Hamilton Naki was a laborer who became a self-taught surgeon of such skill that Dr. Christiaan N. Barnard chose him to assist in the world’s first human heart transplant in 1967 in Cape Town, but whose contribution was kept secret for three decades because he was a black man in apartheid-era South Africa, died on May 29 at his home in Langa, near Cape Town. The transplant, which took place on Dec. 3, 1967, at Groote Schuur Hospital in Cape Town, made medical history. Dr. Barnard began to acknowledge Mr. Naki’s work only after the end of apartheid in 1991. In an interview shortly before his death in 2001, he called Mr. Naki « one of the great researchers of all time in the field of heart transplants. »
Mr. Naki, who left school at 14 and had no formal medical training, spent five decades working at the University of Cape Town. Originally hired as a gardener there in about 1940, he acquired his formidable surgical skills through years of silent observation and covert practice at the university’s medical school. He retired in 1991. In 2003, the university awarded Mr. Naki an honorary master of science degree in medicine.
Although South Africa’s apartheid laws forbade blacks from performing surgery on whites, Mr. Naki’s skills were so esteemed that the university quietly looked the other way. He worked alongside Dr. Barnard for decades as a lab technician, perfecting his craft and assisting in many operations on people. Operating on animals, Mr. Naki also taught surgical techniques to generations of medical students. Mr. Naki learned to anesthetize animals, and eventually to do surgery on them, operating on rabbits, pigs, dogs and even a giraffe. Many of the animal surgeries he performed, including coronary bypasses and heart and liver transplants, helped to perfect techniques that were later used on humans.
« Hamilton Naki had better technical skills than I did, » Dr. Barnard said in an interview quoted in The Daily Telegraph of London this week. « He was a better craftsman than me, especially when it came to stitching, and had very good hands. »
But because of his race, Mr. Naki’s role in the world’s first heart transplant remained unknown for years. On Dec. 2, 1967, Denise Darvall, a young white South African woman, was hit by a car as she was crossing a Cape Town street. Taken to Groote Schuur Hospital, she was declared brain-dead. Her family gave permission for her heart to be transplanted into the chest of Louis Washkansky, a 55-year-old grocer whose own heart was failing.
As a black man, Mr. Naki could not operate on Ms. Darvall even after she was dead. But Dr. Barnard so prized his ability that he drafted him as a member of the team that would lift out her heart.
In a painstaking operation lasting many hours, Mr. Naki’s team removed Ms. Darvall’s heart, washing it repeatedly to cleanse it of her blood before introducing some of Mr. Washkansky’s. On Dec. 3, Dr. Barnard transplanted the heart into Mr. Washkansky, who lived for 18 days before dying of pneumonia. Hamilton Naki was not allowed to appear on photos with the team. If he accidentally got on a picture, the hospital said he was with the cleaning service, making him a secret surgeon. During his years at the university, Mr. Naki lived on the outskirts of Cape Town in a one-room shack without electricity or running water. When he retired, he was paid a gardener’s pension, far less than a lab technician’s. In 2002, Mr. Naki was awarded the Order of Mapungubwe, one of South Africa’s highest honors, for outstanding contribution to medical science.
In an interview with The Guardian of London in 2003, Mr. Naki expressed little bitterness about a lifetime spent working in the shadows. « I was called one of the backroom boys, » he said. « They put the white people out front. If people published pictures of me, they would have gone to jail ». Hamilton Naki died in 2005.