By Rev. Lyndan Syiem
This is a sequel to my article on Hugh Gordon Roberts, the founder of the hospital at Jaiaw that bears his name and the primary fund-raiser and builder of the Dr. Norman Tunnel Hospital at Jowai. The subject here is Dr. Robert Arthur Hughes, who was born at Oswestry in 1910, exactly one hundred years after the pioneer, Thomas Jones (1810-1849). Those were the heydays of the British Empire and missionary activities were, frankly, an important part of the colonial project in India. Dr. Hughes however was someone who transcended the limited missionary circle of activities and distinguished himself as a surgeon and hospital administrator, as well as an influential public health adviser to the Assam government.
Oswestry town in England, 8 kilometres from the Wales border, had a large number of Calvinistic Methodists, part of the Welsh diaspora in the West England border counties. The Rev. Howell Harris Hughes ministered at chapels in Oswestry, then at Bangor, Liverpool and Llandudno; so little Robert Arthur and his twin brother, John Harries, had to change schools everytime their father was transferred to another pastorate. Arthur entered the Faculty of Medicine at the University of Liverpool in 1928, graduating in 1933 with a Gold Medal in surgery. Dr. R. Arthur Hughes had a brief but brilliant pre-missionary career, as house surgeon at the Royal Southern Hospital, Liverpool, as the John Rankin Fellow in Human Anatomy at the University, and as Surgical Tutor, Pathologist and Registrar at the David Lewis Northern Hospital.
Therefore, it was with great delight that the mission directors received an application for missionary service from the accomplished 28 year old. The Welsh Mission Hospital at Jaiaw had been established sixteen years ago in 1922, and now Rev. Dr. H. Gordon Roberts, the 53 year old founder, was looking for another surgeon to support him, and eventually succeed him as Administrator. As part of his preparation, Dr. Hughes received training in Tropical Medicine at the University of London, at the Radium Institute and at the Mount Vernon Hospital. It was a hurried departure as Arthur married Nancy Wright, a qualified nurse, on 7 January 1939, and they sailed for India on 28 January. Their only son was born in Shillong and he later also became a physician – Dr. John Hughes.
Upon arrival at Shillong, Dr. Hughes took charge of medicine and surgery, as Dr. Roberts concentrated on administration and the hospital’s expansion. World War II broke out in September 1939, and the Japanese Army invaded Burma in 1942. Dr. Hughes was posted briefly to Dimapur, treating wounded soldiers and civilians, before being recalled to the Welsh Mission Hospital. He also served as consultant at the Civil Hospital and Military Hospital in Shillong. According to Welsh historian, Ben Rees, Dr. Hughes treated 2,851 officers and soldiers from all over the world from 1942 to 1945, plus the hospital’s regular patients. Dr. Gordon Roberts retired in 1942 after 29 years of service, and Dr. Arthur Hughes took over as Senior Medical Officer and Administrator.
Dr. Hughes’ expertise enhanced the hospital’s reputation; patients included ministers and civil servants of the Assam government, tea planters from Upper Assam and Cachar, as well as members of Indian royal houses. These patients provided valuable income for the hospital and allowed cross subsidy for the treatment of the very poor, some of whom travelled over one hundred kilometres from interior villages. This is the financial model of successful mission hospitals like CMC, Vellore, which attracts the very rich with its world-class professional treatment while helping the very poor with its subsidized fees.
Dr. Hughes maintained Dr. Roberts’ standards of discipline, self-sacrifice and meticulous organization, standards that the hospital needs till today. Every morning began with devotion at 7.40 am, followed by visits to the wards, private rooms and administrative work. The OPD on Tuesdays and Thursdays continued till late evening, sometimes extending till 10 pm, as patients insisted on meeting Dr. Hughes. Surgeries on Mondays, Wednesdays and Fridays sometimes extended till 8 pm. Despite this workload, Dr. Hughes maintained a cheerful demeanour: “Just his smile was enough to alleviate half your illness!” (Old Khasi saying). Despite this schedule, Dr. Hughes found time for the ministry of his local church, the Jaiaw Presbyterian Church, of which he was elected as elder in 1944. To my knowledge, this is the only instance of a missionary serving as a ‘Tymmenbasan’ of a Khasi church.
While he had many Khasi doctors as colleagues in medicine, Dr. Hughes did not have long-term support in surgery. Dr. Stanley Russel served during 1942-1947, which allowed Arthur and Nancy Hughes to go on furlough after World War II. Dr. Norman Tunnell served at Jaiaw during 1951-1953, before moving to Jowai as the medical superintendent of the new hospital there. Dr. Peter Shave and other doctors came on short-term tenures.
Apart from regular procedures, Dr. Hughes also pioneered new areas of surgery. Ben Rees credits him with introducing Caesarean section before the days of antibiotics, improvements in general anaesthesia, innovative surgeries in the treatment of ulcers, and identifying ‘kwashiorkor,’ the protein calorie deficiency disease, as a major cause of childhood mortality and lifelong susceptibility to illness. Dr. Hughes’ approach included prevention as much as the cure – addressing public health challenges and identifying systemic causes of illness. He sometimes toured interior villages to conduct medical and statistical surveys on endemic diseases and experimented with preventive measures. Dr. Hughes discovered that among children over six months in Ri Bhoi, half had enlarged spleens due to endemic malaria; the high infant mortality rates were also due to dysentery, malnutrition, rickets, kwashiorkor, anaemia, goitre and other diseases and deficiencies.
He advised preventive measures to the government: change of diet, personal and home hygiene, clean drinking water and pro-active distribution of medicines against malaria and dysentery and vitamins to prevent rickets, anaemia and other deficiency diseases. Unfortunately, Dr. Hughes’ immense contribution to public health in erstwhile Assam has not yet been fully documented and recognized, being overshadowed by his formidable reputation as a surgeon. In 1947, the hospital received a large donation from the women of the South Wales Auxiliaries in memory of Margaret Buckley, the first matron of the hospital. Dr. Hughes bought and equipped a vehicle to serve as a ‘travelling dispensary;’ for two decades it toured the interior regions of the Khasi-Jaiñtia Hills, bringing medical treatment, preventive measures and public health awareness to villages.
The late 1960s brought changes in government policy that required all foreign missionaries leave North-East India. After 30 years of service, Arthur and Nancy Hughes left Shillong on 16 May, 1969. At the many farewell meetings, eyewitnesses recall the tears and eulogies for Dr. Hughes and the other missionaries. Back at Liverpool, the vastly-experienced 59 year old joined the University’s Faculty of Medicine. In 1984, Dr. Hughes returned for a brief period to the Roberts’ Hospital. In 1991, he and some former missionaries attended the KJP Synod’s 150th Anniversary Celebration, where we were privileged to meet him.
In 1992, Dr. Hughes was honoured by the Presbyterian Church of Wales with the position of Moderator. In his later years, Dr. Hughes suffered from heart illness and gave up medical practice although he continued church ministry. He died at Liverpool on 1 June, 1996. At the funeral, Roberts’ Hospital was represented by the then medical superintendent, (L) Dr. Pherlok Lamare, whose own dedicated service as a surgeon endeared him as the Dr. Hughes of my generation.