Hamilton Naki
Encyclopedia
Hamilton Naki was a black
laboratory assistant to white
cardiac surgeon
Christiaan Barnard
in South Africa under apartheid. He was recognized for his surgical skills and for his being able to teach medical students and physicians such skills despite not having received a formal medical education, and took a leading role in organ transplant
research on animals.
A controversy arose after his death in that at least five periodicals and the Associated Press
retracted statements in their obituaries of Naki that claimed that he participated in the world's first human-to-human heart transplantation
in 1967; the incident has been cited as an example of inadequate fact checking
by the newsmedia and delayed corrections
of the errors.
region of the Eastern Cape
of South Africa
. He received six years of education up to the age of 14, after which he moved to Cape Town
. Beginning about 1940, he commuted from Langa, Cape Town
to the University of Cape Town
to work as a gardener, specifically rolling grass tennis courts.
valves to determine why giraffes do not faint when bending to drink."
Several years after Goetz left, Naki started working for Christiaan Barnard in the laboratory as an assistant. Barnard had studied open-heart surgery techniques in the United States and was bringing those techniques to South Africa. Naki first performed anaesthesia on animals for Barnard, but was then "appointed principal surgical assistant of the laboratory because of his remarkable skill and dexterity." Barnard was quoted as saying "If Hamilton had had the opportunity to study, he would probably have become a brilliant surgeon" and that Naki was "one of the great researchers of all time in the field of heart transplants".
In 1968, Barnard's cardiac surgical research team moved out of the surgical laboratory, and Naki helped develop the heterotopic or "piggyback" heart transplantation technique. In the 1970s, Naki left Barnard's team and returned to the surgical laboratory, this time working on liver transplantation. His contributions at this time were described as follows:
He taught many students during his career; although newsmedia accounts placed the number of students in the thousands, Hickman said that that number appears to have been exaggerated. Naki assisted Hickman until his retirement in 1991, after which he received "a gardener's pension: 760 rand, or about $275, a month."
After retirement, Naki helped the community of Kentani, where part of his family lived, for example "in the construction of a school and in the provision of a mobile clinic" by soliciting donations from his "medical contacts". He received public recognition of his medical work after his retirement, including:
He died in Langa on 29 May 2005, aged 78, of "heart trouble."
and The Lancet
), one magazine (The Economist
), two newspapers (The Independent
and The New York Times
), and an unknown number of newspapers publishing Associated Press stories, printed obituaries
that made the following claims about Naki's participation in the world's first human-to-human heart transplantation:
Between 14 July 2005 and 3 September 2005, the five aforementioned periodicals and the Associated Press issued formal retractions of statements in their obituaries of Naki that claimed that he participated in the world's first human-to-human heart transplantation. The reasons given for the initial mistakes included:
Evidence cited in 2005 that Naki was not present at the first transplant included:
Instead, the surgeons who removed the heart from the donor were Marius Barnard (Christiaan Barnard's brother) and Terry O'Donovan.
Despite the retractions, the claim that Naki participated in the 1967 heart transplantation has been perpetuated in journal articles and books published after 2005. Examples include:
A 2007 book traced the origin of the incorrect story to a 1993 article in the Associated Press
that stated "Barnard had Naki on his heart-transplant backup team. … When Barnard performed the first heart transplant in 1967, Naki was part of the backup team at Groote Schuur Hospital in Cape Town." The story's "blossom[ing] into accepted fact" was partly attributed to neither Barnard's nor Naki's taking steps to refute the story. The 2007 book noted that the 2005 corrections in the newsmedia "did not include any statement about adopting new procedures to prevent the same thing from happening again."
A documentary film Hidden Heart which was released widely in 2009 included interviews with Christiaan Barnard and Naki suggesting that Naki was present at the 1967 heart transplantation. Marius Barnard was quoted as describing the claims in the film that Naki removed the donor heart as "rubbish, a joke, it’s a total distortion of the facts" and as stating that Naki was at the time "in his bed, about 8 km away from Groote Schuur". The co-director of the film "acknowledge[d] that Naki was not present the night of the operation." A South African Broadcasting Corporation
investigation after the release of the film quoted five people about the event:
Black people
The term black people is used in systems of racial classification for humans of a dark skinned phenotype, relative to other racial groups.Different societies apply different criteria regarding who is classified as "black", and often social variables such as class, socio-economic status also plays a...
laboratory assistant to white
White people
White people is a term which usually refers to human beings characterized, at least in part, by the light pigmentation of their skin...
cardiac surgeon
Cardiac surgeon
A cardiac surgeon is a surgeon who performs cardiac surgery—operative procedures on the heart and great vessels.-Training:A cardiac surgery residency typically comprises anywhere from six to nine years of training to become a fully qualified surgeon...
