How politics influenced the first human heart transplant

Around the 50th anniversary of the first human heart transplant, people are once again fascinated by this event and the extraordinary life of the heart transplant pioneer Chris Barnard.

By Marina Joubert

3 December 1967 will forever be marked as the day when South African surgeon Chris Barnard astounded the world by becoming the first person to transplant a human heart. The historic surgery captured the world’s imagination and was hailed by 20th-century historians as on par with the moon-landing in 1969 in terms of its social and scientific significance. During my research into this defining moment in medical history, I was reminded of how different things were in my home country at that time.

In 1967, South Africa was in the midst of its apartheid regime that lasted more than 40 years. The country’s policies of segregation along racial lines extended into its health system. There were separate hospital wards and services, including separate ambulances, for black and white patients. Black doctors and nurses were not allowed to tend to white patients. South Africa was loathed by the world and Cape Town was considered as part of the medical backwater at the time. Under these conditions, it would be understandable if Barnard would accept an offer to stay on at the University of Minnesota after completing his Ph.D. there in 1958. But, with a wife and two young children waiting in South Africa, he returned to his home country to establish a cardiac surgery unit at Groote Schuur Hospital.

Noticing Barnard’s passion for research into open heart surgery, one of his US mentors, Professor Owen Wangensteen, donated a heart-lung machine that Barnard could ship back to South Africa, as well as a generous research grant of $2 000 dollars per year for three years. This allowed Barnard to start experimenting with heart transplants on stray dogs brought in from the city pound and to gain the expertise and confidence that was needed in order to proceed to heart transplants on humans. With the heart-lung machine, Barnard was able to perform the first open heart surgery on the African continent in 1958. The same heart-lung machine was used in the donor theatre during the first human heart transplant.

Barnard spent many nights and weekends in the animal laboratories at Groote Schuur Hospital and built up a strong technical team around him. Hamilton Naki, a former gardener at the hospital, became so skilled at heart transplants that he could eventually transplant dog hearts without any assistance from Barnard. Naki demonstrated dissection and surgical procedures to a long list of trainees who eventually became surgeons. However, because of his skin color and lack of formal qualifications, Naki was not allowed to assist in the hospital’s operating theatres. He was not part of the team that transplanted the first human heart. In fact, due to the country’s politics, there were no black doctors, nurses or technicians in the heart transplant team featured on the front page of the Cape Times on 4 December 1967. Also missing in this photo is Chris’s brother Marius, an integral member of the transplant team, who opted to go to church that Sunday morning when the surgical team was called to the hospital for this photo.


The issue of race, however, was a determining factor in the first heart transplant. Ten days before the transplant would eventually take place, a heart from a black person was available. Barnard was keen to proceed, since the patient identified to receive a new heart – the 53-year old Louis Washkansky – was desperately ill and struggling to breathe. However, Barnard’s superiors insisted that both the donor and recipient in the first heart transplant would be white, since they feared being accused of experimenting on black people in a country where black people were politically and socially oppressed.

When a registrar at Groote Schuur Hospital called Barnard on the afternoon on 2 December 1967 to inform him that they may have a suitable donor and confirmed that she was white, Barnard knew it was time to head to the hospital.

The 25-year-old Denise Darvall and her mother Myrtle were crossing a street outside a Cape Town bakery when both were hit by a speeding car. Myrtle died instantly and Denise was rushed to hospital with severe brain injuries. Denise’s grieving father consented to donating her heart, unaware of how it would immortalise his daughter’s name in medical history. The surgery was performed during the night, marking 3 December 1967 as the historic date of the operation. There were many tense moments as the intricate surgery continued through the night and much relief when the donor heart finally started beating normally.

No one could foresee the media avalanche that would hit Barnard and key players in the event. It was unlike anything seen in this part of the world before where the government had a strong hold on the mass media and television would not be introduced until 1974. Years later, Barnard famously said: “On Saturday I was a surgeon in South Africa, very little known. On Monday, I was world-renowned.”


Barnard’s medical milestone was a propaganda coup and the government seized the opportunity to improve South Africa’s image around the world. But, Barnard did not always toe the line and his anti-apartheid views infuriated politicians. Similarly, his insistence on a single intensive care ward for his black and white cardiac patients led to clashes with his superiors at Groote Schuur hospital.

The media hysteria surrounding Barnard continued for many years, with enthusiastic reporters keen to interview him wherever he went, and large crowds of fans waiting to see him when he arrived at airports. Barnard responded enthusiastically to his new celebrity status and quickly built up a reputation as a showman and Casanova. Despite his hectic travel schedule and numerous appearances around the globe, he continued doing pioneering work in cardiac surgery and made huge advances in the intensive post-operative care of cardiac patients. He also became known for operating successfully, and for free, on children with congenital heart defects at hospitals and clinics around the world.

Read the full article: '1967: Reflections on the first human heart transplant and its impact on medicine, media and society' http://journals.sagepub.com/doi/full/10.1177/0963662517738619


Marina Joubert is a science communication researcher and lecturer at CREST. After working as a science communication manager and consultant for two decades she joined Stellenbosch in January 2015 where she launched the first online course in science communication in Africa. 
Marina serves on the scientific committee of the global PCST  network and the editorial board of Science Communication, as well as the editorial board of the online, open access Journal of Science Communication.

2 comments:

  1. Still one of South Africa's greatest science moments - thank you for sharing it.

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  2. It is a pleasure - glad you enjoyed it! You may also enjoy this - https://theconversation.com/how-an-historic-heart-transplant-created-a-celebrity-scientist-50-years-ago-88277

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