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Biographical entry Stirling, Leader Dominic (1906 - 2003)

Hon FRCS 1993.

Born
19 January 1906
Essex, UK
Died
7 February 2003
Dar-es-Salaam, Tanzania
Occupation
General surgeon

Details

Leader Stirling was an eminent missionary surgeon and a former minister for health in Tanzania. He was born on 19 January 1906 in Essex. Many of the family were doctors, although a cousin did found the SAS – the Special Air Service. Stirling was educated at Bishop’s Stortford and then went on to the London Hospital for his medical studies. His father lent him £1,000 for the five-year medical course. After house surgeon appointments and time spent in general practice, he was eventually able to pay him back. Not knowing the direction of his career, he prayed for guidance. Two days later a cable from the Universities Mission to Central Africa arrived, urgently requesting doctors for the Masasi region.

When Stirling arrived the operating theatre was a bamboo building with a grass roof, every gust of wind filling it with dust and dead leaves. There was no running water and no lighting except for oil lamps. Cooking pots, stores of food, live hens, spears, bows and arrows were stowed under the beds in the mud huts that served as wards. A visit to an outlying hospital could mean a 24-mile walk through the bush. He built his own hospital in nearby Lulundi from scratch, borrowing a book from an engineer uncle, and roofing it with pantiles fashioned by his local Scout troop. He also started a nurse training school there, despite opposition from the medical establishment who believed that only white women could be trained as nurses.

After 14 years at Lulundi he became a Catholic, took the name Dominic and joined the Benedictine Mission. They sent him to Mnero, where he built another hospital, this time with the help of a brother who had been an architect. There he started a school for rural medical assistants who were trained on a three-year resident course to diagnose and treat the 15 conditions that accounted for 80 per cent of visits to the doctor, and to send anything else to a doctor. Fifteen years later he was transferred to Kibosho, on the slopes of Kilimanjaro.

In his book Africa: my surgery (Worthing, Churchman, 1987) Stirling describes the conditions he encountered. These were as diverse as belly-ripping by a jealous husband, to crocodile and hippo bites. He devised instruments from simple materials. Screw-drivers made ideal supracondylar traction pins, sewing cotton became perfect ligatures. Thomas splints were contrived from bamboo, extension cord from plaited palm leaves with stones as traction weights. For intravenous infusions he used triple-distilled water, to which he added salt and glucose. When plaster of Paris ran out, he made his own from locally quarried gypsum. He was one of the first to operate on tuberculous abscesses of the spine causing paraplegia, draining them from the front. He devised a new bloodless operation for the giant swellings of the scrotum caused by filariasis.

After the war he stood for the Tanganyika African National Union in the new legislative council, the forerunner of a parliament. When independence was agreed in 1961 Stirling became a Tanganyikan citizen. In 1973 Julius Nyerere made him minister for health and he strove to bring tuberculosis and leprosy under control, closing the obsolete leprosaria. He dealt with an outbreak of cholera and reformed the treatment of mental disease. His rural medical assistant scheme was adopted by many other developing countries.

He retired from politics at 75, but continued to practise surgery. His last operation, at 85, was a favour to a friend who would trust no one else. In 1993 the College made him a Fellow by election – a rare honour. He married an African nurse, Regina Haule, in 1963, who died of septicaemia nine years later. He then married Anna Chilunda, a nurse (and also a princess), who was a widow with six children. He died in Dar-es-Salaam on 7 February 2003 at the age of 97.

Sources used to compile this entry: [The Times 8 April 2003, with portrait; BMJ 2003 327 56.].

The Royal College of Surgeons of England