Categories
Medical Zambia

Renewing Old Friendships

Last week, young Desmond (see a previous blog Desmond Doktah), saw me in the doctor’s vehicle negotiating the muddy potholes of the street outside the police station which leads to the clinic. He hauled himself up onto the running board and grinned at me. I grinned back. I had heard that he had been unwell, but he looked fit and healthy. He said that he would come for a consultation with me at the health centre during the school holidays.

I enjoy re-establishing links with people whom I have met or treated in my two previous missions here in Kakumbi. Of course, the doctor has a high profile, and everyone recognises the doctor’s car, even if they confuse me with another male muzungu doctor.

Occasionally, I will see my writing in someone’s health records, a cheap school exercise book and it strikes a chord. Or at least, I can see how I was thinking about the clinical problem at the time.

Most of the health centre staff are new to me apart from six: Jesse, the cleaner and register keeper, Erina and Margaret, who help in the mother and child health block, Celestino and Mike who are community HIV support workers, and John Mbewe who is the enrolled nurse in charge of HIV care.

John Mbewe vaccinating while wearing his waistcoat “Champion Against Open Defaecation”

Daillies, my former translator, and Helen, who was so skilled at handling hysterical patients using the power of Jesus, both work at the Airport Clinic now. Chanda, who volunteered at Kakumbi for ten years without pay, now has a post at the district HQ in Mambwe. Mr Chulu has taken over as environmental health officer at Kamoto District Hospital. I have met them all again (apart from Helen).

Maurice, another one of our volunteer community health workers, weighing babies

Dr Mashanga, my supervisor at Mambwe District, warmly welcomed me back to the Valley and promised to get me the additional drug supplies to enable me to treat patients with mental illness, asthma, hypertension and diabetes. We now have atenolol, nifedipine, metformin and glibenclamide in stock at Kakumbi.

I also visited Caroline Mwanza, the District Commissioner. I could see her outside her office, under the shade of a magnificent tree. I waved at her and she cocked her head onto one side, wondering who on earth this old muzungu could be, coming to greet her. Then her face beamed into a smile as she recognised me. We hugged and embraced each other before she marched me off to her air-conditioned office for a long chat.

It’s great to be appreciated and greeted so warmly by everyone. Zambians are so friendly (and so are the expatriates living here).

Categories
Kenya Medical

Suicide

Maggie was painting the inscription on the wooden cross which would mark the grave of Francis Thumbi. In the obituary columns of the newspaper, people eschew “Born” and “Died” for the terms “Sunrise” and “Sunset”. She was waiting for the family who had commissioned the casket to confirm the exact dates. “Well, sunset is going to be 2018, isn’t it?” I asked. She laughed and agreed with me. “I think he was born in 1990,” she said. “And do you know how he died?” I asked. “Yes, it was suicide. He killed himself, aged 28. He was not even married.”

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I said that in England many years ago, people who committed suicide could not be buried in consecrated ground, in a churchyard. “Why is that?” she asked. “I suppose because it is against God’s law to kill yourself.” “Then you should burn the body,” she said. “Here, he will go into the ground in this casket, under this wooden cross.”

“When I die, I have asked that my body should be used for medical science. They will take it so medical students can cut me up and learn anatomy,” I said. “Waaaah!” said Maggie, “We would not do that here in Embu.”

I turned to scrutinise the coffin. She proudly showed me her handiwork. There was a metallic sign saying “RIP” above a small inspection panel, with a fancy metal knob. I pulled it down and looked inside. The casket was lined with pale blue shiny cloth. There was also what looked like a pair of pants, which Maggie whisked away before I could make a positive identification.

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I asked Maggie if she thought that being married might have helped prevent Francis from killing himself. She said it might have, but there were too few women around to marry here in Embu. I begged to differ. “There are many nice Kenyan girls here,” I said. “What about you, Maggie, are you married?”

“No, do you want to marry me?”

“I don’t, Maggie. I am too old for you.”

“Age doesn’t matter. Do you want me?”

“We hardly know each other!”

“Well, take me with you to Japan,” Maggie said.

“But I am from England,” I replied

“No matter, England is better,” she said. “If you won’t marry me, then sponsor me.”

“I can’t do that, Maggie. I am a volunteer working here in Embu.”

“What is your work?”

“Mimi ni Daktari,” I said.

“Then you have plenty of money to sponsor me!”

I heard gales of laughter coming from the neighbouring corrugated iron shack, a hair salon. Obviously, they were enjoying eavesdropping on our conversation.

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I tried to change the topic of conversation. “Is this funeral shed your business?” I asked, hoping she would say yes.

“No, I just work here. The business is called Leemak,” she replied.

“Lee Mack is a comedian in my country,” I said.

“What?”

“Never mind”, I said. “Can I take your photograph with the coffin?”

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She refused but invited me to take photographs of the coffin. As I did, I noticed some of the white paint used on the cross had dripped onto the metal rail at the side. I tried to rub it off, but Maggie said she would use some spirit to clean it all up.

She went inside the shed and I took my leave, saying, “Faida – goodbye.”

As I walked away, I wondered about poor Francis who had killed himself. In last weekend’s newspaper, there was an article about a schoolboy aged 15 who committed suicide after his family failed to pay his school fees and he was turned away.

Our project here may well expand to cover mental illness. We already have anti-depressants and anti-psychotic drugs on standby in our store. I know that there have been successful primary care psychiatric projects in Uganda and Tanzania, so I am optimistic it could work well here in Kenya. And we might be able to help prevent young men like Francis and the schoolboy from taking their own lives in future.