Time felt interminable. My mind was clouded in confusion. An average 22 year old should be spending their time trolling girls on social media, playing some sport, idling around with friends or swiping left on tinder. Anything but a discussion about having your mom’s leg amputated.
I am the first born of three children; a younger brother and sister. My folks — as I loved to call them — had a unique relationship. They were always engaged in good-natured banter despite being co-workers. Someone would think they had said everything they needed to say to each other in their 23 years of marriage but they still evidently loved each other.
One weekend in August 2018, they, together with some relatives, travelled 380km to Kakamega for a function. Because they were on a tight schedule, the plan was to do a round trip in two days. On their way back, on Saturday evening, my mum called at around 10 pm to let me know that they would be home in two hours. As was routine, I waited up for them, slouched on the couch as I watched TV.
One hour later, I got a distressing phone call that the folks had been involved in an accident in Naivasha and had been taken to the nearest public hospital there. I burnt rubber on that highway accompanied by one of my dad’s friends and was in Naivasha in 45 minutes.
I drove into the hospital and went straight to the casualty area. The first person I came across, was my aunt lying along the corridor on a stretcher with a sutured cut on her forehead. She was coherent although she seemed to still be in shock. As I spoke to her, I could hear someone groaning nearby from where I stood. I asked her about the folks. She wasn’t sure where my mom was but pointed to where my dad had been taken.
As I walked towards that area, the groaning became louder; it was unmistakably my dad’s voice. I stopped for a minute; gripped by the fear of what was coming. In all my 22 years, I had never seen or heard my dad in such anguish. I walked into the room and was met by the heavy smell of copper. It choked me. My dad was on a stretcher making deep continuous groaning sounds as a male medic sutured a cut wound on his face. His clothes had small streaks of blood here and there but nothing stood out at that point. I touched his arm. “Dad.” His eyes fluttered open. “My son. Thank God you have come. Where is your mother?” Even in his anguish, it was my mum he thought about first.
I left immediately to look for her and met my aunt again who mentioned she may have been taken to the female ward.
There was only one female ward; weirdly structured like an asylum. It had a grilled burglar proof door at the entrance and it was locked with a huge padlock. I looked through to a long abandoned hallway to the end of the ward. There was no one in sight and it was deathly silent. At first I knocked politely and then imagining that my mum could be locked in there, I began to shake the bars of the door. Still no one came. I hit, kicked and literally body slammed that door until eventually I saw a female patient limp towards what seemed like the nursing station.
I could tell she was trying to wake someone up as a figure resurrected from behind this huge desk and sleepwalked towards me. I enquired about my mum as she struggled to unlock the padlock, still half asleep. For some reason, I didn’t wait for her to respond. As soon as the way was clear I walked in and found my mum in the first cubicle on my right.
At a glance, she seemed ok. In fact you couldn’t tell just by looking at her, that she had been involved in an accident. But she too was groaning and rubbing her right thigh, trying to move or position it. I was by her side in a flash. She looked relieved to see me. “Kyama. My leg. I can’t feel it. Please turn it this way.” She pointed to her right side. I didn’t quite understand what she meant but I simply followed instructions while asking the nurse what injuries she had and what tests had been done. She was still groggy and all I could hear was ‘the machine is not working’, or ‘has broken down’ and I knew I had to get my people out of there. Thus began the process of getting them transferred. It was now two and a half hours after the accident.
To add to this delay, their insurer claimed they were not on the system. It is only after numerous phone calls that the mistake was rectified. Eventually we managed to get an ambulance to come to the hospital to pick them up. By this time I could feel the fatigue creeping in so I positioned our car to face the main gate so that I would spot the ambulance immediately it arrived.
Unknown to us was that as we waited by the main gate, the ambulance arrived and used the side entrance to access the hospital compound. Confusion ensued. The emergency response team found the casualty area abandoned save for a few casuals milling about. There was no one to receive them and identify the patients they had come to pick. This hide and seek lasted another two or so hours.
In a nutshell, we were leaving Naivasha at 5am; six hours after the accident. I rode with my parents at the back of the ambulance; mostly in silence except for the occasional groaning sounds they made everytime we drove over a pothole,a bump or worse — rumble strips. Those made my dad squeeze his eyes so hard I saw tears roll down his eyes. If pain had a face this was it. All the while he held my mom’s hand across the stretcher.
We finally arrived at a private hospital in Nairobi at 7 am; eight hours after the accident. The team there responded in haste. They received us and immediately separated the folks; each being managed by different teams. I wanted to split myself in half. I opted to follow my dad first because he looked worse off. During the examination, he bent over and threw up vomitus with old blood. There was the smell of that copper again. Unable to compose myself, I went into the waiting area and remembered I had not called anyone. Not even my siblings. I made two calls. One, to another close friend of my dad and the other to my siblings.
