After being unceremoniously discharged from UTH, Mother was in so much pain but she still had some energy to chat. It was then that she narrated to us that whenever she tried to sit down or stand up while at the farm, it felt like she was giving birth. She recalled that she had felt something drop down in her abdomen and that resulted in failure to urinate and constipation. During that weekend, she barely ate and the catheter kept filling up with both blood and urine. Wednesday seemed like forever away.
Jennipher. She kept us strong, kept us sane during this time. She told all of us, her siblings, that we now needed to treat mum as if each day was her last, that it was important for us to shower her with love and stand strong for her. It is these words which kept us going for the next couple of weeks.
Around 02:00 hours on Monday, January 30, 2023, Mum told us she needed to go back to the hospital in the morning because she was uncomfortable. By 07:00 hours, we were back at UTH. Mum was put back in the same observation room she was in on Friday. She was only seen by a doctor around 11:47 and he prescribed some pain medication and decided to admit her. She was kept in the observation room until almost at 18:00 hours when all bureaucratic processes were completed. During the waiting window, Jennipher and I were sitting at a small waiting area at the Out Patient Department. By Midday, Mum called for me. As I walked in to talk to her, I noticed that there were two other patients in the room. The young girl who was on her right side appeared to be in labour and her mother was holding her hand, assuring her that it would be over soon. What left me puzzled was that the pregnancy was only about five or six months along. Mother must have noticed my confusion so she pulled me closer and whispered that the woman had forced her teen daughter to terminate the pregnancy. She said some medical personnel had given her an injection to induce labour. She was distraught. She told the young girl’s mother, “you will remember that child”. She then asked me to bring more pillows and I left to collect them.
Once I returned, the door was slightly open so I pushed it and almost entered when I saw some medical personnel standing around the young lady’s bed, seemingly coaching her through labour. They didn’t even cover the area with a curtain or any other type of privacy veil. I was puzzled. Immediately, they noticed me, they asked me to leave and I obliged. I wondered what story the woman gave to the medical personnel for them to perform the procedure. And I do not want to go into the pro-life, pro-choice debate at this time. My issue is, and was, that the young lady deserved privacy, just as Mother and the other patient did not deserve to witness that procedure, which, in my mother’s case, stressed her out – she talked about it until she was too weak to chat.
The next day, Tuesday, specialist doctors made rounds in CO2 but the nurses forgot to hand them Mother’s file so they skipped her bed. A junior doctor, however, saw her and requested an abdominal ultrasound scan and an x-ray. He said ultrasound scan which had been done on Friday was for the pelvic area and was unable to give a clear picture of what was happening on the inside. And so began the venture of getting that ultrasound scan. I say venture because I soon learnt that at UTH, nothing really ever moves unless you give someone ka samufing, as the President says, or you know someone. When we finally located the only operational ultrasound scan which works at UTH, we were told there was a long queue and they could only accommodate us in 48 hours. I was defeated. Jennipher is a master at negotiation but even her skills only reduced the waiting time by 24 hours. We went to sit in the car park to recollect our thoughts. An uncle joined us and as Jennipher was updating him on what had happened, I was updating my husband on the phone.
“They’re saying the scan can only be done tomorrow and I can’t even look at Mum right now. She is in so much pain but everything is dragging out too long,” I remember telling him.
Luckily, he has a friend who works for UTH. He arranged for us to do the scan immediately. We put Mum on a wheelchair (she was now unable to walk) and took her to do the scan. To our surprise, there was no queue. Once we entered that scan room, I can swear it appeared like those medical practitioners were attending an online lecture. Once Mother was on the bed, one of them came, greeted neither of us, and did the shortest scan I’ve ever witnessed. She sent us out to wait as she wrote down some notes, saying the printer was not working.
“Massive ascites,” she wrote.
After consulting ‘Dr Google’, we learnt that massive ascites is a fluid build-up in your abdomen. We knew we had to wait until doctors’ rounds the next day to get an explanation. The x-ray, on the other hand, we were able to get it without much difficulty. The only issue was that the report only came out about five days later, after constant follow ups.
When doctors made their rounds the next day, February 2, they said they would try to schedule Mother’s hysterectomy for the coming week. They said they would remove the fluid in her abdomen during the operation and told us we needed to get some tests done on the heart to ascertain whether it was strong enough to handle a procedure of that magnitude. And guess what? UTH doesn’t have an Echocardiogram, at least one which satisfies demand. So, we had to go and get this done at Phil Labs off Tito Road. The nurses attempted to organise an ambulance but to no avail so we requested to use our own private vehicle. We were told that while her heart was slightly weak, it could withstand an operation. We were happy, there was hope – could see it in mum’s eyes too. We were counting the hours to when the doctors could finally come and confirm the operation date.
But the following day, it was a different story. Yet another doctor, a specialist doctor this time, came to see mum and ordered yet another scan, a CT Scan. He said there was no way they could proceed to conduct the operation without getting a clear picture of what was happening internally. The last CT scan on mum’s file was from October. He narrated that he had recently opened up a patient whom he thought was at Stage II cancer, only to discover that the patient was already at stage four. We understood his logic, but we wondered why we couldn’t be given a list of all the tests and scans to do at once so that we could finally know the way forward. That senior doctor also ruled out the possibility of operating on mum that week beginning February 5, saying there were too big operations scheduled and it was impossible to squeeze her in.
If you haven’t already guessed it at this point, UTH has no CT scan machine, so we had to find an alternative. We decided to go to Royal Diagnostics, a private lab which operates within UTH because it was logistically easier. Fortunately for us, we were using NHIMA so some of such costly scans were done for free. We had to wait 48 hours to get NHIMA authorisation to go ahead with the scan. Being a Friday, and seeing that the doctor had ruled out an operation for that week, we didn’t mind waiting.
The doctor had ordered another kidney function test and this time, Phil Labs sent one of their officers to draw blood from our patient in the ward. God bless those people. When the results came back, the creatinine levels were even higher, at 216.9 when the biological reference interval was 45-100. Mother was now barely eating and vomiting a lot. We couldn’t wait for Monday for answers so we consulted Dr Google. Such high levels of creatinine were an indication of kidney failure, we learnt.
On Monday, February 6, I woke up to this message from Jennipher: “Morning family. At 04:30 hours, Mum became restless after turning and was now put on oxygen. She is now stable and was moved to the bed at the entrance of the ward”.
My knees got weak.
To be continued…
Final thoughts for today – This is a tale of one patient, one family. But there are thousands, if not millions going through exactly the same thing. Our health care system needs some urgent attention.