The Sunday Mail
Garikai Mazara
In 1984 Miguel Makombo was crowned Mr Zimbabwe Junior and he felt on top of the world. He had every reason to.
“At about that time I tipped the scales at an impressive 120kg, I was huge, man,” he laughed as we sat Thursday morning chatting about the trials and tribulations that he has had to go through in the 16 years that he has lived with failed kidneys. “The Herald Editor, Caesar Zvayi, is small in proportion to what I was then,” he adds with another chuckle. Apparently Makombo, who has maintained an interest in body building since then, attends the same gym with Zvayi.
He added, matter-of-factly, that there is no need for one to change their lifestyle once they are diagnosed with kidney problems.
“Live a happy life, continue with the things that you used to do and enjoy your life. After all, it is not a death sentence.”
Though Makombo refers to kidney ailment as not necessarily a death sentence, he says the biggest challenge to surviving a kidney failure is the cost of having dialysis twice a week. “I would say I am lucky that I have two sessions a week, there are some who have three sessions a week, and with each session costing around $200, many have died not because the condition cannot be controlled but because it is costly to contain it.”
In a different but related discussion, a Harare-based physician, who cannot be disclosed for professional reasons, said he has a patient who undergoes dialysis on a daily basis. “She is every doctor’s nightmare,” the doctor said, explaining that it is difficult to admit her into hospital for other ailments, if she gets sick, because she has to go on her daily dialysis, as well as being admitted!
Back to Makombo, after winning the Mr Zimbabwe Junior body building contest, everything seemed to be in the groove for him. “I was a hard-working fellow who knew how to look for money in Harare. Around 1989, when I was about 26, I bought a house in Waterfalls, which was a remarkable achievement back then. I also became one of the first guys to run kombis in the capital as well as one of the first guys to run a car sales.”
For a decade or so, he lived the high life – running around town in the company of the late Peter Pamire, Boss Pams to many of his friends, one of Harare’s foremost loud and colourful characters then. When you kept Pamire’s company, chances were you would also bump into Phillip Chiyangwa, for Pamire and Chiyangwa were the proverbial trousers and belt.
Then came the decline in and around 2000. “I started having difficulty in breathing, I would throw up every time I ate something, even a cup of water, coupled with a loss of appetite and weight. All along I knew I had been hypertensive and there is no known medication for high blood pressure that I did not try.
“It looked like we were going round and round in circles with my doctors and the swelling would not stop, until one doctor suggested a kidney test. Then came the news, the earth-shattering news, that my kidneys had completely failed.”
It took a lot of persuasion and counselling for Makombo to accept his new status. “I have to give a lot of credit to my wife, who was a nurse, who explained to me what kidney failure meant and why I needed to have a fistula fitted on me. Grudgingly I took the long drive to Parirenyatwa to have the fistula fitted.”
But it seemed as if the gods were not really keen on him having the fistula inserted. “When I went for the fistula insertion I met my former school mate by the entrance, he was then with the police and he was the one who processed death papers, for patients who had died at the hospital. He asked me what business had brought me to Pari and when I informed him, he looked me straight in the eye and said, ‘the doctor you said is going to operate you, look at all these death papers I am processing, he is the one who did the operations’. My mind went into overdrive and I cancelled that booking.”
Another round of persuasion and interventions by the wife saw him finally having a fistula implanted in 2000 and the start of what has been more than a decade-and-half of haemodialysis.
Though Makombo says his body is now used to the twice-a-week sessions, a process which he says is not even painful, what he repeatedly bemoaned during the hour-and-half chat on Thursday is the cost of containing the disease.
“The downside is I don’t have permanent friends, especially at the centre where I go for sessions. Every Tuesday I am in session for five hours and every Friday for another five hours. You kind of bond with the person who would be next to you because for five hours you are seated next to each other and there is no option but to tell stories.
“You do that for a couple of weeks, and in some cases, months, and then the next thing you hear is the person you had bonded with has passed on. Because they could not keep up with the cost of dialysis.
“One session you come and the centre is full, like there are so many people and the next session you come and it is almost empty, and you are told all those people could not make it. It is really heart-rending.”
The other downside, Makombo said, was the normal routine life is gone. “Between Tuesday and Friday sessions I have Wednesdays and Thursdays. And between the Friday and Tuesday sessions I have Saturday, Sunday and Monday. So I have to build my life around that schedule. I cannot go for long trips, attend funerals that interfere with my dialysis or even visit my family which is now domiciled in Australia, they wouldn’t even give me a visa.
“In most of the Western countries, dialysis is free and is budgeted for so they cannot have visitors coming who want to go on dialysis now and then, for that visitor becomes a burden to the public health budget, so they would deny you a visa outright.”
Makombo’s family left the country in 2004 and the hope then was that his condition would improve so that he could follow his family.
As that has not been the case, how has he survived the 12 years without a family support structure?
“I have very loving cousins, nephews, uncles and friends. In fact, I don’t even feel the absence of family, I have been blessed to have very wonderful people around me.”
Sixteen years on dialysis would mean that during the hyper-inflationary era, life must have been tough. “It is by the grace of God that I am talking to you today, I don’t even know how I survived to this day or how I used to raise the money.
It was a tough time, indeed. We used to have letters from our dialysis centre that we would use to withdraw money from the bank with, but if you stayed for three hours with that money in your hands, you would not have been able to buy the foreign currency that was needed at the centre.
“So once you withdrew the money from the bank, you would have the money changers on the ready and get your forex – then make a dash for dialysis. Then I also had a number of friends who were in the banking sector, who were very helpful in mobilizing and informing me when and where I could make withdrawals.”
After working for a furniture retail outlet, which is currently under liquidation, Makombo was thrown into the streets last year, during the notorious days of the Zuva judgement. “After giving a company 30 years of my life, I was sent home just like that, no pension, no benefit no gratuity.”
So how is he making ends meet? “The house I bought back then is the one supporting me. The money I get from rentals, I pay my medical aid, which in turn pays for my dialysis. In short, my survival is at the goodwill of my tenant.”
