For 13 years, Bamuwamye has lived with one breast and no uterus

Josephine Bamuwamye’s story is that of a life of loss, struggle and final triumph. She was widowed, had her breast cut off and uterus removed.

This mother of five and retired midwife of Pumwani Maternity Hospital in Kenya realized she might be having breast cancer when her left breast grew at a tremendously fast rate compared to the right breast. 

The initial self examination tests left her with the impression that she might be having cancer with the evidence of the lump in her breast. Nevertheless, she silently killed off thoughts of probable cancer until she could not bear the marked difference in the breast sizes. She confided in her breast friend, also a midwife at the hospital. It was February 2000.

“My friend felt the lump in my breast but did not want to imagine that I had breast cancer because to her, it meant a death sentence. She told me I was ok,” Bamuwamye recalls.

She lived off that encouragement but with some voices telling her to consult a witchdoctor to abet the curse; others brought her the gospel of Jesus heals packaged with intensive prayer and yet others took on her situation as food for gossip. But she can never forget a 20-year-old prophet who prayed for her.

“He prayed while touching my breast and kept saying the lump is moving and when we came to the end, he said that it had disappeared,” she says. “But I still felt it and this is when I decided to visit my neighbour in the hospital staff quarters who agreed to go with me for authentic medical tests.”

Meanwhile, Bamuwamye lived off Chinese medicine that cost her Ksh 500 (Shs 15,000) per week, without improvement. Then came the first tests at City Council hospital in Kenya that prepared her for the worst announcement of her life.

“Do not waste time. Go to Kenyatta hospital for immediate advanced tests,” the doctor said. She harkened to the call. 

At Kenyatta Hospital, Bamuwamye and her neighbour had a breast fine needle aspiration (removal of some fluid or cells from a breast lesion or cyst with a fine needle similar to a blood sample needle to help determine the nature or diagnosis of the lesion and to plan treatment if necessary) and were told to collect their results a month later.

Upon return, she noticed a difference between the packaging of her results and those of her neighbour. Hers were enveloped while those of the neighbour weren’t.  Before the results were presented to either, they were counselled. Her neighbour, being the first in the room came out excited upon receiving the good news that she was ok.

It gave Bamuwamye a sense of false hope and she went in confident. However, her exit was no more than tears, pensiveness and shock – she had breast cancer! It was April 2000.

Two weeks down the road, she was operated on and her left breast was cut off. She was discharged two days later with a discharge tube running throughout the left side of her body.

More medication:

To ensure total recovery, the oncologists advised Bamuwamye to undertake chemotherapy every week for three weeks which she did bringing forth undesirable effects.

“All my hair was cut off, my nails and tongue darkened and I became very frail. This is how I attended my first born’s graduation from Day Star University,” she recalls.

Then for 25 days, she underwent radiation and followed this up with monthly check ups. After two years, her doctors advised her to go for a scan of her abdomen and chest in order to establish that the cancer had not spread. She was in for yet another shock; her uterus was endangered and had to undergo total hysterectomy (removal of the uterus).

Now 63 years old, Bamuwamye has beat the odds of living with one breast and no uterus since she was 50 years. She wears special bras available at Mulago hospital and the Uganda Women Cancer Support Organization (UWCSO) in Ntinda.

Changed lifestyle, new priorities:

Her diet now consists of less meat and eggs but more of vegetables and water because of her low body immunity.

As a volunteer of UWSCO, she is involved in counseling and advising women to go for regular breast checks. During her free time, she visits the sick and prays for them.

Nkumba’s iron lady lives for the afflicted

“Grace is an achiever. She is so principled and if you are working on a policy and a collective decision has to be taken, she’ll always stick to the right thing,” commented John Matovu of Grace Obalim, the vice guild president of Nkumba University.

Obalim’s leadership ethos has been shaped by her leadership background. Throughout school, she held positions of time keeper, head prefect, assistant head girl and dormitory captain. Her integrity has earned her nicknames like iron lady and mover.

Throughout our interview she kept mentioning the fact that a good leader ought to give to the people what they want and not raise excitement among them and then fail to deliver.

“I want to lead everywhere I go because in every community, there will always be something wrong and this is why I believe that a good leader should also be a good administrator,” she says with a gait of pride. 

Daily, she is charged with the duty of attending to student’s complaints, debating students’ matters and assisting the guild in the day to day running of the students’ council.

Currently, her plate is full with projects of forming an alumni club of St. Mary’s College Lacor and establishing a psychology centre in northern Uganda to facilitate psychological rehabilitation for those struggling with the scars of the LRA war.

Obalim hope to become a speaker of Uganda’s parliament some day and come 2016, she is taking the bull by its horns and campaigning for Youth MP, northern region.

Her past achievements, current responsibilities and future ambitions however tell half the story. It’s been a gory struggle to the top for Obalim darkened with scars of neglect, sexual abuse and dropping out of school.  

