I recently returned to the office from maternity leave – it was quite eventful. I have learnt more about life in the past three months than I have ever learnt in my years on this earth. Up until this point in my career, I have never taken any story or issue too personally. But recent events in my life have caused a shift inside of me and I have a burning need to share my reflections with everyone who cares to listen, everyone who is in a position to make a difference. I am unable to ignore this push I feel to contribute to the conversation about the state of our public health care system and the overall health of us as a society. If the authorities don’t see what I have seen; if they don’t hear what I have experienced in the past three months trying to keep my mother comfortable and alive for one more day, I am afraid, our healthcare system will continue to escort our beloved ones to early graves. Please join me as I share the story of how we lost our mother and how we are dealing with the aftermath, mentally as well as health wise.

So mum, Selina Mary Phiri, succumbed to Endometrial Cancer at 68 years old on February 20, 2023. We only learnt that she had cancer in October last year, after several months of waiting for test results, and the prognosis was pretty encouraging at the time – Stage II they said, and even booked her for an operation at the University Teaching Hospital (UTH) for March 9, 2023. Now, this was a lot to process. Cancer? Mum? How? What does this entail? And a whole bunch of other questions. She herself was in denial. For over 10 years, her biggest health complaint had been pain in her legs, so none of us understood how that had suddenly turned into cancer. We were all hopeful though, and we supported her in her goal to lose some weight before the operation, as guided by the doctors.

On November 2, I went into labour and religiously called mum, Mother as I fondly called her, and she came dashing into the delivery room. Even though I knew she would laugh at me for screaming and being dramatic, just knowing she was in the room praying for me gave me so much peace. You see, Mother was such a strong woman; her pain tolerance threshold was through the roof. I am the complete opposite. If I just as much sustain a cut on my finger while chopping vegetables, the whole house will know about it. In that labour room, Mother and my husband would coach me through some ‘recommended’ breathing technique. I would only manage to take one good deep breath but midway into the second one, I would be back to my default setting – screaming my lungs out and squeezing the life out of nurses, and my husband lol.

Mother, on the other hand, used to tell me a story of how she at one time told my dad that she was in labour but he brushed her off saying, “ulebepa, takwaba labour imoneka ifi (you are lying, there’s no way a woman in labour can look like this)”. He comfortably went for work only to be called about three hours later with news that he had a bouncing baby girl. After that, she said, whenever she mentioned the word labour, he was out the door with a hospital bag in two seconds! That was mother. In fact, growing up, there was never a single day I saw her stay in bed when she was sick – she always pushed through pain to complete any tasks or to do something for someone. It was only cancer which managed to confine her to a bed.

She stayed with us for six weeks after the birth of my son. Taking care of him, taking care of me and wanting to give me massages on a daily basis even though she too was in pain. She only gave me two massages and after that, I always made excuses about why I couldn’t prepare the hot water and oil because while I needed those massages, I knew she needed them more. So, we ate, we laughed, we argued and we told thousands of stories, little did I know that our time together in this life was almost finished. During this time, she had a daunting craving for chocolate. Her only request whenever I went out to buy some groceries was “chocolate”, wow, I can still hear her sweet small voice, coupled by seeing her naughty manipulative expression. I would always give in, but I would tell her it was counterproductive to our goal of her losing weight before the operation. And she would always say, “this is the last one, I promise. I won’t eat another one tomorrow”.

Against all her children’s advice, Mother decided to go to her farm to cultivate. “At least when I go there, I actually lose weight because there’s a lot of work to do,” she insisted. Every year during farming season, for as long as I can remember, Mother would relocate to her small field in Situmbeko area. She would go and stay in her small clay-block house without electricity or running water for months, but she would be her absolute happiest.

Mother stayed at that farm for a week, during which I noticed she was calling me more than usual. One time, she video called me and she looked so happy to see my daughter and I. She spoke gibberish to my daughter and made her laugh so hard and then showed me some village chickens and guinea fowls she had secured for me as promised the previous day. The very next day, Mother finally came clean about what was really going on.

