The Sunday Mail
It was in March 2005 — that is about 11 years ago — that Sitheni Zimuto’s world collapsed around her.
Two years earlier, she and husband Raphael had bought their 22-acre plot in Christon Bank, to start a tomato-growing project, using green houses. The proximity of Christon Bank to Harare was the catch, they could get their produce to the capital city in no time.
The first harvest went well and all looked rosy.
A decade earlier, she had given birth to her first child, in 1994, to be followed by another one three years later, in 1997. “During those two pregnancies, I had high blood pressure, which was somehow consistent with the pregnancies. So as soon as I gave birth and my blood pressure ‘normalised’ I would stop taking my tablets,” she narrated last week at her Christon Bank plot.
Then in 1999 she started experiencing headaches, strong ones for that matter. And in circumstances that her close family members mistook for a good life, she started getting fatter (which in actual fact was swelling) and getting pale. “People close to me would applaud me, saying our move here was, indeed, having an effect on our outlook, I was now fatter and paler,” she laughed.
Little did she know that what people were applauding was in actual fact anaemia setting in and the fattening was water accumulating in her body. It only took her sister to mention to her doctor later on, that Sitheni was not using the toilet as frequently, for it to be suggested that she took a kidney function test.
In fact, a teacher then, she used to boast to her colleagues that she only used the toilet once in the morning when she bathed and in the evening when she went back home. And as she saw the routine as rather hygienic, she did not notice that she had, in the meantime, stopped using the toilet altogether.
“I think medicine was not as advanced as it is now. We went to a number of doctors and different hospitals and no-one could pick that my kidneys were the problem. Otherwise if I had noticed that my urine was no longer as it used to be then I could have been diagnosed a bit earlier. Or better still, if I had not stopped my BP medication, I think my condition would have not deteriorated as much as it did.”
When the condition was finally diagnosed, it was too late for mama, both her kidneys had collapsed. The immediate solution was dialysis or a kidney transplant. When they asked around for the cost – and procedure for a transplant – the family reasoned their financial resources, albeit a good first harvest of tomatoes, could not help them in that endeavour.
“So we opted for dialysis. But there was a problem, remember I had become pale, it meant my blood levels had dropped to critical levels such that even the dialysis could have been dangerous with such low levels. I needed blood transfusion as quickly as possible. After sourcing and securing the blood, another challenge emerged – my veins had almost collapsed and the transfusion could not be done.”
For hours, as medical personnel battled to transfuse her, her life hung in the balance. She says it was by the will of God, which she says has helped her survive up to this day, that the transfusion was finally done, and she began her life journey of dialysis.
For some months her medical aid paid for her dialysis until she reached her global limit and no further help could be accessed from the medical aid. “This was about the time when inflation was the buzzword in town. Either you could find your US$200 elsewhere and bring it to the dialysis centre or you were asked to pay the Zimdollar equivalent for the day you were being treated. Mind you the payment had to be in cash, the full amount. Not $199, no.
“If for any reason you did not bring the full amount, they advised you to sit in the reception whilst your family members or whoever would have accompanied you, looked for the difference. It was only after paying the full amount that you would be put on the machine.
“Up to today, sometimes we sit back and ask each other how we managed to go through that time. We don’t even know how. It must just have been by the grace of God.”
Chipped in the husband, “Things were so tight that at times she had to skip the other session but life would become unbearable in the home. We would all know that she had skipped a session because there was no money but her worsening condition would affect the whole household. You know how it is like when one member of the family is down, it affects almost everyone.”
A missed session means that toxins would have accumulated in the body. Usually these toxins are removed by the kidneys and disposed as waste, as in urine. In the absence of the kidneys and a dialysis session, a patient has a build-up of fluids in the body, hence the swelling, which is usually mistaken for being fat, or good living.
Another symptom is bad breath, because of the accumulation of urea in the body. Relatedly, the accumulation of urea means there is loss of taste – and appetite. Though body chemistry differ from person to person, Mrs Zimuto said when she skipped a dialysis session, and with the accumulation of fluids in her body, she tended to be thirsty.
“I would want to drink a lot of water, and yet there was no outlet for the same water. The build-up of water results in some of the water getting into the lungs, such you become breathless, you find breathing difficult. Or the legs and faces swells, the water would be moving into any pockets that it can get. For some, the water accumulates in the heart, obviously with fatal consequences.”
Besides the hyper-inflationary environment that she had to survive under, Mrs Zimuto says a shortage of consumables in the country then also had its effect. “All the liners, liner kits and tubes that are used for dialysis are disposable and by then every patient had to supply their own consumables. Either you had to have a relative or friend travel to South Africa very often, depending on how you would afford it or you would engage the cross-border traders who would bring them, of course at a profit to them.”
In a separate discussion, Mr Makombo (see opposite) said it was only in 2014 when kidney patients were able to access all their drugs and consumables in the country. This was partly because the Government took long in approving the sale of the drugs locally.
After negotiating around cost and affordability, the next challenge for a kidney patient is diet.
“It is safe to say we don’t eat,” quipped Mrs Zimuto. “Most fruits are a no-go area, especially those that have a high concentration of potassium. Our regime is classified into good, fair and poor, the ones classified as poor are as good as poison. If you want to die within three hours, take those foods you have been told have a poor rating. The good food for us is the white meat, your pork, chicken and fish. Again, because of different body chemistries, some might find beef good for them but for me, even when it is being cooked in the kitchen just the smell of it gets me vomiting.”
Whilst the Zimuto readily acknowledges that the grace of God has kept them going this far, they are equally agreed that family love played a part.
“Both families — my family and my husband’s family — have been very supportive. And to an extent our church community has also been pivotal, the prayers, the moral and financial support. You don’t know what that visit during dialysis means, it means a lot. Just that moral support.”
