A situation when my impotence has consequences
on Melissa Hipkins (Rwanda), 03/Nov/2010 05:46, 34 days ago
Zebounissa texted me this morning with a message to say one of her cats was not well, was I at home and would I come and have a look? I was a bit uneasy as a lot of times cats look rough but there’s nothing much to put your finger on and without a stethoscope or even a thermometer I could be struggling to be much help other than to suggest she calls the vet.Anyway I turn up about an hour later and find Zebounissa up to her ears in her daily business of phone charging; receiving phones in and dispensing phones once charged to the majority of the town population who do not have mains electricity. There is a continual stream of her clients needing her attention and for some reason she is loath to delegate this constant getting up and down to Innocent, her domestique. Once free to talk, she begins by bewailing the loss of the market.The market is the town and all life revolves around it. Those who enter by its substantial walls are regaled by all forms of trade. The vegetables and fruit take only a small proportion; it’s the department store of Nyanza with everything from clothes and household goods to workshops repairing shoes and tools or selling stoves and cooking pots. The permanent shops outside the market place have sprung up because of it and the buses and moto taxis all gravitate to it for their customers.The market has always been on her doorstep, literally a step across the road. This has been to her benefit as it attracts a stream of people who pass her door in order to do business in the market and helps her other business of supplying spares for bicycles. Last Saturday, the market was closed and all the stalls dismantled and carried away. This plan for a radical revamp of the market has been in the pipeline for years and now is being acted upon. Unfortunately, the planning did not go so far as to select a temporary site that was anywhere near the old site. It is now a trudge of 2 kilometres to reach and the date for opening the refurbished market could be anytime between 1 and 3 years, depending on how the money holds up. Her bicycle business in particular has taken a hit and now Innocent spends much of his time journeying on errands and less on helping her when she’s overrun by clients. As I was passing the market on the way to Zebounissa, the demolition gang were removing the tiles from the permanent booths that line the high market walls and some were sitting astride this wall already taking its bricks apart ready to expose the site in all its squalor ofdiscarded cardboard boxes and rotting vegetables.Zebounissa now turned to Mitsoua, the patient. The cat had been fine the day before but hadn’t eaten today. Zebounissa had expected her to give birth any day and thought she may have started yesterday. I could see her diagnosis of pregnancy was spot on but the purulent vaginal discharge, infection of a breast and the general lassitude made me fear that the outcome would not be good. A call to the local vet was essential, but Zebounissa knew from past experience that she had no surgical knowledge.Louise has had many dealings with Zebounissa and her cats. She responded to the call within 45 minutes and gave her a brief examination. Mitsoua was running a fever which I think is always good news; some of the lethargy may be due to the temperature and the response to medicines is generally better. Louise showed me what she had available to inject, a rather farm animal cocktail of penicillin and streptomycin, phenylbutazone for the inflammation and something I hadn’t heard of used in horses for colic. All with the aim of facilitating the birth of the kittens, I suppose.Zebounissa's contribution was to furnish a couple of used 5 ml syringes from the top of her cupboard and a cup of hot water to flush them with. This was topped off by a used needle from Louise, the one serving all three injections, each enough to treat the average calf and then some. I offered to do the operation but Louise said she had no anaesthetic or equipment; if we were contemplating surgery she would have to go to Kigali and buy it all. This was obviously no solution so I volunteered to call a Vétérinaires sans Frontières vet I had contact with in Butare, 45 minutes away by bus. My text has remained unanswered throughout this whole unhappy episode.It was getting too late to think of going to Kigali that day, I could not get a bus home in time. The cat seemed no worse the next day and with the failure of my vet from Butare to call back, I contacted ISAE Busogo for a referral vet who was known to operate on cats. Dr J offered the name of someone he would recommend and I gratefully telephoned him to see if he could fit her in that afternoon. My enthusiasm was dampened after my enquiries revealed that he had no general anaesthetic; all would be conducted under sedative and local anaesthetic. What was more disquieting was the local would be applied in the form of a spray onto the skin and not injection. In fact the operation would be performed under sedation alone, local is notoriously ineffective at penetrating intact skin. With a heavy heart I asked the price of all this; 40,000Rwf, about£45.00. Telephoning Zebounissa with this news she initially baulked at the cost so I put them in touch with each other to arrive at a mutually acceptable fee.Zebounissa rang me back to say they were at impasse; Dr S would not come down from his 40 and Zebounissa was not budging from 10. I had asked the good doctor about euthanasia but he himself admitted the agents he used amounted to no more than poisons. So what to do. If I had had more faith in the chance of success of an operation I might have contributed financially, as it was I would have been the one to take Mitsoua to the clinic in Kigali. When offered the option of euthanasia, Zebounissa refused. I am of the opinion that in terms of welfare and unnecessary suffering, the cat was no worse off taking an albeit infinitesimally small chance of pulling through without surgery than to submit to an anaesthetic in name only. That together with a standard of aftercare that excluded fluids (I quote:”cats’ veins are very difficult to find”). I went to see her the day after and Zebounissa reported that she had eaten and looked a bit more lively. More messages followed over the next few days indicating progress one day but relapse the next. With no signs at all of any kittens being passed,the outcome was inevitable. Mitsoua died on the following Sunday night, 6 days after the beginning of her kittening.There is a community of ex-patriots of many nations living in Kigali, all of them earning good money. Many of them have dogs, perhaps a few have cats. I cannot believe that they would put up with such sub-standard care for their pets, just as they don’t when it comes to doctors and hospitals. The moneyed section of Kigali society make sure there is a network of reliable health care for themselves outside the congested and cash strapped system for those who are unable to pay. I’m sure if I delve deep enough I would come across similar arrangements for their pets.