round Falkirk in the 1970s, had also considered the speciality and asked advice from a colleague.
“And do you know what he told me, Dr Vost?” said my dear mentor and fellow chain-smoker, grimacing through the cumulus of smoke, adjusting the kilt he always wore and smoothing his shining bald dome before replying to his own question.
“He said, ‘Ach, McWhan, dermatology is just masterly inactivity and sulphur ointment. You might as well be a rat-catcher or a sausage-stuffer for all the challenge you’ll get. Just let folk talk out their troubles. By the time they’ve finished, they’ll have forgotten about their rash – if they haven’t, give them a pot of sulphur ointment and see them in a month’.”
The excellent skin disease book from Groote Schuur Hospital in Cape Town points out that many skin afflictions disappear without specific treatment and not a few of the remainder will persist until you change your job, your spouse or your ambitions.
My first exposure to Africa’s skin problems was at a leper colony on the northern shores of Lake Victoria. Hundreds of afflicted souls were virtually imprisoned here. Many of their hands and feet were ugly stumps of deformed and infected tissue. Shunned by most of their fellow Ugandans, theirs was a living death, without hope. Nowadays, when it can still crop up as a diagnosis, leprosy is curable in months without deformity.
Skin can also be a political statement. Walking in Khartoum before the fall of Omar al-Bashir when the city was a centre of Islamic extremism and sharia law was unquestioned with all women hidden behind black chadors, we were always impressed with the Dinka girls.
Noisy throngs of them were flaunting garish skimpy clothes with much flesh in evidence, a deliberate and brave challenge to Bashir & Co.
Warts in Africa can be formidable in numbers and size. We are not talking here about the odd one on a finger but scores of the beasties, like mini-cauliflowers, gathered round a private Ground Zero. They can be frozen, or burned off with electric cautery. Last year, I was surprised at one patient’s insistence on being diathermied.
“You burned a lot off my brother last year, doc. He said it smelled like a weekend beef barbecue so he just lay back and enjoyed it.”
The mobile phone camera is a boon to us non-specialists who can now help far-off patients and ask opinions from real dermatologists. Misunderstandings do happen, of course. I told one university lecturer his photo showed a bacterial infection called erysipelas but my Scottish accent let me down. “Syphilis? How dare you!”
Acne is widespread here. The cost of effective treatment is way beyond the means of most patients. Its impact on most sufferers was brought home to me as a student. Brian Clough, the manager of Nottingham Forest FC, was asked before a crucial European Cup game how his very young team were coping with the tension.
Replied Clough: “Tension? The lads are more worried about their pimples than Real Madrid.” Dr David Vost studied medicine at Glasgow University and works in Swaziland. He lives on a farm in Northern Uganda.
asking why our young people are not “oven-ready”. There can be no excuse for the failure of the educational shambles today for which I would hold this Government accountable and not, as it would have us believe, another problem caused by immigration.
His assumption that our young people in the future will only be offered harvesting and fruit picking is so pathetic it could be coming from the mouth of Ms Patel as she makes her case for her answer to the immigration problems caused mainly by her party.
It also suggests that our young people are incapable of making a success of life as they see it and have no ambition. Anyone who pays attention when young people speak will realise that is not the case.
His implication that jobs working the land are somehow beneath us is deplorable. This work was open to everyone but our young people mainly declined the offer.
If Mr Maclean really thinks that every young person is interested in a career and further education, maybe he could advise all those with a degree working in pubs, or worse still, without a job, where exactly all these career jobs are. Michael Tolland, Glasgow.