Christiaan Barnard
Christiaan Barnard
Christiaan Neethling Barnard was a South African cardiac surgeon who performed the world's first successful human-to-human heart transplant.- Early life :...
in South Africa under apartheid. He was recognized for his surgical skills and for his being able to teach medical students and physicians such skills despite not having received a formal medical education, and took a leading role in organ transplant
Organ transplant
Organ transplantation is the moving of an organ from one body to another or from a donor site on the patient's own body, for the purpose of replacing the recipient's damaged or absent organ. The emerging field of regenerative medicine is allowing scientists and engineers to create organs to be...
research on animals.
A controversy arose after his death in that at least five periodicals and the Associated Press
Associated Press
The Associated Press is an American news agency. The AP is a cooperative owned by its contributing newspapers, radio and television stations in the United States, which both contribute stories to the AP and use material written by its staff journalists...
retracted statements in their obituaries of Naki that claimed that he participated in the world's first human-to-human heart transplantation
Heart transplantation
A heart transplant, or a cardiac transplantation, is a surgical transplant procedure performed on patients with end-stage heart failure or severe coronary artery disease. As of 2007 the most common procedure was to take a working heart from a recently deceased organ donor and implant it into the...
in 1967; the incident has been cited as an example of inadequate fact checking
Fact checker
A fact checker is the person who checks factual assertions in non-fictional text, usually intended for publication in a periodical, to determine their veracity and correctness...
by the newsmedia and delayed corrections
Correction (newspaper)
A correction in a newspaper is usually the posting of the notice of a typographical error or mistake that appeared in a past issue of a newspaper. Usually, a correction notice appears in its own column....
of the errors.
Early life
Naki was born to a poor family in Ngcingane, a village in the TranskeiTranskei
The Transkei , officially the Republic of Transkei , was a Bantustan—an area set aside for members of a specific ethnicity—and nominal parliamentary democracy in the southeastern region of South Africa...
region of the Eastern Cape
Eastern Cape
The Eastern Cape is a province of South Africa. Its capital is Bhisho, but its two largest cities are Port Elizabeth and East London. It was formed in 1994 out of the "independent" Xhosa homelands of Transkei and Ciskei, together with the eastern portion of the Cape Province...
of South Africa
South Africa
The Republic of South Africa is a country in southern Africa. Located at the southern tip of Africa, it is divided into nine provinces, with of coastline on the Atlantic and Indian oceans...
. He received six years of education up to the age of 14, after which he moved to Cape Town
Cape Town
Cape Town is the second-most populous city in South Africa, and the provincial capital and primate city of the Western Cape. As the seat of the National Parliament, it is also the legislative capital of the country. It forms part of the City of Cape Town metropolitan municipality...
. Beginning about 1940, he commuted from Langa, Cape Town
Langa, Cape Town
Langa is a suburb found in Cape Town, South Africa. It was established in 1927 interms of the 1923 Urban Areas Act. Similar to Nyanga, Langa is one of the many areas in South Africa that were designated for Black Africans before the apartheid era. It is the oldest of such suburbs in Cape Town and...
to the University of Cape Town
University of Cape Town
The University of Cape Town is a public research university located in Cape Town in the Western Cape province of South Africa. UCT was founded in 1829 as the South African College, and is the oldest university in South Africa and the second oldest extant university in Africa.-History:The roots of...
to work as a gardener, specifically rolling grass tennis courts.
Medical career and retirement
In 1954 Robert Goetz of the University's surgical faculty asked Naki to assist him with laboratory animals. Naki's responsibilities progressed from cleaning cages to performing anaesthesia. Most of Naki's work under Goetz involved anaesthetizing dogs, but Naki also assisted in operating on a giraffe "to dissect the jugular venousJugular vein
The jugular veins are veins that bring deoxygenated blood from the head back to the heart via the superior vena cava.-Internal and external:There are two sets of jugular veins: external and internal....
valves to determine why giraffes do not faint when bending to drink."
Several years after Goetz left, Naki started working for Christiaan Barnard in the laboratory as an assistant. Barnard had studied open-heart surgery techniques in the United States and was bringing those techniques to South Africa. Naki first performed anaesthesia on animals for Barnard, but was then "appointed principal surgical assistant of the laboratory because of his remarkable skill and dexterity." Barnard was quoted as saying "If Hamilton had had the opportunity to study, he would probably have become a brilliant surgeon" and that Naki was "one of the great researchers of all time in the field of heart transplants".
