DR HENRY HOLLAND OF QUETTA MISSION HOSPITAL "He Gave Sight to 100,000"

HENRY HOLLAND was born on February 12, 1875 at Durham, England, in the home of his Grandfather Tristram, residentiary Canon of Durham. On the paternal side of his family there were also close ties with the Church of England, his father being a parish priest and his father before him Vicar of Walmer Beach and chaplain to the Duke of Wellington. An aunt, Katie Tristram, who went to Japan as an educational missionary, was the first family link with the mission field.

The dominant influence of his life was his energetic mother, whom he remembers as always on the lookout for a way to help others. It was genial and hospitable Canon Tristram's zest for life, interest

 

in people and moral courage that also set for the boy a pattern of character to follow. He took example, too, from his father's visits and kindness as a parish priest to every family in the community, whether Churchmen or not.

His travels began in infancy when he was taken to Riga, Latvia, where his father served as English chaplain until the boy was five. The father's next appointment to the parish of Cornhill in north Northumberland brought the family back to the seat of three generations of forebears on his mother's side. The Holland home was on the banks of the Tweed and, though considered delicate, the boy reveled in the fishing, riding, and hunting to hounds afforded by the country life. Later, this experience was to serve him well when he would make arduous journeys to remote parts of Baluchistan on camel or pony.

 

Tutored by his father and two maiden aunts until he was 11, he went to Durham School for one term and then on to his uncle's school, Loretto, near Edinburgh. Training there was in a Spartan tradition, with high educational standards, daily exercise and much time spent in the open air. His son RONALD also attended this school and three grandsons have followed.

 

At the end of his last term at Loretto, HENRY went by his parents' arrangement but against his will to a two weeks summer camp instituted to bring the claims of Christ before public school boys. The camp provided a full schedule of exercise and each evening ended with an appeal to the boys to give their lives to His service. He resisted until the last evening before making the decision that revolutionized his life.

 

Deciding to serve God as a doctor, he enrolled at Edinburgh in 1894 for medical training. Prompted by the example of men he came to know who had chosen a missionary vocation, he joined the Student Volunteer Missionary Union, pledging himself to become a missionary doctor. This step, taken toward the end of his undergraduate study, gave his life a new sense of drive and direction. Advised to interrupt the first year of his medical course after several prolonged attacks of influenza, he had spent a six weeks holiday on the Continent when a Liverpool merchant invited him as a traveling companion on a trip to the United States. Two months later, when his benefactor offered to make him his U.S. representative at what seemed to the college student a staggering sum, he declined the offer. Returning to the University, he entered wholeheartedly into missionary activities and by severe self-discipline was able to graduate in 1899, passing among the first eight, with distinction in both second and final examinations.

 

The next seven months he spent visiting various colleges and universities in Great Britain and Ireland as Traveling Secretary of the Student Volunteer Mission, a position his elder brother had held when he left Oxford. Professionally, he was later to feel acutely his lack of practical experience on a hospital staff, and, when his two sons decided to join him on the Frontier, they took hospital appointments in England before going abroad.

 

Dr. HOLLAND had offered his services to the Church Missionary Society shortly after graduation and, in March 1900, still with four months left of his contract as Traveling Secretary, he was called to Quetta, on the remote North-West Frontier of India, to take the place of the doctor shortly going on leave. He had three weeks to prepare for his journey to a place he had never heard of.

 

Traveling by cramped third class overland to Marseilles, he continued on by sea in an airless lower berth, such as was allotted to second class passengers at the turn of the century. A typhoid inoculation beyond Port Said made him severely ill, and he suffered a virulent attack of the fever seven months after reaching Quetta. From Karachi, he completed the last 400 miles by train, climbing from the dust-thickened air over the Sind desert and plains, through the desolate Baluchistan hills to the upland plateau where Quetta stands, ringed by towering peaks, 5,500 feet above sea level. As he left the plains he began to see large, fierce-looking tribesmen who seemed a piece with the harsh surroundings. His first sight of the city-oasis that was to be his home was memorable—arriving on the 6th of May, the weary traveler delighted in the greenness and profusion of blooming roses.

 

The medical mission at Quetta, established 14 years earlier, was one of a chain of four along the North-West Frontier originally encouraged by British army and political officers to help keep peace among the tribesmen as well as treat their physical ills. To the first outpatient building constructed in 1889, had been added four wards with 28 beds for inpatients, one operating room and a dark room for ophthalmoscopic work. It was a small but brave assertion of Christian care and compassion in the heart of a hostile land, for killing an infidel as a way to attain Paradise was common practice among fanatical Muslims in those early days.

 

The Frontier it served was a bleak and isolated land of rugged mountains and great stretches of arid, rocky plains. Apart from the railway to Quetta, there were few roads and only rough trails across the wastelands and through the passes. Excepting the British garrison and government officers at Quetta and the few other stations, the inhabitants were mostly scattered tribespeople who changed their dwellings with the season. Separated by deserts and mountain ranges, the various tribes seldom mixed together. Education in a formal sense was unknown, and there was little desire for schooling among those living in or near the Frontier stations to whom it was available.

