By Paul Alexander Wolf 🇦🇺

There are places whose stories run deeper than the walls that frame them. Elim Hospital is one of them, shaped by more than a century of hands, voices and quiet acts of endurance. It was born in 1899 through the resolve of Georges Liengme, a young Swiss doctor whose education had been paid for by the mission boards of the Free Church of Vaud. He built the first hospital in the Transvaal through war, famine, malaria and poverty, and in doing so created not just a building but a refuge. Patients arrived from far away because it was a place where suffering was met with skill and compassion, where the mission ethos and medical service grew side by side. The early Swiss missionaries and the communities of the Elim-Waterval area built something that became more than an institution. It became a shelter, a school, a place where mothers could deliver safely, where soldiers sought peace, where those who no longer fit in their families found sanctuary. Elim became a microcosm of South Africa long before anyone called it that.

Into this lineage was born Pierre Henri Jaques in 1928. His grandparents and parents had served at Elim before him. His father founded Lemana School. If Liengme was the beginning, Jaques was the continuation, inheriting not a title but a moral thread woven through generations. He grew up between Swiss missionary values and the rhythms of the northern Transvaal countryside, and later carried that fusion into King Edward School and Wits. When polio struck him in his first year of medical school, leaving him with a limp he would carry for life, it did not diminish him. It revealed the character with which he would serve. He trained further in surgery in the United Kingdom, and when he could have stayed abroad, he chose instead to return to the place where he had been born.

In 1964 he succeeded his uncle, Dr Jean Rosset, as Superintendent of Elim Hospital. For nearly three decades he led it through shifting political landscapes, changing administrative structures and the deep transitions of the homeland era. Under his leadership Elim grew into an institution of regional significance: a 660-bed hospital, a renowned eye unit, a nursing college, and outreach clinics reaching deep into the rural north. He guided it not with rhetoric but with steadiness, the kind that holds its shape under pressure, the kind that becomes a quiet pillar for others.

I met him only twice, yet even in that brief contact I understood the measure of the man. At the time I was working at Siloam Hospital, which is in the Venda region, serving in its outer clinics at Madombidzha, Tshilwavhusiku and Kutama. The work mattered to me deeply, but Siloam was under strain. Resources were stretched thin, the administrative burden was heavy and the broader political currents of the time pressed into the hospital in ways that were difficult to name but impossible to ignore. There were strikes at Siloam too – often initiated by hard-liner ANC members both within and outside the hospital – and although the clinics remained standing, the entire structure felt as though it was carrying more weight than it could bear.

I drove to Elim with a conflicted heart. My wife was unwell. My desire to continue serving in the region stood in tension with the responsibility I carried for my family and the unspoken loyalty that binds mission doctors to their colleagues. You do not walk away when things are difficult. Yet sometimes life forces choices no one prepares you for.

Pierre welcomed us warmly even though we had never met before. There was no hesitation in him, no guardedness, only a quiet generosity that felt both natural and deeply rooted. After a brief conversation he extended an invitation that surprised us by its openness: to join him at his home for coffee and scones. His wife was present when we arrived, gracious and attentive, and the atmosphere in their house carried the gentle weight of a life lived in service. It was his free Sunday afternoon, yet he gave us a fair part of it without any sense of hurry. One of the doctors was working peacefully in her garden outside, as if Elim moved at a slower, older rhythm. The place felt almost historical, as though the walls remembered every decade of the hospital’s story.

It was there, in that quiet setting, that he made the impression he would leave on me for life. His simplicity, steadiness and quiet depth made me want to continue at Elim Hospital. It felt like a place where one could root a life of service. But loyalties in a human being like me are rarely simple. The pull to remain in Limpopo, the duty toward my colleagues at Siloam, the responsibility to my unwell wife – none of these could be resolved in one direction without breaking something else. The decision to return to the Netherlands was not made in that moment, but it was accepted there. And acceptance is sometimes the heavier act.

Years later, when we were living in Scotland, the question returned. Gert Maritz – then Medical Superintendent of Elim Hospital – visited us. We had known each other from Siloam, part of that close-knit group of rural physicians who carried different responsibilities but understood the same pressures. He told me simply that there was room at Elim, that the option to return was real. But he also told me that the Elim he now led faced storms of its own. Strike after strike. Periods of unrest. The unsettled tremors of the post-apartheid transition pressing hard against a mission-rooted institution. In a short span he had endured pressures that even Pierre Jaques, in his long tenure, may not have confronted with such intensity.

