I was researching the qualitative achievements of the Katumba Rehabilitation Centre in Western Tanzania for the Ryder-Cheshire Foundation. The centre provides physiotherapy for disabled children of Burundian refugees and sees all sorts of problems from polio to cerebral palsy to worried parents! The local healthcare centre is within walking distance and I was looking for a good opportunity to visit.
On arrival I saw Regina and Hudi on their way out of the centre carrying a bag of bandages. They had sent a message that a man had been injured when fishing and might need a plaster cast. It was the perfect excuse to see the healthcare centre and watch Rudi and Hudi at work.
The centre looked like a small derelict hospital where people loitered outside empty offices looking confused. A white jeep, donated by a Japanese aid agency, sat in the middle of the complex waiting for spare parts.
Karoli, the medical officer, arrived bright and breezy cracking jokes in Swahili, English and Burundian in a monotone voice. He pointed towards the man we wanted to see, a hunched figure swathed in a bloody sheet decorated with roses. Karoli beckoned him. Karoli directed him to a corner of the ward which had filthy threadbare sheets also stained with blood from long ago. The sink by my elbow had not been cleaned and had not held water for many moons. I looked out of the window and sighed. Karoli talked to the old man and asked him what kind of treatment he wanted; did he want an X-ray? He got no answer. The old man just dribbled and peered out from his sheet. Karoli called for the two men who had accompanied the old man but they could not be found.
After much deliberation and many uncalled for wisecracks, Karoli decided to inspect the wounded and possibly broken arm. First he donned plastic gloves, so as to avoid infection, he told us repeatedly, and then he slowly unwound the filthy rags. One of the old man’s children arrived. He reminded me of a thief as he shifted uneasily from foot to foot. As the bandages came off the room filled with a putrid odour and I was glad to sit down in case I passed out. When I saw the wounds I was glad that I was sitting by an open window. Everyone else took it in their stride. There was a huge wound on his forearm and a massive tear with flesh hanging out behind and above his elbow. Everybody was laughing which made me feel more uncomfortable. Suddenly it dawned on me, while I was coping with just being there, that Karoli, Hudi and Regina and numerous others were all trying to say an English word for my benefit. Slowly I worked out what they were saying……… ‘hipotopomous’….. ‘hipopopomous’ ….. . ‘hipatetimus ….. ‘hippopotamus!’
Now I understood, amongst gales of laughter, that the poor man had been attacked by a hippopotamus, ‘Kiboko’ in Swahili. He had been fishing in a river on his own, far from home and had been attacked. This was exciting news; I was actually in the same room as someone who had not only seen but had been in combat with a hippo! The only wildlife I had seen so far were thousands of grasshoppers escaping from bush fires in Katavi National Park.
Karoli cleaned the wounds as Regina held the broken arm carefully. The child in the next bed moaned. “Cerebral malaria” Karoli said confidently and told a nurse to administer another injection.
A murmur ran through the room and a short elderly man entered, not too steadily. ‘Shikamoo’ we all chorused as a greeting of respect. Who is this funny little man I thought? He was accompanied by the old man’s other son who looked even shadier than the first. There seemed to be an argument about the old man’s treatment. The first son wanted to send his father to Tabora which was a day’s journey by train. In Tabora he would be able to get an x-ray so that the arm could be set properly as Karoli had recommended. The second son wanted the old and unsteady man to advise them. Who was this old and unsteady man? Hudi explained that the man was unsteady because he had been drinking local beer and that he was the village ‘mganga’, the witchdoctor who specialised in broken bones. This made things even more exciting – a real life witchdoctor, even if he was drunk.
The main problem was that the two sons disagreed. The first son wanted to take Karoli’s advice, but sending the old man to Tabora would cost a fair amount of money. The second son wanted the witchdoctor to treat his father which would cost a bottle of beer. I was feeling better because the arm had been cleaned and bandaged.
It was decided that the old man should go to a hospital. The old man actually spoke and said himself that he wanted to go for an x-ray. Regina prepared to make a plaster of paris back slab to make the arm comfortable for travelling. Then another argument started and Regina waited and waited until all was finally agreed. It was decided that the old man would go to Mpanda hospital, which is local and his children went off with the witchdoctor to look for transport.
I then decided to speak and pointed out that, even I, a guest, knew that there were no x-ray facilities in Mpanda. The decision seems to have been based on economics. There had even been a suggestion that the old man would be sent to Mpanda (a 45-minute drive) on the back of a bicycle!
A week later Regina visited Mpanda hospital to administer physiotherapy treatment to some in-patients. She saw the old man and he had not yet had his bandage changed or the plaster of paris back slab removed.