In 1968, Barnard's cardiac surgical research team moved out of the surgical laboratory, and Naki helped develop the heterotopic or "piggyback" heart transplantation technique. In the 1970s, Naki left Barnard's team and returned to the surgical laboratory, this time working on liver transplantation. His contributions at this time were described as follows:
- Rosemary Hickman, transplantation surgeon whom Naki assisted and taught in the laboratory, and who worked with Naki for nearly 30 years: "Despite his limited conventional education, he had an amazing ability to learn anatomical names and recognize anomalies. His skills ranged from assisting to operating and he frequently prepared the donor animal (sometimes single-handedly) while another team worked on the recipient."
- Del Khan, "head of Groote Schuur HospitalGroote Schuur HospitalGroote Schuur Hospital is a large, government-funded, teaching hospital situated on the slopes of Devil's Peak in the city of Cape Town, South Africa...
's organ transplant unit," whom Naki taught in the laboratory: "A liver transplant on a pig in the U.S. would involve a team of two or three medically qualified surgeons… Hamilton can do this all on his own." - Ralph Kirsch, "head of the Liver Research Centre" at the University of Cape Town: “He was one of those remarkable men who really come around once in a long time. As a man without any education, he mastered surgical techniques at the highest level and passed them on to young doctors."
- Barnard: "A liver transplant is much more difficult than a heart transplant… [doctors who work with Naki] tell me that Hamilton can do all the various aspects of liver transplantation, which I can't do. So technically, he is a better surgeon than I am."
He taught many students during his career; although newsmedia accounts placed the number of students in the thousands, Hickman said that that number appears to have been exaggerated. Naki assisted Hickman until his retirement in 1991, after which he received "a gardener's pension: 760 rand, or about $275, a month."
Personal life, post-retirement activities and recognition, and death
Naki was reported to be married with four sons and one daughter. He lived in a small one-room house without electricity or running water and sent "most of his pay to his wife and family, left behind in Transkei," but "could pay for only one of his five children to stay to the end of high school." He was active in his church and read the Bible frequently.After retirement, Naki helped the community of Kentani, where part of his family lived, for example "in the construction of a school and in the provision of a mobile clinic" by soliciting donations from his "medical contacts". He received public recognition of his medical work after his retirement, including:
- Metropolitan Eastern Cape Award, 2002.
- The Bronze Order of MapungubweOrder of MapungubweThe Order of Mapungubwe is South Africa's highest honour. It was instituted on 6 December 2002, and is granted by the president of South Africa, for achievements in the international area which have served South Africa's interests...
, 2002, presented by President Thabo MbekiThabo MbekiThabo Mvuyelwa Mbeki is a South African politician who served two terms as the second post-apartheid President of South Africa from 14 June 1999 to 24 September 2008. He is also the brother of Moeletsi Mbeki...
. One of the highest South African civil honoursSouth African civil honoursAn overview of South African civil orders, decorations and medals, which form part of the South African honours system.-Union of South Africa:The Union of South Africa was formed in 1910, as a self-governing dominion in the British Empire...
, this Order is "awarded to South African citizens for excellence and exceptional achievement." - BTWSC Black S/Heroes Award, 2003.
- An honourary master's degreeHonorary degreeAn honorary degree or a degree honoris causa is an academic degree for which a university has waived the usual requirements, such as matriculation, residence, study, and the passing of examinations...
from the University of Cape Town in 2003, presented by vice chancellor Graça MachelGraça MachelGraça Machel, DBE is a Mozambican politician and humanitarian. She is the third wife of former South African president Nelson Mandela and the widow of Mozambican president Samora Machel...
. The honourary degree was described as MMed (Master of Medicine) in some sources and MSc (Master of Science) in others. - Inclusion in a "senior civil guard of honour" at the 2004 opening of the Parliament of South AfricaParliament of South AfricaThe Parliament of South Africa is South Africa's legislature and under the country's current Constitution is composed of the National Assembly and the National Council of Provinces....
.
He died in Langa on 29 May 2005, aged 78, of "heart trouble."
Controversy concerning participation in 1967 heart transplantation
After Naki's death, obituaries published 9 June 2005 to 2 July 2005 in at least two medical journals (BMJBMJ
BMJ is a partially open-access peer-reviewed medical journal. Originally called the British Medical Journal, the title was officially shortened to BMJ in 1988. The journal is published by the BMJ Group, a wholly owned subsidiary of the British Medical Association...
and The Lancet
The Lancet
The Lancet is a weekly peer-reviewed general medical journal. It is one of the world's best known, oldest, and most respected general medical journals...