“I have stayed for days without passing urine, I don’t even eat because I am afraid it is also not coming out,” Mother posted in a WhatsApp group chat with all four of her girls on Thursday, January 26, 2023. My heart sank.

“I can’t drink water because it is not coming out. I’m hungry, can’t eat! I bled a lot the first four days of coming here, it had started from home but then it stopped. I had problems sitting and standing, it always felt like I was giving birth. I’m feeling like there’s something blocking the passageway.”

She proceeded to give us alternative numbers we could reach her on in case she was unreachable, a first! We were all confused. Scared. My eldest sister, Jennipher, and my eldest brother, Chatila, went to pick her up from the farm. Once she was back at her house in Lusaka, she gave me a call to ask whether I preferred to have my chicken dressed, I can’t even remember what response I gave because at that point I was thinking, “typical Mother! Willing to push through her pain for my comfort”. My younger sister, Kalunga, ended up dressing the chickens because mum apparently swore she’d do it herself.

First thing Friday morning, Jennipher took her to UTH, Out Patient Department. The doctor only saw mum around 11:00 hours and ordered some blood tests and an ultrasound but this had to be done at Phil Labs because UTH doesn’t have capacity to service the demand. In fact, Phil Labs and other private laboratories have taken the initiative to provide transportation, at their own cost, for patients who need various tests done because transport is also scarce at UTH. Mother was barely walking unaided at this point but my sister had to remain behind because there was no space for her on the VITS which was transporting patients on the material day. The results of the blood tests showed that some components in her blood were extremely elevated and it was labelled very urgent. Creatinine was the highest reading at 186, the normal range according to the report, is between 40 and 100. Meanwhile, the ultrasound scan report indicated that mum’s uterus appeared to be lodged into her urinary bladder.

“There is a mass indenting/ ENVAGINATED into it- appears to be UTERUS UTERUS- Not clearly seen in its normal position. Sonographic features in keeping with; ENVAGINATED UTERUS INTO URINARY BLADDER. See urgently,” read the report.

Back at UTH, Mother was ushered into an observation room around 14:00 hours, still untreated. Jennipher had to beg the doctor to relieve her of some of the pressure the urine was causing, having not urinated in about five days. They offered no explanation of the blood test results as well as the ultrasound scan. Eventually, around 15:30 hours, the medical personnel put a catheter on mum and I finally got a chance to sneak in to see her. She was smiling and very energetic. The relief from finally having some urine leaving her body made her feel like she was healed, I thought. When I was about to leave the room, guess what she told me she wanted? Chocolate! We laughed. We thought she would be admitted for sure so Jennipher asked me to go and pick up a few clothes and beddings from Mother’s house and I did. Upon arrival, however, we were told that mum was getting discharged and that she should return for a check-up on Wednesday. No medication was administered, not even to manage pain.

“How can you discharge her in this condition?” Jennipher asked the nurses but they said the doctor, who had already knocked off, had decided that was the best course of action and should her condition worsen before Wednesday, she could be brought back to the hospital earlier.

Usually, when a loved one is getting discharged, the reaction is joy but I felt terrified, horrified even. I knew for sure that something was amiss.

Before I delve into the emotional rollercoaster that was February, allow me to share some of my biggest lessons.

1. Our public healthcare system is truly a mess. We need more doctors and specialised doctors, as well as other healthcare workers and they must be well motivated. We need more infrastructure and medical equipment which must be regularly serviced. We need more ambulances. Of course, the current government has taken a positive step by hiring almost 12,000 health workers, but how good are they without the equipment they need to diagnose patients? There’s need for massive investment in healthcare, period!

2. We need to do all we can individually to stay away from the hospital for as long as possible. You know how doctors like to encourage us to go for regular health check-ups? WE NEED TO LISTEN TO THEM. It is not just some fancy tagline they like to utter just for the heck of it. Sometimes, it could just be those check-ups which save your life. For any ailment, the earlier you treat it, the better. This is especially true for cancer, more so here in Zambia where there is only one hospital which specialises in treating cancer. If you are like me and you cannot afford to fly out to Dubai, India or South Africa for medical attention, #grabyourbestieandgoforcheckups

To be continued…