He was barely alive, if you can call it life. The energy acquired by each breath was just enough to take the next one. His head bobbed back and forth as he breathed almost ready to detach from his wasted, skeleton like frame. He was the first in a line of 5 patients that day with whom I would share the cursed word ‘cancer'. The other 40 or 50 waiting outside would not hear that word today.
That word has no real equivalent in Swahili. That is to say, I cannot explain to someone what it means to have some cells in the body grow without regulation or reason. I use phrases like ‘kidonda kibaya' which literally means ‘a bad sore'. I say that this bad sore has grown from the bottom of your big toe (for example a melanoma) and has spread to your bowels, lungs and even brain (which is not uncommon in this particular kidonda kibaya). That is literally from head to toe.
This is hard reasoning for the literate and learned. Imagine how it sits with a person who recognizes two diseases and two diseases only. For most people it is either malaria and typhoid or typhoid and malaria. I guess there is some variety. They have been treated for these two illnesses for days, weeks, even months and years before they come to see me. The blood in their stool, urine, breast nipple or phlegm has been diagnosed over and over again as one of these familiar illnesses for ‘a long time'. That is the typical part of the history when asked, ‘just how long have you been vomiting blood?' The answer is ‘kutoka zamani', meaning, for a long time.
When they arrive at the surgical clinic, it is not unusual for my patients to come with a large envelope full of x-rays ‘kutoka zamani'. Likewise there a bits and pieces of dirty scraps of paper, CT scans, ultrasound pictures, fine needle biopsy reports, letters of introduction with official stamps, seals and fancy letterhead. By the time they have spent their life's savings (literally sold the farm or better yet barren fields), they have nothing left to pay for the necessary and most often palliative care. They have been hampered by hope. The physicians either string them alone for cash, or literally have no idea what the diagnosis is. However, rather than say ‘sijui' (I don't know) or ‘uende pengine utubiwe', go somewhere else to be treated, the physicians and surgeons choose to offer hope when there is none.
Culturally it is either rude or evil tell people bad news, so it is easy to hide behind cultural sensitivity and hamper with hope. No one gets hurt. The disease is already well advanced. Typhoid and malaria medicines are cheap. They want to be treated. Besides I need the money.
This kind of hope can hamper. It is best to offer hope that helps and heals. That is what I offered the man whose head was bobbing back and forth. I was afraid he would expire in my office, so I hurriedly called in the family for counsel and consolation. I told them the truth. I told them this man their father, husband and grandfather was dying. I told them he needed to get his affairs in order over the next several hours, maybe day or so. I confessed that I had nothing to offer him and it was easy to take the last coins in the pockets of his dirty, threadbare pants to pay for more useless tests. I then told them that there was hope for a better life. That life was soon to come for him.
They confessed they did not know of such hope. I told them about Christ. It was a lot to lay on people in less than fifteen minutes. The others waiting outside the office were wondering why I was taking so long with this one case. They had important issues too. As for this family, I am sure they did not have any idea of what I was saying. Kidonda kibaya was still brewing in their heads. They were still hampered by the hope there was a cure to come. They left my office, angry, confused and thinking ‘daktari huyu ni mjinga' (that doctor is a fool).
They were very accustomed to being hampered by hope. I pray that they would come to know that one hope can help and heal. That hope is in Christ alone.