), one magazine (The Economist
The Economist
The Economist is an English-language weekly news and international affairs publication owned by The Economist Newspaper Ltd. and edited in offices in the City of Westminster, London, England. Continuous publication began under founder James Wilson in September 1843...
), two newspapers (The Independent
The Independent
The Independent is a British national morning newspaper published in London by Independent Print Limited, owned by Alexander Lebedev since 2010. It is nicknamed the Indy, while the Sunday edition, The Independent on Sunday, is the Sindy. Launched in 1986, it is one of the youngest UK national daily...
and The New York Times
The New York Times
The New York Times is an American daily newspaper founded and continuously published in New York City since 1851. The New York Times has won 106 Pulitzer Prizes, the most of any news organization...
), and an unknown number of newspapers publishing Associated Press stories, printed obituaries
Obituary
An obituary is a news article that reports the recent death of a person, typically along with an account of the person's life and information about the upcoming funeral. In large cities and larger newspapers, obituaries are written only for people considered significant...
that made the following claims about Naki's participation in the world's first human-to-human heart transplantation:
- That Barnard had asked Groote Schuur Hospital for permission for Naki to be on the transplant team, and that permission was given in secret because of hospital rules and apartheid laws. Under apartheid, black health care providers could not have contact with white patients.
- That on 3 December 1967, Naki removed the heart of the deceased Denise DarvallDenise DarvallDenise Ann Darvall was the donor in the world’s first successful human heart transplant, performed at Groote Schuur Hospital, South Africa, by a team of surgeons led by Christiaan Barnard....
, who was white, for transplantation into Louis WashkanskyLouis WashkanskyLouis Washkansky was the recipient of the world's first human heart transplant.-Biography:Washkansky was a Lithuanian Jew who migrated with his friends to South Africa in 1922, aged nine, and became a grocer in Cape Town. Washkansky saw active service in World War II in East and North Africa and...
by Barnard.
Between 14 July 2005 and 3 September 2005, the five aforementioned periodicals and the Associated Press issued formal retractions of statements in their obituaries of Naki that claimed that he participated in the world's first human-to-human heart transplantation. The reasons given for the initial mistakes included:
- The Economist stated that its obituary was based on Naki's "own words in interviews," but that Naki's role "was gradually embellished in post-apartheid, black-ruled South Africa" and that Naki came to believe the story himself. Furthermore, the magazine reported that the University of Cape Town did not initially deny the story because it appeared "ridiculous."
- The author of the BMJ and The Independent obituaries wrote that she had "relied on secondary sources" such as The Economist.
- In an article published the same day as its correction, the New York Times concluded that reports that Naki was involved in the 1967 transplantation emerged "most prominently" in a 2003 article in The GuardianThe GuardianThe Guardian, formerly known as The Manchester Guardian , is a British national daily newspaper in the Berliner format...
. The 2003 article mentioned that "a team led by Mr. Naki went to work, a 48-hour marathon" to remove the donor heart. - The Associated Press cited a reliance on previous (1993 and 2003) Associated Press articles.
Evidence cited in 2005 that Naki was not present at the first transplant included:
- Surgeons at the hospital where the 1967 transplantation was performed "assured" The Economist that Naki "was nowhere near the operating theatre."
- The Economist reported that "a source close to" Naki said that Naki said that he had heard of the first heart transplant "on the radio."
- The chief of the laboratory in which Naki worked as of 1967 stated that Naki at the time was a scrub nurse and that Victor Pick was the surgical assistant; Naki became surgical assistant only after Pick died in the early 1970s and only "at the experimental surgical operating table."
- Hickman was quoted as saying that Naki "was an honest man and he wouldn't have made that claim [of being present at the 1967 transplanation]".
- Filmmaker Dirk de Villiers stated that heard Naki "tell other people" that he assisted in the transplant but did not say this to de Villiers in private.
- David Dent, Acting Dean of the Faculty of Health Sciences at Cape Town University as of 2005, asserted that he worked with Naki "on transplanting pigs' livers" in 1967, but that technicians such as Naki did not perform surgeries in hospitals.
- In a letter to BMJ, Dent wrote that Naki "did not participate in the first heart transplant, did not ever operate on humans, nor ever work in Groote Schuur Hospital…. The suggestion that Hamilton Naki performed the donor operation was never mentioned in life by the man himself, by the department of cardiac surgery, or by the university in his citation for his honorary degree in 2003. It was not mentioned after his death at his family funeral, or at the memorial service in the medical school experimental laboratory."
