Hamilton Naki: Innovator in the shadow of apartheid

Where and when was Hamilton Naki born?

Hamilton Naki was probably born in 1926 in the South African village of Centane (situated in today's Eastern Cape region). Since he was from a poor family, he was forced to start fending for himself at an early age. Hamilton Naki had a wife, four sons and one daughter. He died of heart attack on the 29th of May 2005. 

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What was Hamilton Naki's first job?

At the age of 14, after completing primary school, Naki went to Cape Town to look for work. He got a job at the University of Cape Town as a gardener. He was responsible for maintaining the tennis courts on the university grounds.

How did Hamilton Naki's career take off?

By 1954, he was working as a caregiver to laboratory animals. It was at this time that cardiologist and research scientist Dr Robert Goetz noticed that Naki had unique skills. He taught him to dissect animals and prepare them for surgery. Naki later became a technician in the research laboratory at the Medical School. With time he learnt how to perform transplants on animals in the laboratory. This is how he came to work with Professor Christiaan Barnard, the first cardiac surgeon to perform a human heart transplant. 

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Did Hamilton Naki perform transplants on humans?

No, he did not. Naki's career took off while apartheid was in full swing. As a Black he was not allowed to work in the Whites only operating theatre. In fact, black health care workers were by law forbidden to get into contact with white patients. Naki's contribution was in the preparation and research of novel surgical procedures.

How did Hamilton Naki contribute to the first heart transplant?

Hamilton Naki was not present when, on 3 December 1967, a surgical team led by Christiaan Barnard removed the heart from deceased donor Denise Darvall and transplanted it into recipient Louis Washkansky.

According to the Heart of Cape Town Museum, a museum established in honour of those who played a major role in the transplant, Naki's career with Chris Barnard started with performing anaesthetics on animals. His exceptional performance triggered his promotion to Principal surgical assistant of the laboratory. An article in the Royal College of Surgeons of England's Bulletin in 2014 states that, "Naki anaesthetized the dog for the earlier work in heart surgery in the laboratory which was on the establishment of open-heart bypass, using an external pump." In this sense, he was part of the team that paved the way for Barnard's breakthrough. 

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Various sources maintained that Hamilton Naki participated in the first heart transplant. How could these rumors spread?

While apartheid systematically covered up achievements by the country's black majority, the new South Africa brought with it the urge to uncover these injustices. Naki's career in the shadows reflected the stories of many black South Africans and was magnified through the years. After Hamilton's death on 29 May 2005, several renowned publications published his obituary stating that he took part in the first ever human heart transplant. The publications had to later publish retractions. In 2009, a documentary titled "Hidden Heart" also hinted that Naki's role might have been under-estimated. In recent years, family members expressed their indignation. Claiming Naki was the one who did the surgery, his son, Thembinkosi Naki, said, "That thing hurt him so much. Chris got all the awards, but my father got nothing."

How did Christiaan Barnard feel about Hamilton Naki's contribution?

In his later years, Christiaan Barnard was open about the high esteem he held for Hamilton Naki. In an interview with the Associated Press in 1993 he said, "If Hamilton had had the opportunity to perform, he would have probably become a brilliant surgeon." And in 2001, shortly before his death, he told the UK's Daily Telegraph that Naki became "one of the greatest researchers of the time in the field of heart transplants… He had better technical skills than I did, especially when it comes to stitching, and had very good hands."

Did Hamilton Naki receive any awards?

In 2002, former South African President Thabo Mbeki awarded Naki the Order of Mapungubwe in Bronze, an award given to South Africans who have made excellent achievement.

In 2003, he received an Honorary of Science in Medicine Degree from the University of Cape Town.

How does Hamilton Naki's name live on?

2007 saw the launch of the prestigious Hamilton Naki Clinical Scholarship. Inspired by Naki's career, the scholarship was established by the Netcare Physician Partnerships Trust to support disadvantaged South Africans to undertake high-level research. In the same vein, the National Research Foundation has installed the Hamilton Naki Award which honours individuals for achieving world-class research performance despite considerable challenges. In 2017, Salazar Plain in Cape Town, a public space situated opposite the Christiaan Barnard Hospital, was renamed after Hamilton Naki.

Scientific advice on this article was provided by historians Professor Doulaye Konaté, Professor Lily Mafela and Professor Christopher Ogbogbo. African Roots is supported by the Gerda Henkel Foundation.