 

Dr. HOLLAND found the hospital in full swing; spring and autumn were the busiest, when caravans could move without hindrance of snow and freezing temperatures or the intolerable summer heat. Among the patients were small-statured Brahui, of supposed Dravidian stock, who came in droves after their winter sojourn to the plains south of Sibi on their way back to the uplands. Tall, hardy Pathans, the Afghan tribes living on the then British side of the border, came down from the mountains to the north. A Pushtu-speaking Semitic people, they claimed descent from the 10 lost tribes of Israel. Baluchi arrived as the weather warmed, from the southern foothills and plains running east from Sibi to the Punjabi frontier. Also a Semitic people and often of fine physique, their language was a form of Persian. Journeying up from the plains were Sindhis and Punjabis.

 

The doctor was not put off by the Muslim fanaticism, blood feuding and raiding that characterized a part of the tribesmen's way of life. Seeing their strength in adversity and the obvious need for medical attention, he quickly took up the challenge of adjusting to life in entirely strange surroundings.

 

Work for the young medical graduate began at once. Dysentery and malaria were common ills. Surgical needs were great though limited facilities permitted treatment mostly of hemorrhoids, tubercular glands and cataracts. As he had not had hospital experience, he spent several hours each day working with the doctor he was soon to replace, learning surgical technique. Otherwise learning by doing, he was soon administering treatment for all manner of ailments. Later, he was able to widen his knowledge through visits to hospitals in Kashmir, the Punjab and Sind.

 

By adhering to a rigorous daily regimen of work and study, he passed examinations in Urdu, Persian and Pushtu and mastered the rudiments of Brahui, Baluchi, Punjabi and Sindhi. Whenever the hospital work slackened, the adventurous doctor made treks into the outlying countryside, sometimes hunting and always learning more about the lives of the tribespeople and their medical needs. Cataracts and eye infections were endemic to the area, induced by glaring heat, searing winds, dust, flies, vitamin deficiency in the diet and calcium-laden water. Perhaps because the plight of the blind touched him most, he developed a special talent for eye surgery. On his return to Quetta in 1907, after a serious illness had necessitated an extended leave, he was given charge of the medical mission.

 

In the autumn of 1909, a wealthy Hindu merchant and philanthropist invited Dr. HOLLAND to spend the winter weeks treating patients at Shikarpur, in North Sind, offering to cover all expenses. The doctor and his two colleagues refused payment for their services, but agreed to return if the merchant would provide a building for their operative work. The small hospital that was ready the following year has now grown into one of the largest eye clinics in the world, able to care for 600 patients at a time. Though some other surgical cases are treated, the main work is ophthalmic.

 

Since 1920, some 150 eye specialists have come from India, Pakistan, the Continent, the United Kingdom and the United States to observe and work at Shikarpur. They pay their own traveling expenses and board and room for the privilege of working there. In a mutually beneficial exchange, the visiting doctors have brought the latest developments in surgical technique and themselves had valuable operative experience, performing up to 200 cataract operations in a month's stay, whereas two or three a week would be the average in most clinics elsewhere. Other medical missionaries also have come each year to join in the work. This outside help has meant that four doctors could each operate six hours a day. With such teamwork, as many as 3,000 operations have been performed during one two-month season at Shikarpur, of which 1,400 were for cataracts.

 

A second clinic was later established at Khairpur, also in North Sind, and for a time a clinic was operated for a few weeks each year in Karachi under the auspices of the Poor Patients' Relief Society. As other doctors joined the mission, stations were set up in the surrounding countryside to which medical and nursing staff were regularly assigned.

 

The main base was still Quetta, and the hospital there grew steadily, chiefly due to the increase of eye work. Facilities were better adapted to local custom with the addition of wards where patients could be accompanied by relatives with cooking pots. Between 1904 and 1930, 14 such wards were built for patients who would rather pay a rupee a day than go into a public ward; all were the gifts of grateful patients. Similar accommodations for very poor families were provided free. Patients often came from long distances, and to have their relatives with them during convalescence with a family camel, donkey or goat in the courtyard was a natural arrangement they appreciated.

 

The tradition of service was strengthened at Quetta by the building of a Christian nursing profession and the institution, in 1926, of a full-fledged training program for male nurses. From 1931, the mission hospital also trained a succession of dispensers. An X-ray unit had been purchased, in 1925, with donations from local sirdars and chieftains. By 1934, the number of beds had been increased to 124 and that year inpatients numbered 3,447 and major operations totalled 3,760. With the exercise of much faith and patience in a Muslim environment, old suspicion and distrust had given way to confidence, notably regarding surgery.

 

All of this painstakingly built physical plant was destroyed, in May 1935, when a disastrous earthquake laid Quetta in ruins, killing some 25,000 people in the city and environs. After five days in a hospital recuperating from a back injury sustained when he was pinned under falling beams, Dr. HOLLAND was appointed Chief Medical Officer of Baluchistan, in charge of rescue work, making provision for casualties and prevention of epidemics. This task completed, the intrepid doctor then faced the problem of reconstruction. "Striking while the iron was hot," he made a trip to England to raise funds. Other support for the Rebuilding Fund came from not then partitioned India. Temporary structures were in operation in 1936 and two years later the first permanent buildings went up. The new hospital was completed on the same site on May 6, 1940, 40 years from the day of his first arrival at Quetta.

