In Sickness and In Health

B, our part-time cook, has his wife and most of his children in the village in Western Kenya, hours and hours away from us, in Nairobi.  So I was particularly worried when on a Monday he told me he'd be going back to the village at the weekend, as his wife had been taken ill with anthrax.

Anthrax?  OMG.  Pictures of those unfortunate archaeologists who broke into the Egyptian pyramids, biological warfare and very very rapid unhaltable onset.  

'Go now, go now, don't wait for the weekend, here's your coat,' I urged.

And I think he read from the whites of my eyes and involuntary recoil, that maybe we needed to delve a little deeper.

Aching joints, severe pain, sudden inability to do jobs around the house. 'Arthritis?' I offered tentatively?  'Mmm yes, I think that's maybe what she said.'

He decided he would wait till the weekend, and travelled 8 hours by bus to offer her support.  And brought her, painridden, back to Nairobi by bus on Monday. 

Tuesday at work he's clearly very preoccupied. We search together on the internet for the symptoms of arthritis, possible ways to alleviate through diet, and possible equipment he could maybe get a local fundi to knock up, to help her to manage more independently at home. 

'I'm taking her to a doctor in Nairobi tomorrow,' he said, 'those rural doctors in the the clinic, they're just in it for the money, I want to be sure.'

Wednesday, he's at work, all smiles. 'Its typhoid, not arthritis!   I knew those rural doctors were crooks.'  She's been given antibiotics, and after a week's treatment they say she'll be back to her old self.

But reading through our medical guide, typhoid, if not caught during the second week, turns to severe diarrheoa, intestinal perforation & bleeding.  How then would she have got by matatu to the more reliable doctors in the capital?  It's been a close call.

I remember, sixteen years ago in Madagascar, travelling by taxi-brousse (matatu) from Tana the capital, to Taolanaro (Fort-Dauphin) in the south. The trip was meant to take three days, on dirt tracks, through the arid desert.  We were crammed in, six of us across the width of a minibus (I was slimmer then!) Chicken under our feet. Hot, dusty.  Then we broke down. Needed a spare part. We waited hours for another vehicle to pass in the opposite direction, to take the driver and the spare part back to the capital, for him to patch it up and get a new one, and return to us a day later. And we waited, patiently, or not so patiently, in the dirt on the road in the shade of the bus.  Allocated the more capacious front seat, by popular unspoken consent of the matatu, was one poor woman, with very distended stomach.  She looked very ill, groaned weakly through the journey.  I learned from the women around me that she had end stage cancer. Had travelled, alone, three days on the bus to Tana, to confirm the diagnosis, and discover what else might be done. And learning there that the answer was nothing, was now enduring this journey from hell, four days back home, to die.

I'm an avid fan of House, the medical diagnosis detective series. I get that medicine can't always be an exact science.  And I've been highly impressed by tales, from our visiting medical students from Kings College Hospital, of the video conferences they hold with rural doctors in Somaliland, to show London doctors diseases they might never otherwise encounter face-to-face, and to give Somaliland doctors the benefits of House-style consults down the wire.  But boy is it something to be grateful for when we DO have access to doctors who diagnose reliably.

I keep assuming that my haziness and lack of clarity on key bits of information for life here are because I'm new to the country. Slowly I'm learning, not least through B & wife's complete uncertainty what the doctor had said to her, that this is part of the Kenyan experience. Not really knowing. Not being sure. Unable to verify or find out more due to lack of access to books, reference guides, reliable practitioners or the internet.  Expecting to be reliably informed, believing that one will understand if things are explained clearly, feeling one can rely on clear information, - these aren't self evident truths, I learn, for much of the rest of the world.