Date: 28 September 2024.
Authors: George Lmangeyan.
Country: Kenya
SUMMARY
This paper provides my very own story. A dreadful experience encountering kalazar. The community was stricken by the illness, and many villagers, regardless of the age, showed symptoms of persistent fever, weight loss, and an enlarged spleen. Without timely intervention, kalazar could easily become a death sentence.
BACKGROUND
Introduction.
I was born and raised in a pastoral-nomadic setup in one of the remotest place on earth. A place where time seems to have forgotten. The arid plains of Marsabit County, Northern Kenya. Moving with our livestock in search of pasture and water as well as cultivating lands back at home for food production is our way of life.
The family lives in an area far from any formal healthcare facility. Up to date, the nearest dispensary doesn’t have infrastructure to tackle any serious illness that might arise. The presence of the so called health facility in the region is a beacon of hope because of the ordinary antibiotics and painkillers.
Five years ago, I was a student at Maseno University. It was my on my long holiday and I had to go back home. I missed everyone and my everyday routine at home. While tending to my family’s livestock, walking long distances in search of water, and managing the entire herd its normal to feel tired, dehydrated and weak sometimes. There’s no time to waste when you are out in the jungle. It’s my responsibility for the larger decisions on where to move.
Weeks passed by and I started to feel unusually tired. I was losing the strength to walk the distances that I used cover in no time. Initially, I dismissed it as exhaustion from the long treks under the scorching sun.
The heat of Marsabit’s sun and the dust seem unbearable, and soon, I can no longer keep up with my usual herding duties. My condition worsened as I started to experience intermittent fever, joint pain, and rapid weight loss.
Opening up to a friend amongst my colleagues about my condition, several other people both old and young were feeling the same. We ignored it to being Malaria since we live in open spaces with a lot of mosquitoes.
We started to notice that the health of a teenager was deteriorating faster and we could not ignore. We made arrangements for him to be taken home as early as possible. It takes three days to get home from the place we were located.
Unfortunately, the little boy lost his life on his way home. The two other men who were taking him home were also ailing. They managed to get home and they found out that the local dispensary was flocked by sick people. It was like a plague. They could not reach out to inform us about the situation back at home due to lack of network signals for communication. The only way of reaching out to us regarding what was happening back at home was to send back someone.
These sudden case terrified the entire community because the medication available could not help anyone. People lost faith in antibiotic, painkilling pills and other medication from the local dispensary. Suffering is engulfing the entire community. Sudden deaths one after the other are witnessed hence escalating panic.
I arrived home and this point I could not believe what was happening both to me and many other people I knew growing up. The only option left was to turn to traditional remedies. People started to use herbal treatments and ritualistic healing for their loved ones. Local elders are consulted to perform spiritual rites, which provide no relief.
My grandfather who was 111(hundred and eleven) years old by then, recalled that he experienced the same case in his youth. He claimed that the same kind of illness almost wiped his village in Ethiopia during his youth. He vividly acknowledged that as the main reason why they migrated southwards from Ethiopia which explains how we ended up in northern Kenya.
He could not stop talking about a certain herb. It is not a commonly used herb not even known by many. This herb resonates within warriors when they stay in the wilderness for a long time. My grandfather was obsessed and actually recommended it. He called ‘Jiro’ which meant life in Rendille language.
The problem was the way to access it. A handful of people knew where it can be found. It’s a shrub when harvested it is dried and crushed into powder. Only one man in the entire area had it so it costed a fortune. Just like my grandfather he referred to it as an antidote. I didn’t have what it took to have the herb. After all the process of diagnosis, treatment and recovery from the hospital, comparing my process and a friend’s who used the herb, I realized its results were impressive.
The Struggle to Seek Help
Over the course a week or two being at home, my symptoms intensify. My spleen became swollen, visible even through my thinning body, and my skin turned pale, almost grey. The fever is unrelenting, and at this time I was unable to eat at all. The aroma of the food being cooked could trigger me into puking.
My family realized that the traditional methods are not working with other people so it was not option for me. Since we did not have much money to go for proper medication at well-equipped hospitals in Marsabit town and leaving our livestock unattended could endanger our livelihood. A decision had to be made to avoid the loss of livestock and lives of their loved ones by every family.