- Chris Logan, author of a biography of Barnard, wrote that Naki "did not at any stage assist in the first or subsequent human heart transplant operations, nor could he have done under the apartheid laws at the time".
Instead, the surgeons who removed the heart from the donor were Marius Barnard (Christiaan Barnard's brother) and Terry O'Donovan.
Despite the retractions, the claim that Naki participated in the 1967 heart transplantation has been perpetuated in journal articles and books published after 2005. Examples include:
- "In December 1967… Naki, with amazing dexterity, removed the donor heart from Darval, irrigated it with electrolyte solution and passed it to Barnard."
- "1967 Dr. Christiaan N. Barnard of South Africa performed the world's first human heart transplant operation… Working with a team that included… black South African surgeon Hamilton Naki…."
- "One of the most interesting people I learned and read about was Hamilton Naki. He assisted Dr. Barnard with the first transplant in 1967…."
A 2007 book traced the origin of the incorrect story to a 1993 article in the Associated Press
Associated Press
The Associated Press is an American news agency. The AP is a cooperative owned by its contributing newspapers, radio and television stations in the United States, which both contribute stories to the AP and use material written by its staff journalists...
that stated "Barnard had Naki on his heart-transplant backup team. … When Barnard performed the first heart transplant in 1967, Naki was part of the backup team at Groote Schuur Hospital in Cape Town." The story's "blossom[ing] into accepted fact" was partly attributed to neither Barnard's nor Naki's taking steps to refute the story. The 2007 book noted that the 2005 corrections in the newsmedia "did not include any statement about adopting new procedures to prevent the same thing from happening again."
A documentary film Hidden Heart which was released widely in 2009 included interviews with Christiaan Barnard and Naki suggesting that Naki was present at the 1967 heart transplantation. Marius Barnard was quoted as describing the claims in the film that Naki removed the donor heart as "rubbish, a joke, it’s a total distortion of the facts" and as stating that Naki was at the time "in his bed, about 8 km away from Groote Schuur". The co-director of the film "acknowledge[d] that Naki was not present the night of the operation." A South African Broadcasting Corporation
South African Broadcasting Corporation
The South African Broadcasting Corporation is the state-owned broadcaster in South Africa and provides 18 radio stations as well as 3 television broadcasts to the general public.-Early years:Radio broadcasting began in South Africa in 1923...
investigation after the release of the film quoted five people about the event:
- Tollie Lambrechts, a member of the transplantation team, said Naki "was definitely not in the operating room on that night."
- Dene Friedmann, a member of the transplantation team, said Naki "was not here that night, the only people here were the ones that would actually do the work. Hamilton never worked in the theatres. He wasn’t allowed to operate on a human being without a medical and surgical degree."
- Hickman said that Naki's being there was "highly unlikely."
- Naki’s youngest son said that Naki was "the one who took out the heart and gave it to Chris Barnard."
- The former wife of Barnard stated that Barnard "never mentioned Naki was there the evening of the first transplant."
Further reading
- Cheng TO. Hamilton Naki and Christiaan Barnard versus Vivien ThomasVivien ThomasVivien Theodore Thomas was an African-American surgical technician who developed the procedures used to treat blue baby syndrome in the 1940s...
and Alfred BlalockAlfred BlalockAlfred Blalock was a 20th-century American surgeon most noted for his research on the medical condition of shock and the development of the Blalock-Taussig Shunt, surgical relief of the cyanosis from Tetralogy of Fallot—known commonly as the blue baby syndrome—with Vivien Thomas and pediatric...
: similarities and dissimilarities. Am J Cardiol 1 Feb 2006;97(3):435−6. - Pendergast S, Pendergast T. Contemporary Black biography. Volume 63. Profiles from the international Black community. Detroit, MI: Gale, 2008. ISBN 9780787679354.
- Williams M. Black scientists & inventors. Book 3. London: BIS Publications, 2007. ISBN 9781903289990.
External links
- Hidden heart: the true story of the first heart transplant: Christian Barnard and Hamilton Naki. (Official site for the film.)
- Jonker-Bryce T. Our forgotten surgical pioneer. Daily Dispatch (South Africa) 3 August 2002.
- Jonker-Bryce T. Our forgotten hero honoured, at last. Daily Dispatch (South Africa) 20 June 2003.
- Mall AS. Hamilton Naki − a surgical sherpa. S Afr Med J Feb 2007;97(2):95−6.
- Pereira E. Transplant gardener. BMJ Careers 6 Mar 2004.
- Smith D. Film on black surgeon in first heart transplant team rekindles controversy. The Guardian 1 June 2009.
- South African History Online. Hamilton Naki 1930−2005.