He advised against returning – not because the work was unimportant, but because the conditions would not allow the kind of stable, grounded service that rural medicine requires. And so the door closed again – not out of lack of calling, but out of realism.

After his retirement in 1993, Pierre continued teaching, examining, writing and supporting rural doctors across South Africa. He carried the mission ethos into modern structures, advocating for the dignity of rural patients and the doctors who served them. When he died in 2007 in Blairgowrie, Randburg, there were no national headlines. But those who understood rural medicine knew what had been lost.

Pierre Jacques belonged to a different generation of rural doctors, but his retirement told a different story from that of mission colleagues. Where Evert and Leida returned to the Netherlands with no pension fund, no state superannuation, and almost no financial recognition for forty years of service, Pierre left Elim under the structure of the South African public service. His decades as medical superintendent were carried within the GEPF system, and when he retired, he did so with the stability that comes from being held by a system – not forgotten by it.

It is not a judgment, only a truth: two men gave their lives to rural medicine, but the ledger of history did not treat them equally. Pierre’s ending was shaped by policy and payroll; Evert’s by calling and sacrifice. Yet both carried the same weight of responsibility, and both held hospitals together long after they should have collapsed. The difference lies not in the value of their work, but in the cost they personally bore. Pierre stepped into retirement supported. Evert stepped into retirement stripped of everything except dignity, faith and memory.

If anything, this contrast reminds us that the cost of service is uneven. Some are carried by the system; others carry the system on their backs. And still they serve — not for reward, but because healing people in forgotten places is not a profession, it is a decision of the heart.

Today Elim stands at a crossroads. Its infrastructure is crumbling. The mortuary has failed more than once. Boreholes have dried up. Patients wait in corridors a hundred metres long. Theft has stripped the old mission museum. Technicians struggle to keep essential systems alive in heat that overwhelms outdated machinery. Committees meet in Pretoria. Leadership programmes are launched. Workshops are planned. A new hospital is promised, then delayed, promised again, then delayed. And through these cycles the deterioration continues.

But beneath the decay lies something that has not yet died: the legacy of those who carried Elim through the hardest decades. The memory of people like Liengme, Rosset and Jaques remains the true foundation on which the institution still stands. Their steadiness allowed Elim to survive scarcity, politics, upheaval and change. Their lives are reminders of what service once meant here, and what it can mean again.

The story of Pierre Henri Jaques matters now not as nostalgia but as clarity. He embodied the kind of leadership that does not seek applause and does not chase titles. He led by standing firm. He served by returning to the same dusty ground year after year. He held the centre when lesser spirits might have walked away.

Even brief encounters with him revealed something essential:

greatness in rural medicine is not loud.

It is faithful.

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Epilogue – The Bend in the Road

In writing about men like Evert Helms and Pierre Henri Jaques, I found myself returning to an old, private question: whether their endurance was simply greater than mine. They stayed through decades of scarcity, unrest, and political tremors that shook entire regions. They held the line when lesser spirits might have stepped back. It is easy to look at such lives and imagine a different kind of strength – deeper, steadier, forged in some interior place we never fully see.

But life, I have learned, is not a contest of resilience. It is a negotiation of responsibilities. And the hardest decisions are often the ones made not in hospitals or boardrooms, but in our own homes. My road in Limpopo bent when my wife fell ill. The outer clinics at Siloam still stood; the colleagues I admired were still there; the calling to serve had not dimmed. But unity at the home front was shifting, and the body cannot be divided against the heart. Leaving was not a failure of commitment. It was the form love took when circumstances made staying impossible.

The road home to Europe felt abrupt, almost undeserved. And yet, looking back from the quiet distance of years, I see that bend for what it was – not an ending, but an enforced pause, a safeguard drawn by something wiser than my ambitions. Life has a way of protecting us even when we resist it.

What astonishes me is that the pull toward rural medicine never dissolved. It softened, then steadied, and eventually settled back into the shape of possibility. The children grew up. My wife, through her art and creative work, rebuilt her health in ways that neither of us foresaw during those difficult days. And now, at seventy, the landscape of Limpopo calls again – not with urgency, but with recognition. The kind of recognition that comes when an unfinished promise waits patiently for the season to return.

In that sense, Pierre and Evert never left my life. Their endurance became a compass, not a comparison. They showed that service is not measured by how long one remains, but by whether one stays true to the thread that first pulled the heart forward. And sometimes that thread, tugged by love, responsibility and time, loops back to where it began.

A bend in the road is not the breaking of the journey. It is simply the way love redraws the map.

And sometimes, much later, the dust rises again – and the road opens, quietly, as if it had been waiting.