Tears of the past:

Obalim and her eight siblings were raised by a single mother, Regina Agol, a peasant who struggled to see all of them through school. However, to mark this milestone, a toll of her children’s energy had to be employed.

“I remember us following mum every weekend to brew crude alcohol and since a bottle cost only Shs700, we made sure we brewed at least 20 litres. It was tough!” she recalls.

Then the LRA war meddled into her family’s affairs forcing her to drop out of school in senior three at Ramasa Girls College in Mukono. For the one and a half years she was out of school, her life was no more productive than idling at home, hanging with friends and visiting night clubs. At a certain point, she conceived.

“This was the greatest shock of my life and I do not know how it happened. I only realised that I was pregnant when I was about four months gone,” she says, her eyes squinted.

Her elder brother, Youth MP northern Uganda, Hon Dan Kidega on realising she was pregnant, gave up on her. He stopped paying her school fees. Although the thought of him ceasing to pay her fees gave her depressions, Obalim was ready to give it a fresh start.

“For me, the sky was the limit and with or without my brother’s help, I knew I would sit for my Senior Four and ascend the education ladder,” she said.

She immediately applied for a scholarship from Invisible Children, an organisation founded in 2004 to bring awareness to the activities of the LRA.

Dream come true

Despite having applied along with over 700 others, Obalim was picked on. When a staff from the organisation visited her family to warrant approval of her scholarship, he was moved to tears with her painful story.

Then she was able to join school for her senior four at St. Mary’s College, Lacor in Gulu and completed her A ‘level there too. Later, she joined Nkumba University, where she is now a final year student of Science in Psychology, Guidance and Counseling.

Being the leader that she is, Invisible Children sponsored her trip to the US in 2010 to speak on the effects of the LRA war. After four months of deliberations, she returned and changed her course from the original Journalism she was offered to Psychology after reflecting on the trauma of her fellow tribesmen.

Her inspiration:

Obalim’s mother, Agol remains her role model.

“My mum has raised all of us and regardless of what we’ve been through, she managed to educate us and three of my four brothers have masters [degrees],” she says with pride.

She is also inspired by her mentors at Invisible Children and Nelson Mandela for his determined, objective and persistent character.

She cannot do without God, her mother and friends.

Hobbies:

Although Grace hardly has free time on her hands, she loves listening to RnB, country and gospel music, read her Bible and visit friends.

More cash for GAVI, HIV and TB

Foreign funding for health projects in developing countries is still holding steady, a new research from the Institute for Health Metrics and Evaluation (IHME),an independent research centre identifying the best strategies to build a healthier world at the University of Washington, has found.The findings were announced at the Centre for Global Development and published online as part of the fourth annual edition of IHME’s financing series, Financing Global Health 2012: The End of the Golden Age?

The research tracks development assistance for health from government aid agencies, multilateral donors and private foundations and charities. It explores funding trends over three periods: the “moderate-growth” period from 1990 to 2001, the “rapid-growth” period from 2001 to 2010, and the “no-growth” period from 2010 to 2012.  

In its key findings, it was discovered that many of developing countries with the highest disease burden did not receive the most health funding. For example low-income countries like Burundi, Guinea, Mali, and Niger,which are among the top 20 countries with a high malaria burden, were not among the top 20 recipients of malaria funding.

“For some diseases, there is a clear disconnect between funding and burden measured by both mortality and disability,” explains IHME Assistant Professor Michael Hanlon according to a press release on the organization’s websitewww.healthmetricsandevaluation.org. 

“These comparisons serve as a guide for policymakers to discuss, reassess, and improve upon their health spending.”

After reaching a historic high of $28.2 billion in 2010, development assistance for health dropped in 2011 and recovered in 2012. The strong growth in spending from the Global Alliance for Vaccines and Immunization (GAVI) and UNICEF counterbalanced declines in health spending among other donors.

According to the release, Dr Christopher Murray, IHME Directorsays priority setting has become even more important as global health funding flat lines.

From 2011 to 2012, overall health spending channelled through government aid agencies dropped by 4.4%. Development assistance for health from the US, the largest donor, dropped by 3.3%, and health funding from France and Germany declined by 13% and 9.1%, respectively.

Among the six largest bilateral donors, only donations from the UK and Australia increased from 2011 to 2012.

With the deadline for the Millennium Development Goals (MDGs) approaching in 2015, policymakers will need to carefully assess the trends in resource flows to decide where and how spending can have the maximum impact on population health.

Other major findings from the report include:GAVI continued to have very strong rates of growth. In 2012, expenditure by GAVI reached an estimated $1.76 billion, a 41.9% increase over 2011.

 The sub-Saharan African region received the largest share of health funding. In 2010 (the most recent year for which recipient-level estimates are available), sub-Saharan Africa’s share was $8.1 billion, or 28.7% of total health funding.

Health funding for HIV/AIDS, tuberculosis, and maternal, newborn, and child health continued to grow through 2010.

