A piece of my day

Addis Ababa, 1998.

He looked much older than his 57 years. 

It was easy to note how emaciated he had become.  He was pale. His breathing was shallow. His belly was distended. His legs were thin, barely any muscle on his bones.

His daughters and his wife were standing by the bed side.

They had a resigned look with swollen eyes and dried tears.

 “Yimarih,” he said.

That was his last word.

His liver had failed from Hepatitis C virus and repeated doses of Hagenia Abyssinica or Kosso, the word used for the medicinal plant that many Ethiopians of my generation used for intestinal worms which is quite frequent as a result of consumption of raw beef or minced raw beef marinated in spiced chilli powder. The food tests so good most would risk having worms than cook it. The use of plants for medicinal purposes is very common place and wide spread in Ethiopia, a country endowed with diverse resources with different habitats and vegetation, knowledge often passed by word of mouth from generations to generations. Hagenia Abyssinica is one such plant commonly used for medicinal purposes especially in adult tapeworms but without much appreciation of its toxic effect on the liver particularly when used in large doses and multiple times.

Liver disease and liver cancer are very common in Ethiopia and other developing countries. Aside from the toxic effect of herbal medications, Hepatitis B and C viruses have high prevalence.

He suffered with many complications that required hospitalizations.  Treatment for Hepatitis C virus was not available. Not too long ago he survived a major bleeding episode.  During his last few months, he had to have 3-5 liters of fluid removed from his belly almost on a weekly base to ease his shallow breathing and distress.

“Yimarih (bless you),”he uttered after I sneezed; his voice was very faint.

It didn’t register in me until I sat down in the nursing station to write his death summary. It was overwhelming. I wasn’t feeling well myself with common cold but nothing compared to his ordeal.

He died of complications of liver disease; he was a good person, I wrote.

WHO Key facts

Hepatitis C is a liver disease caused by the hepatitis C virus.

The disease can range in severity from a mild illness lasting a few weeks to a serious, lifelong condition that can lead to cirrhosis of the liver or liver cancer.

The hepatitis C virus is transmitted through contact with the blood of an infected person which can occur through injections with contaminated syringes and needle-stick injuries, injection drug use, being born to a hepatitis C infected mother,  sex with an infected person, receipt of contaminated blood transfusions, blood products and organ transplants

About 150 million people are chronically infected with hepatitis C virus, and more than 350 000 people die every year from hepatitis C-related liver diseases.

Hepatitis C can be treated using antiviral medicines.

There is currently no vaccine for hepatitis C; however, research in this area is ongoing.

About Tenayistilign

I am a physician trained at Jimma Institute of Health Sciences ( now Jimma University, in Jimma, Ethiopia) and Wayne State University ( Detroit, MI, USA). I teach and practice General Nephrology/Hypertension and Kidney Transplantation in the USA.
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