Liver Disease- Pregnant with air for 16 years

Jul 07, 2010

JUST the mere mention of Mama Tumbo and any child in Mugungu village in Busia town will lead you to Teopista Nabwire, a 34-year-old woman who has been ‘pregnant’ for 16 years.<br>Since 1997, Nabwire has been selling a mixture of cooked maize and beans known as kitheli. Her hut in a slum at the

By Egessa Hajusu and Irene Nabusoba

JUST the mere mention of Mama Tumbo and any child in Mugungu village in Busia town will lead you to Teopista Nabwire, a 34-year-old woman who has been ‘pregnant’ for 16 years.
Since 1997, Nabwire has been selling a mixture of cooked maize and beans known as kitheli. Her hut in a slum at the border town, stands out.

She happily attends to her customers, some of whom sit on a bench to eat the morning meal, while others carry theirs home.

With a big tummy that almost touches the ground when she sits, Nabwire has trouble breathing, is very thin and frail.
But as she narrates her story, the dark-skinned woman is full of life, often flashing a bright smile, contrary to her sad story.

How it started
Born in 1978 to David and Pacalia Awori, Nabwire is the third born in a family of 10 children.

She went to Kilu Primary School but stopped in Primary Four because of financial hardships. She was sent off to live with a grandmother in Busia on the Kenyan side.

When she was 15 years old, thugs attacked their home and she fled back to Uganda.

Nabwire was then married off.
However, four months into the marriage, her tummy started swelling - it all pointed to a possible pregnancy.
She occasionally menstruated, but since the cycle was irregular, elderly women concluded that she was experiencing pregnancy spotting.

“My mother-in-law said it was normal. But after three months, the stomach hurt none stop for three days. I developed diarrhoea, but it stopped,” Nabwire recounts.

“I would feel like a baby was moving in my tummy and it was progressively swelling. After 11 months, I went to a clinic and the nurse said the baby was just taking its time, but recommended that I seek help from a hospital.”

Since there was not major pain, save for the discomfort of a big stomach, Nabwire chose to wait a little longer as she put money together.

Two years later, her husband’s family chased her away because she was not giving birth.

They said she had been bewitched and would bring bad luck to their family.
“I went to Murumba Hospital in Kenya and was told my condition was advancing. I was referred to Kisumu Hospital where they recommended an X-ray.

“I was told I needed an operation, which would cost Ksh15,000. I fled and did not go back because I did not have the money,” she says.

Her parents advised against the operation, fearing that she would die. Okumu, her father, believes his daughter was bewitched. “Normally herbs can cure such a condition within three to four months, but hers is rare.

I think the gods are saving her for a reason otherwise she would have died a long time ago,” Okumu notes.
He says they have seen a number of native doctors but none has been able to solve the problem.

“One succeeded in reducing the stomach slightly, but he demanded a lot of money. He wanted sh700,000 for her to recover. We could not raise the money. We have sold everything; land, animals, but the herbs have failed to cure her,” he says.

Nabwire wants an operation. “The pain is too much. I can’t endure it anymore,” she says.

“Something as hard as a stone keeps moving in the tummy. During such days, the pain increases and I eat very little food.

“The hard thing keeps changing positions, but it gets worse when it settles into the lower abdomen. My ribs hurt, especially when it moves to the left.”

Nabwire says her menstrual cycle is not regular, she usually suffers from constipation, urinates frequently and when she eats, her stomach feels bloated.

Nevertheless, Nabwire tries to keep herself busy with daily chores. “I dig, collect firewood, do house chores and cook,” she reveals.

Nabwire says she has been called all sorts of names, but fears to insult anyone because they will not support her business.

“Besides, I love children. I have many nephews and nieces,” she says.
But that is the joy she may never experience – to have children of her own.

“Men do not make advances because they think I am pregnant,” she says.

Medical explanation
Dr. Chris Oundo, the medical superintendent of Masafu Hospital in Busia district refers to Nabwire’s condition as a gross abdominal distension.

“She suffers from fluid accumulation in the abdomen. There are many diseases that can cause fluid accumulation in the abdomen, including, but not limited to, liver disease, inflammation or infection of internal organs such as the pancreas, and cancer of any of the internal organs,” he says.

Oundo says he needs to do a thorough medical assessment on Nabwire to ascertain the cause of her distended abdomen before he can draw any conclusions.

He says he sees many cases of gross abdominal distension both in adults and children.

“We get about three cases per month. The condition is mainly caused by inflammation of the liver, cancer of the liver, enlarged spleen, ovarian cysts and Hepatitis B,” he says.

Oundo says Nabwire requires a CT scan. However, despite the presence of the equipment, the hospital, the only major health facility in Busia district, does not have a radiologist to operate it.
“Private facilities charge sh15,000 for the test,” Oundo says.

He says, many of the causes of abdominal distension can be managed surgically and controlled, depending on the stage of the condition.

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