Dreaded word - cancer
By Young Hoy Kim Kimaro
.jpg?w=728)
When Florence K showed Dr. Makupa, her family doctor, a canker sore on her tongue that had been bothering her, he called in a dentist who called on Dr. Nduka, the most seasoned of dentists in Moshi. Dr. Nduka immediately dispatched her Florence to Muhimbili hospital in Dar es Salaam for diagnostic tests. It’s there that she heard the dreaded word, “cancer.”
Yes, she could be operated on at Muhimbili hospital. But if she is, she will lose a good part of her tongue and, with it, her ability to speak for good because they are not able to give her reconstructive surgery in Tanzania.
“Go to India if you can,” the lead doctor advised her, and go quickly because squamous cell carcinoma is aggressive. It spreads fast.
Florence is a medium scale farmer. On a few hundred acres of farmland she grows maize, bananas, oranges, and papayas and raises cows, goats and chickens. Her farm has done well. But borrowing from a bank would be a lengthy process; her health insurance won’t cover treatment abroad. Her parents who retired from international organizations stepped in to underwrite her medical expenses.
Within days she was off to Apollo Hospital in New Delhi, India. She arrived Friday morning. She underwent tests the very same day. Tuesday morning she was operated on.
Over six hours a team of three doctors removed the affected part of her tongue plus some healthy tissue surrounding it. They removed 22 lymph nodes nearby, then immediately proceeded to reconstruct the tongue with skin tissue harvested from her thigh. A minor corrective surgery a few days later and all was done.
No chemotherapy or radiotherapy was called for. All the lymph nodes removed had not been affected. She was discharged a week later with antibiotics for five days.
For just five days? Back home, in Tanzania, Florence was used to antibiotics for 2-3 weeks, even for minor ailments. Your body has a capacity to do a lot of healing, Dr. I.P Singh at Apollo Hospital assured her. Let it do its work. A week later, rolls of gauze stuffed below her tongue were removed.
A notebook and a pen by her side were her chief means of communication. The swelling on her tongue began to subside. Soon there were pinching and tingling sensations on her tongue. She imagined nerves growing and reconnecting. Good! From her third week, she began to form words haltingly.
Back home in Tanzania, she followed a regimen of three monthly then six monthly check-ups. Dr. Nduka personally kept a sharp eye on her progress. Every check-up was positive.
Her tongue had good days and bad. She kept on talking. When she got stuck on a word and couldn’t get it right, she would burst out laughing and try it again and again.
Two years after the operation, Florence was sent off again to India for a check-up. There too, doctors found her clear of the dreaded squamous cell carcinoma.
Then she mentioned a mild, annoying skin irritation on her back which had been with her for years. She showed her doctors. Perhaps there was an ointment which would help heal it?
Instead of an ointment she landed a biopsy. The biopsy revealed Hodgkins lymphoma. No, this wasn’t because of the squamous cell carcinoma. This problem had preceded it.
Florence’s spirit sank. Of all cancers, Hodgkin’s was one of the easiest to treat and manage, her doctors reassured her. Florence heard about a family friend whose father who was in his 60s when he was diagnosed with Hodgkin’s. Now a 91 year old, he is still going strong. Everything she heard and read about Hodgkin’s were along the same lines.
Twelve rounds of chemotherapy over 6 months were prescribed. She returned home to Tanzania taking one precaution, however. She traveled back from India with as much of the medication she would need for her chemotherapy.
As far as she knew, there was only one hospital that treated cancer in the whole of Tanzania of 50 million people.
“Congestion” would be an understatement for the hospital. There, patients overflow from the waiting hall and through the corridors. Undertrained and overworked nurses are impatient. They have no energy (nor inclination) to give patients individualized attention. Patients wait endlessly to be called in for blood tests, to see a doctor, for their turn to be treated. Their treatment schedules slip for days. Often the hospital runs out of drugs.
She knows it all too well. She frequented the hospital when she was taking care of a cousin who had breast cancer. To this day she believes the radiotherapy which was given to her cousin for five consecutive days hastened her cousin’s early demise.
She and her parents searched for alternatives. Aga Khan hospital in Nairobi, Kenya, has a good reputation and is actually closer to Moshi than Moshi is to Dar es Salaam. That should be less taxing physically.
Meanwhile, there was some surprising news. A new Oncology unit opened last September at the Kilimanjaro Christian Medical Centre (KCMC) in Moshi. “Go and see it for yourself,” urged Dr. Makupa. Her parents checked it out. It was promising. The place was brand new. The small unit is run by two doctors, one German and one Tanzanian, and a horde of nurses.
This week Florence will be getting her 4th treatment at the KCMC Oncology unit. She feels very lucky to receive treatment just minutes from her parents’ home.
The infusion room at the Oncology unit is bright with windows all around. Reclining chairs for about a dozen patients are placed along the windows. A nurse’s station stands at the center commanding a 360 degree view of the room.
Patients chat and encourage each other. At her previous chemotherapy session Florence heard about a “miracle juice” from a fellow patient. The juice made from beetroot, carrots and apple, ground together, delivers an abundant dose of vitamins. Florence believes that that’s what’s giving her this burst of energy and high spirits.
The writer resides on the slopes of Mount Kilimanjaro in Tanzania. She worked for the World Bank for nearly 30 years and her email is youngkimaro@gmail.com.