You go to an office in Kampala (Uganda) and want to do your bussines, you get to a desk to get some information, to speak a certain person, to get papers, to get a signature, but the man with the key has gone! In other words, you just go home and try another day to do want you wanted to do. At crucial times, the man is missing, the key is missing, maybe a bit of çhai’ would help, but basically the key has gone. We are very sorry, Sir, Madam.  

Ian Clarke is a medical doctor who worked as a general practitioner in Northern Ireland. He is married with three children. He ends up in the famous Luweero triangle in the landlocked country of Uganda. In that area the ravages of the civil war were still present. Working for the Church Missionary Society he starts Kiwoko medical work in this area, after he did some specialist training in Liverpool, to get acquainted with tropical situations. 

We follow him (and his wife and his children) in the day to day running of the medical work, the upgrading and another upgrading and in the end the small place gets the status of a hospital with medical workers in the area.  We follow him on his endless trips to Kampala, his clashes with the world of corruption and the bumps and potholes, the local workers and the foreign workers, the rise of the HIV/AIDS, the number of people that ware traumatised by the war, the financial constraints, the breakdowns of cars, the schooling of the children at  a boarding school at Turi (Kenya), the long and odd hours of work. 

In the Foreword it is said that this book is not just another ‘missionary story’. To me it sounded very much like a ‘missionary story, taking in consideration that in the late eighties and the early nineties there were other ideas around about setting up medical work from scratch. The aproach of Clarke is very much the topdown approach. At the top we find the doctor who seems to be the only medical doctor even when the medical work is expanding. Take for instance the building of a Maternity Ward, as one of the first actions he took in the field of building. I did not read anything about training Traditional Birth Attendants. Even before Clarke entered Luweero  ladies gave birth to children. He does not seem to start with the given situation.

Clarke worked for the Anglican Church, but the connection between this church and the medical work is not clear and hardly mentioned. For instance, who owns the medical work? Is it dr. Clarke or the Anglican Church or the local community? Do not expect any ideas on community based medical work, or a connection with the Ministry of Health.

It is a wellwritten story about the endeavours of Clarke, written with a sense of humour  and a sense of evanglical urge. He stays clear from the political situation in Uganda, though he writes about the turmoil in Kenya, when his children schooled at Turi.

Ian Clarke – The man with the key has gone! – 1993 

Post Scriptum When I finished the book I searched the internet for some more information on the hospital. The hospital is still a functioning hospital, with expatriate leadership. 

At the end of the book Clarke has left Uganda due to his illness. But later in life he returned to Uganda, set up a chain of clinics, took Ugandan citizenship, got involved in local politics, owns a hotel on Zanzibar.  There was something about his early years in Northern Ireland  that came back to my mind when I read about his business endeavours. When he and his wife decided to work in Uganda one of the things he had to deal with was a business he was running next to his work as a general practitionar. He sold his business. In later years he became a businessman again, now in Uganda. He seems to be a well-off man.