While there, one of the doctors approached me. “Are you the next of kin?”
“Yes I am. Those two are my parents.”
“ In that case you need to sign consent for us to take them to theatre. Your dad sustained blunt force injury to his chest. He has some internal bleeding and we need to operate to arrest it. Your mum also sustained blunt force injury to her abdomen and damage to the artery supplying her lower limb; possibly because of her safety belt.”
Up until this point in my life, the most significant thing I had ever signed was an application form to open a bank account. Now I was being asked to make a decision to allow them to operate on both my parents and I was all alone.
“There is no time. They are both seriously injured,” he said as if he had read my mind.
I signed. By 8am both my parents were in theatre — nine hours after the accident.
By this time my dad’s friend, my siblings and a few other relatives had arrived. At one pm, 14 hours after the accident, my siblings and I were called for a debrief. We were in a small waiting area when the primary surgeon walked in. He was a tall, Arab doctor who was poised and exuded confidence.
“So we took your dad in, almost immediately after you arrived. As I mentioned to you,” he turned to me, “he had some internal bleeding in his chest cavity. We opened up his chest and came face to face with a huge clot.” He demonstrated the size with his hands. “ Unfortunately he had severed a major vessel and with all our attempts at repair he bled out on the table. I am sorry. We did all we could….”
I definitely did not see that coming. Not from a million miles away. My mind did not comprehend what he was saying but my body did. I fell to the floor in utter shock. My sister broke out in loud continuous sobs, each louder than the last. My brother cried silently — tears streaming down his cheeks. To think that I was with my dad just a few hours ago in the ambulance and now he was suddenly…no more.My thoughts veered towards my mom. How would we tell her?
In quick succession, the police from Naivasha called me — through the hospital — to discuss the details of the accident. Details that I had not yet known at this point. Once I was done with them, it was time for another debrief; this time in ICU where my mom was. They reported that they had found her intestines gangrenous and had to resect the diseased areas. They also attempted repair of the artery that supplied the right lower limb and were optimistic that her leg might be reperfused. However, because she was still unstable, she was placed in a medically induced coma. We were allowed to see her briefly so we prayed with her and left.
Mental anguish. That’s what it was. The death of one parent while the other lay in critical condition —all in less than 24 hours. The next few days were spent criss crossing between funeral arrangements and the ICU. What was even more perturbing is we couldn’t set a burial date because we wanted my mom to be involved in that decision.
In a pleasant turn of events, her level of consciousness began to improve. If you were loud enough, she responded by a gentle squeeze of your hand or a flutter of her lids. Her right thigh had regained it’s blood supply but the right leg remained poorly perfused. That was what necessitated the decision to amputate her leg. As I signed the consent forms I remember wondering how she would feel when she woke up to find no leg and worse still no husband.
The surgery went well but her kidneys began to misbehave a day later and she was started on dialysis. A few days later when I was preparing to turn in, I was summoned by one of my uncles who had just fine from the hospital. I met him downstairs in the living room, barely awake.
“Kyama, on our way here from the hospital, we were called by your mum’s doctor. While they were preparing her for dialysis, her organs began to shut down one after another. They said they tried to resuscitate her…but were unsuccesful.”
My world as I knew it ended at that very moment. I had such a deep feeling of hopelessness and utter despair. My mind wandered in search of answers to questions I could not articulate. I did not utter a word. To speak meant I had acknowledged what I had just heard — so I remained silent. We went back to the hospital to see her and I remember touching her and feeling her warmth — a warmth I could not fathom I would not feel again.
She had followed my dad — her best friend- exactly a week and a day after the accident. I was silent for a long time after that.
I was gripped by such gall as I went through the events of that fateful 24th day of August 2008. So many what ifs clogged my mind. I remembered the derelict state of the public hospital we were in and thought, if that was the actual state of our hospitals, how many needless deaths are courted in this country.
We never got to know the exact circumstances of how the accident happened; just that it was a head on collision with another vehicle. Everyone in the vehicle was tired from the trip and asleep ; except the driver who seemingly also could not remember what transpired. He survived.
The phrase ‘til death do you part’ clearly did not apply to my folks. I am consoled that even in death they remained together. God saw it fit.
As narrated to me by Kyama S Mutui.
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There are six building blocks of a health system:
Health financing
Service delivery
Health workforce
Health information systems
Access to essential medicines
Leadership and governance
They are each connected in an intricate web to be able to deliver effective, efficient, timely, safe and quality healthcare to those who need them, when they need them without causing financial catastrophe to the patient.
None is superior to the other and if one block is missing or inadequate, like a house of cards the health system will soon come tumbling down.
It is not enough to insure yourself against accidents and illnesses; we need to lobby for improvement of services in our public healthcare system.