Elia was seven years old when we met him in the pediatric ward of Kilimanjaro Christian Medical Center (KCMC) in Moshi last fall.
The village where his journey had begun just a few weeks earlier was impossibly beautiful and appeared to our western eyes to have been plucked off a Hollywood stage and set down at the base of Mount Kilimanjaro half-a-world away. The flowers and birds were challenged in beauty and number only by the many equally beautiful children who lived in the village, all of whom appeared to occupy themselves primarily with playing and singing. As I think of that village now, I can’t imagine ever experiencing another place where life and happiness and love were so abundant.
After visiting the village, it was really no wonder that Elia’s mother preferred not to leave. But her child was sick, and she must have realized that the fears and anxieties she had about the city would have to be overcome. The journey began with an hour-long walk, followed by a thirtyminute motorcycle ride, followed by a two-hour ride in a small public bus called a dala dala – all with a quivering child strapped to her back.
The proximity of the hospital can be judged at any point during the journey by the density of casket salesmen along the street. Within a kilometer of the hospital, the small casket shops line both sides of the road, interrupted only by an occasional restaurant or bar. The craftsmanship of the caskets was every bit as impressive as the size of the caskets was absurd. To my eyes, they were obviously much too small for anyone that would actually need one.
Upon reaching the hospital, little Elia was admitted to the pediatric ward quickly and efficiently, and tests were scheduled and run. KCMC has truly remarkable radiology and diagnostic services, and I watched Elia’s mother’s confidence grow as various practitioners explained the technology behind the x-ray, ultrasound, and CT. Elia himself seemed to look on in amazement as the doctors lined up and actually peered inside his body. Perhaps he wondered if they could see his soul?
After a week of poking and prodding, the Doctors returned with their diagnosis. Elia had a nephroblastoma, also called a Wilms’ tumor – the most common type of kidney cancer in children worldwide. In the United States this would have actually been a good outcome among a lot of bad possibilities because it would mean a relatively easy fix and a survival rate of at least 90%. However in low income countries like Tanzania, chemotherapy and radiotherapy are generally unavailable. Without adequate treatment, these cases end in death.
Elia spent a few more days at the hospital while the pathology was performed and his diagnosis was confirmed. We tried to help him enjoy the time as much as possible by bringing him Fanta, and chicken and chips for dinner. After Elia was discharged, we helped take him home.
As we drove back to the village, Elia’s mother indicated that she wanted to stop. We watched Elia in the car as she walked slowly through the shop, gently running her hand along the top of each of the smallest caskets. She exchanged a few words with the shop owner and then returned to the car.
As we continued on to the highway, I watched as Elia wiped a tear from his mother’s cheek. He was unusually small for his age, but his eyes were bright and filled with the wonder and optimism of youth.