 

In 1936, the doctor had been made a Knight-Bachelor in recognition of the work of the mission hospital and his contribution to ophthalmology. He had previously received the decoration of the Kaiser-i-Hind gold medal and bar and, in 1929, the Companion of the Order of the Indian Empire (C.I.E.) in tribute of his service to the tribespeople of Baluchistan.

 

His medical work on the Frontier meanwhile was becoming a family affair. Effie Tunbridge, the second nursing sister to join the Quetta mission became Dr. HOLLAND's wife four years later in 1910. Their elder son, Harry, joined his father in 1935. The second son, RONALD, born in Quetta in 1914, followed suit in 1940, after completing his medical training at Edinburgh. Marriage interrupted the plans of their daughter, Esme, also to serve on the Frontier. RONALD's wife, Joan, has carried on as a nurse, keeping hospital accounts and becoming an expert anesthetist though, stricken with paralytic polio a year after their marriage in 1940, she has the full use of only one arm and is unable to walk. When malaria, contracted marching through the Burma jungle in wartime, continued to undermine his health, Harry returned to England and, in 1953, started the Oversea Service, a pioneer venture under the auspices of the British Council of Churches and the Conference of British Missionary Societies to spread a sense of Christian responsibility among laymen going to assignments abroad. RONALD has taken his father's place in charge of the medical mission work in Pakistan. Excelling also in general surgery, he is recognized as the most skillful ophthalmic surgeon of the family. He has learned the many languages of Baluchistan and otherwise has carried on unbroken his father's legacy of compassionate service. Though even more patients than in his father's time are treated during the crowded winter months at Shikarpur and Khairpur and during the spring and autumn at Quetta, Dr. RONALD HOLLAND continues to visit the outlying areas. Setting up mobile clinics along the way he, too, performs delicate eye operations and treats assorted other ailments for poor tribespeople to whom no other help is available.

 

In treating the thousands who come each year to their hospitals and clinics the HOLLANDS developed mass operative techniques that have relevance for surgeons elsewhere who may be called upon to meet large-scale disasters. Where it was no uncommon experience to see 200 to 300 outpatients a day, the choice was made to forego elaborate treatment for a few and take care of as many as possible. Both father and son have done up to 70 cataract operations a day. Records were not as detailed as they would like, but each patient was recorded as to diagnosis, treatment, operation, operator, complications and result. Methods were simplified to the extreme, but the essential preoperative technique has been maintained and postoperative care adapted to the resources available and the mores of the people, proving, for example, that a cataract case can move about within hours after surgery without harmful effect. Despite severe handicaps, these careful adjustments to field conditions have produced excellent results. Though the Shikarpur clinic operates only two months each year, it can record more than 150,000 eye operations, including 80,000 cataract extractions of which 97 per cent have proved successful.

 

Feeling that the scientific part of their work should be brought before the profession, both Sir HENRY and Dr. RONALD HOLLAND have contributed articles to leading medical journals in India, Britain and the United States and read papers at the Oxford Ophthalmic Congress.

 

Following partition in 1947, Quetta and Shikarpur fell within the borders of West Pakistan. The hospitals helped through the difficult period of adjustment and now are continuing their good work. Beside the goodwill among the people and the tribal chieftains, based on trust, has been a growing appreciation of the Christian qualities of concern and integrity for which the hospitals have stood through the years.

 

Sir HENRY's retirement, due according to the rules of his mission society in 1940, was postponed for the duration of World War II and again delayed until conditions were settled enough for him to hand over to his sons and his Pakistani Christian assistant. In those postwar years, he served on Government Commissions, on Church and Mission councils and committees, sharing in the planning of medical policy both for the Church and the Government of India.

 

Finally leaving active service in March 1948, he was promptly called back again to treat the King of Afghanistan. Two years later and until his own eyesight began to fail in 1956, grateful tribesmen, led by a Baluch chief, made up a purse to pay his traveling expenses for an annual visit to his hospitals. During the remainder of those years, he traversed England raising funds, recruiting missionaries and encouraging young people to think less of themselves and more of service to others. Now 85, he came to Pakistan again this year to celebrate his golden jubilee among his beloved tribespeople.

 

Simple and unassuming in manner, this father and son bely their splendid record as two of the world's foremost eye surgeons. Both have been offered professional opportunities with high standing and handsome stipends but have chosen to devote their skills as medical missionaries among an isolated people. Of those who come to work or be treated at their hospitals, no question is asked as to their faith, but the doctors' own lives are a continual Christian challenge to all who know them.

 

Each day's work is preceded by prayer. In operating for hours on end visitors, too, have sensed the therapeutic value of the spiritual atmosphere thus created. To the HOLLANDS, prayer and healing go together, for healing to them "speaks" the same message as Christ's teaching—the love of God in whose sight every individual is important.

 

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