I’m afraid you have cancer (2008)

I got to tell someone yesterday he has cancer – that was a first for me! I assumed he knew when he showed me his medical records but he is blind and his family illiterate and the medical system here doesn’t seem to be advanced enough to actually verbally inform you of a disagnosis.

John is around 40, his wife is also blind and he has 3 children, the eldest of whom is around 12. He is the only English speaker in the blind rehab centre (a community of 11 families who live and farm in a small compound) but when I arrived in Buigiri he was in a hospital in the neighbouring region where he is initially from and where his extended family are still based. I heard he had a wound on his head and assumed he’d fallen over, as is the common cause of injuries amongst the blind here. I later heard his wound was natural and his sister had had the same problem, so naturally cancer came to mind.

He discharged himself from hospital last week and returned to his family in Buigiri. The following morning he came to my house. We’ve always got on well – he is an intelligent man and I often use him as something of a contact within the centre. He told me his discharged himself for two reasons, firstly his extended family were having difficulty supporting him (all they had to do was supply him with food and bandages) during his month stay in hospital, and secondly word had gotten to him that I was back in Buigiri and he was worried that he would miss me if he stayed there. I didn’t quite know how to deal with that infortmation. He was a fool for discharging himself, but so be it.

He has a cancerous ulcer in the skin atop his head. When he first arrived in hospital it had been untreated and when the nurse scraped away the dead skin various insects dropped out. Since his return to Buigiri it has become infected once again as he does not have the resources to get to the nearest clinic, let alone to pay for the Hydrogen Peroxide and bandages the wound requires. It stinks. I tried to stay upwind of him, but when the wind changed I struggled not to retch.

The guy who runs the centre is trying to disown John as he doesn’t want to take responsibility for his treatment. He is claiming that John isn’t an actual member of the centre, rather he is there as the husband of his blind wife. Not only has he been a resident there for 13 years, but he has also been a chairman – a position only attainable by members of the centre. Kenneth, who runs the place, recently had £2,500 spent on his own medical treatment by the centre’s UK based benefecators. He was grumbing to me yesterday about having already spent £7 on John and he was unwilling to spend more.

The centre has a car, donated by a school in the UK. The main purpose of the car is to take members to the hospital in Dodoma when they are ill. This has in the past included everyone resident in the centre, but Kenneth is refusing John help, insisting his family must take responsibility – a family who have zero resources whatsoever. I managed to secure a compromise whereby John is hitching a ride with Kenneth when Kenneth uses the car to come to town for personal reasons on Monday. I’ll come in with him as hopefully the presence of a white person should ensure he gets better treatment in the hospital. Currently his only medical advice is to change the dressings each day and to use the Hydrogen Peroxide to remove the dead skin. This in no way helps cure the problem. To the best of my knowledge there is only one place in the country equipped to deal with cancer and that is 350km away in Dar es Salaam. We’ll see what the doctor says on Monday and then go about sorting something out in Dar. In theory if he can get there, then the medical treatment is free for people like him. Kenneth will no doubt refuse to give him the pittance for the bus fare, even though he receives funds from the UK for eventualities such as this. An added problem is that John would need a sighted person to accompany him and as his wife is also blind and his children too young, there are no obvious candidates. Plus his guide would need accomodation and food whilst in Dar.

I think it is a bizarre situation when someone doesn’t receive medical treatment not cos the hospital refuses it on the grounds of finance, but because they can’t even afford the bus fare to get to the hospital in the first place! Hopefully we’ll get something figured out though.

John