The Challenge of Accessing Medical Help
The nearest medical outpost is several days' journey by foot and people do not own vehicles. The available motors car only comes on on market day. On every Thursday when people go to the livestock market to sell their animals so that they can have cash money to buy foodstuffs, clothes and school fees for their kids. Motor bike charges exaggerated price making it expensive for the majority of the locals.
Donkeys were put in use to transport the very weak who could not walk. Short routes to the nearest medical demanded a trek through the arid, rocky terrain will be long and arduous, especially with everyone in a weakened state.
After an exhausting journey, we arrived to the nearest health post in Laisamis, a small town in Marsabit. We were shocked to see the hundreds of people getting admitted to the sub-county hospital despite the fact that the hospital was already seemed not to have a space for the next patient. The hospital is also underfunded and understaffed, struggling to provide care to the numerous people from the surrounding areas.
I met people I studied with in primary and secondary school. I noticed some faces I interacted back in university. I had a chat with a few of them and that’s when I got to understand more about the disease.
Kalazar, also known as visceral leishmaniasis, is a severe parasitic disease caused by the protozoan parasite Leishmania. It is transmitted to humans through the bites of infected female sandflies. Kalazar primarily affects internal organs such as the liver, spleen, and bone marrow, leading to symptoms like: Fever, loss of appetite Weight loss, Fatigue, Enlargement of the spleen and liver and Anaemia. It is most commonly found in parts of South Asia, East Africa, and South America, often in rural or impoverished areas. As I witnessed first-hand, Kalazar kills if not treated.
With the Kalazar symptoms resembling other illnesses common in the area, such as malaria or typhoid, everyone is initially misdiagnosed. Most people were given antimalarial drugs, but their conditions continues to worsen.
The Emotional and Physical Toll
The clinic staff eventually identifies condition as visceral leishmaniasis, but they have no antileishmanial drugs available. My family is distraught, watching me slip away in front of them, and the stress of caring for alone alone weighs heavily on them.
The family faces emotional exhaustion. Everyone becomes anxious and hopeless, fearing that I will not survive. At this point everyone starts questioning if their journey to seek help was in vain.
Every family with a victim felt abandoned by the healthcare system, which seems distant and unattainable in the remote wilderness of Marsabit. Everyone’s biggest fear was that help will come too late.
Intervention and the Road to Recovery
Help from an NGO
As our hope fades, news spreads that an NGO, Médecins Sans Frontières (MSF), has set up a mobile clinic to treat neglected diseases in Marsabit, including kala-azar. After hearing this news, we decided to take one final gamble.
Diagnosis and Treatment.
The healthcare workers from MSF quickly diagnose me with visceral leishmaniasis and begin administering antimonial treatment. They provide detailed instructions for the long-term care he will need.
The treatment involves daily injections, which are painful and cause side effects such as nausea and joint pain. I was blessed with my family by my side as I battled through the long and difficult process.
Slowly, I began to regain strength. Fever subsided, and my appetite returns. The family is grateful, but they understand the long recovery process ahead.The experience changed the family. They now understand the dangers of kala-azar and the importance of timely treatment. They share their story with other nomadic families, warning them of the symptoms and urging them to seek medical help early.
Doctor Nature.
Everyone who had an encounter with a pastoral-nomadic society knows how conservative they are. Some people call that kind of lifestyle primitive but when you get to know these people in details you realize they have their unique way of doing things. Just like the efforts made by the NGOs in collaboration with the county governments health sector, a God given shrub also saved lives.
After my medication, I turned to using the herb for the first time and it speeded up my recovery. I was amazed because getting well was like a dream to me. I used the herb for like seven months and anyone could tell the post illness health of a person who used the herb is way better compared to those who received the hospital treatment only.
Conclusion.
My story ends with a reflection on the dire need for accessible healthcare in remote pastoral regions like Marsabit. My story is not unique, many families suffer from treatable diseases like kala-azar due to the lack of accessible healthcare services.
This narrative highlights the urgency for government and international organizations to prioritize healthcare for marginalized communities. This could be done by setting up programs aimed at studying and improving the way of life of these communities by recognizing their ways of dealing with health issues while sensitizing hygiene.
Doing this will help reduce the healthcare gap hence saving lives. For instance, their ways of treating diseases. It’s a prove that the use of herbs provided remarkable results. With improved knowledge back by science, important aspects such as dosage and the how the herb works could be determined hence providing better health insights that resonates with these marginalized communities.
REFERENCES
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