Hamilton Naki

Hamilton Naki (26 June 1926 – 29 May 2005) was a South African medical assistant and teacher without any formal qualifications, who was incorrectly cited by a number of publications as a surgical assistant of Christiaan Barnard during the world's first heart transplantation at Groote Schuur Hospital, South Africa, in 1967.

Background

Naki was born in 1926 to a poor family in Ngcingane, a small village in the Eastern Cape. He completed his primary school education there, then, aged 14, he hitchiked to Cape Town in search of work. He was employed by the University of Cape Town as a gardener, and for ten years maintained the tennis courts and university grounds.

Medical career

Naki was selected by Robert Goetz of the Medical Faculty at the University, while working as a gardener, to work in the clinical laboratories, where he helped by caring for the laboratory animals; Goetz first asked him to help him hold a giraffe while he operated. He soon became involved in surgical procedures in the laboratories, including anaesthetics, as well as post-operative care for the animals. Despite his lack of formal education, his technique and capacity was recognised, and he received special permission to continue research in the laboratories. However, he was never able to train as a doctor, and was barred from the whites-only operating theatre during the apartheid era.

Naki became one of four technicians in the research laboratory at the medical school. He assisted numerous young surgeons who spent time training in the animal laboratory to perform research—then transplantation of kidneys, hearts, and livers—and to obtain higher research degrees. Despite being listed in hospital records as a cleaner or gardener, he was paid the salary of a senior lab technician, the highest pay the hospital could give to someone without a diploma.

World's first transplant myth

Naki is best known for being incorrectly cited as a surgical assistant to the world's first heart transplant, most famously by the Economist magazine , who subsequently retracted the story . The story, which proved to be a myth, said that when Barnard returned from the United States to develop cardiac transplant techniques, Naki was enlisted as his assistant, where he assisted in the removal and cleaning of Denise Darvall's heart, who was fatally injured in a car accident, during a marathon surgical operation on 3 December 1967. However, surgeons at Groote Schuur, the hospital where the transplant was performed, refuted this claim as did some sources close to Naki.

The process was assisted by hints from Barnard that Mr Naki had helped him in ways that were not fully known, and by the fact that, under apartheid, any such help on white human subjects would have had to be secret anyway. In the end, a story took shape that looked so plausible to the outside world that many famous publications, including the Lancet, the British Medical Journal, the Economist and many others accepted it. Yet the same story appeared so ridiculous to the University of Cape Town, staff say, that they did not trouble to deny it.

Naki did however help assist a number of the surgeons involved in the operation in their earlier medical training and in 2003, the university awarded him the degree MMed [honoris causa], stating, "Mr Naki assisted with the experimental work that preceded...the historic first heart transplant."

Retirement

Naki retired in 1991 on a gardener's pension. He received some recognition of his work after his retirement, receiving a National Order of Mapungubwe in Bronze in 2002 and an honorary degree in Medicine from the University of Cape Town in 2003. During his retirement, he arranged for a converted bus to act as a mobile clinic for his home area, and supported a school in the Eastern Cape with donations collected from doctors he had trained. He died on 29 May 2005, aged 78.

Legacy

Despite his lack of formal training, Naki provided valuable training to thousands of student surgeons without receiving any formal acknowledgement. Barnard would later praise Naki for his role as a teacher and for his skills as a "surgeon". Barnard himself admitted before he died that "He (Naki) probably had more technical skill than I had". Indeed, he used this skill to become a trainer of over 3000 future surgeons, renowned for expecting high standards from his students. Meanwhile he would use his lunch breaks to read the Bible to the homeless people gathered in the local cemetery, and warn them against alcohol and cannabis.