About IHME:

IHME is an independent research centre identifying the best strategies to build a healthier world. By measuring health, tracking program performance, finding ways to maximize health system impact, and developing innovative measurement systems, IHME provides a foundation for informed decision-making that ultimately will lead to better health for people worldwide.

Fake traditional healers threatening reliance on African medicine

Tucked about 20 KM away from the Busega Main Road is Kityo Herbal Research Project-a haven for those who want to rid themselves of dental cavities and halitosis. Tracing Dr Kityo’s clinic was no easy job as he was new in the area and unfamiliar to many. Infact, one motorcyclist said that he had heard that a witch doctor popularly known as ‘omusawo omuganda’ had invaded the area.

When I finally traced the place, the diminutive Dr Kityo, a name he likes to be called, donning in black socks, a khaki trouser and pale white shirt loosely hanging over the trouser, welcomed me. However, I was supposed to remove my shoes.

I felt a hitch of indignation as I looked at the floor dotted with ash, broom sticks and black minute seeds. My stomach felt strange and my palms were clammy. Having the motorcyclist’s view stamped on my mind, I was terrified. Of course, it’s not really a fear of being in a shrine. Rather it’s the view of what happens there- faceless voices talking to me. My sense of security was screamingly absent.

Smoke and heat swirled around the room as I made my way in. A charcoal stove is kept aglow all the time for easier melting of a few grams of ghee, one of the ingredients Dr Kityo employs. Inside were two youthful clients that had issues with their teeth. I followed the proceedings of seeing them recover.

Kityo grabs a small black pot and cleans it with a few broom sticks and water to steer clear any contamination from the last user. He then drops some herbs into the pot before adding a hot piece of charcoal and the ghee. He quickly crowns the pot brim with a circular woven reed that has a little opening through which clients inhale the odour.

The odour is chocking. Throughout the procedure, coughing, spiting and squinting of teary eyes are the highlights. The inhaling takes 15-20 minutes until the fire is over.

He later uncovers the pot, and uses a pair of hooked metal to remove tiny black, brown or pale white substance that has collected at the bottom. 

“This is the dirt from your teeth,” he tells a client urging her to go home and rest and call him later to confirm whether his teeth have healed. The client, with a happy face but blood shot eyes from the piercing smoke, parts with shs.50, 000 and happily chews away a green apple that she carried along.

Dr Kityo says he has been at this job for 10 years and his medication caters for all age groups.

“I learnt from my father who had over 30 years experience and I am not willing to let it go because it will be a shame,” he says.

Asked to disclose the medicines he uses, he told me that he cannot because there are many fakes who will adopt it and con people.

On average, he receives 20 clients a day according to his visitors’ book that every client must sign.

 

Kityo is among the traditional healers registered under National Council of Traditional Healers and herbalists Association (NACOTHA) as an authentic healer. A traditional healer as defined by the Traditional Healers and Modern Practitioners Together against AIDS (THETA) is one who is recognized by his community and uses native knowledge handed down from generation to generation either orally or spiritually  to alleviate all forms of human suffering.

However, the recent wave of ritual murders, including child sacrifice, has prompted parliamentarians to debate and plead with the government to enact a law regulating the activities and practices of traditional healers and herbalists. The only law governing the operation of traditional healers is the Witchcraft Act of 1964, which stipulates penalties against intended acts of harm.

Dr Gerald Mutungi, the commissioner for non-communicable diseases in the health ministry says a number of organizations register and present as traditional healers when they are not and are deceiving and conning people through the media. For example, in January 2008, 20 Ugandan healers were arrested in Johannesburg for carrying out illegal abortions.

In effect to stop this, Mutungi says the ministry is collaborating with the police to crack down the fake healers.  As such, all traditional healers will have to surrender their licenses for fresh registration

Dr Yahaya Sekagya, the director PROMETRA a local NGO working with traditional healers to increase acceptance of traditional medicine says many fake healers are present because there are no patent rights for traditional healers and so authentic knowledge is easily counterfeited.

He says many of the fakes have a tendency of resorting to witchcraft.

“These conmen claim to have the power to make people rich or even cure illnesses such as HIV/Aids and often advertise in newspapers so as to woo the gullible. After promising to make their victims rich, they take off with the clients’ money,” he says.

He however says that traditional medicine is reliable because it is based on a holistic approach to life with an emphasis on health rather than on disease compared to western medicine.

“The reason for such reliance on traditional medicine is its accessibility and affordability in comparison with western medicine. Most Ugandans will resort to traditional medical practitioners for their health problems because of its cost effectiveness and local availability,” Dr. Karim Musaasizi NACOTHA’s general secretary says.

But the issue goes beyond access. Traditional healing is linked to wider belief systems and remains integral to the lives of most Ugandans. People consult traditional healers whether or not they can afford medical services.

ninsiima@observer.ug