Survival of the Fittest in Zimbabwe

I am writing this from the small desk in my small room at the Traveller's Guest House in Bulawayo, Zimbabwe, where my sister, Angie, and I have come to visit a Zimbabwean friend (really more of a family member – our native brother) who has advanced myeloma.

He was diagnosed in 2014 and is still on chemo (currently on Thalidomide – which intrigued me). Has had radiation and was recently admitted with pneumonia, after which he has had to be on renal dialysis twice a week (at a cost of $165 a session). A myelomatous lesion in his spine has caused his legs to become paralyzed so he is confined to a wheel chair, has an indwelling bladder catheter and has to be lifted in and out of the car to go to his doctors appointments, by his devoted wife and whoever is around to help – often his brothers son, who lives with them, along with their own 5 children.

This for a guy who used to be a dancer/showman and take his Grassroots African dance troupe around England and other countries giving exhibitions of African dance, and perform locally to help, kids especially, with cultural and social development.

Although I am a doctor, I am no expert on myeloma and am appreciating the difficulty any patient with a complex problem has of knowing about the condition – being informed enough to make good decisions. Or help their doctor make good decisions.

Also, his specialist in Harare has been very reluctant to share lab results – which provide crucial information as to the stage he is at (not so different from the “civilized” world).

We met with his local primary care doctor yesterday – a gentle, softly spoken, if rather frazzled looking elderly man in bright pink shirt, who answered our questions patiently, despite his cell phone ringing repeatedly, and we having to wait for him because he was called away to an emergency.

Healthcare in Zimbabwe is in a shambles – or the state run system is, which we are told has no supplies (reputedly because of government corruption, and officials who are pocketing all the wealth from the rich supply of diamonds and minerals the country has). Our friend is going to a private hospital run by an Italian order of nuns – but, though Angie has been energetic in her fund raising in England to pay his medical expenses, he only has about enough money in the fund to last 4-5 more months of dialysis.

And then what?

One of my crass jokes is that working at the Moss Clinic is reminiscent of working in the two mission hospitals that I did in Zimbabwe in 1985 – the similarity being destitute patients and lack of resources.It seems to me that, although there is the best care in the world available in the US if you have the money, the situation in Zimbabwe is a bit like the final end point that the US may end up at if healthcare continues to be “survival of the fittest.”

Our “brother” is one of many around the world who is liable to die simply from not having the money to pay for treatment. But one we are personally involved with and who has given much to others. If you are moved to make a donation (and I know everyone is soliciting your hard earned money these days), go to



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