Miftah Mohammed met us outside the police headquarters in downtown Addis-Ababa with a smile that could warm the hardest of hearts. To Alan and me, who had gotten hopelessly lost in the hustle and bustle of Addis streets, it was a relief to finally meet him. It was also an honour. We had heard Miftah’s story from Dr Yewondwossen, but the quietly spoken, gentle young man with the shining smile tells it much better. His is a story of remarkable resilience, resourcefulness and family love.
Miftah grew up in the rural village of Moherena Aklik, 150km from Addis-Ababa, where he lived with his 8 siblings and mother. Always a diligent and motivated student, he walked over 10km to school and back every day. This commitment to his education and schooling evidently paid off since he managed good grades and was able to enter Arbaminch University to begin a degree in Economics.
Yet he was not able to finish. It was as a 20 year old first-year student that Miftah first heard that he had end stage kidney disease. His father had died of kidney disease when Miftah was only 12, but he had never given his own kidneys much thought until he started getting unusually tired. Usually an active man and an avid football player, he noticed that he was becoming increasingly fatigued: “I could barely walk 500 meters without exhaustion” he told us. The results of a blood test revealed the bad news: “My sister was with me at the doctor, and when they told us the result we both started crying.”
For Miftah and many others a diagnosis of end stage kidney disease can sound like a death sentence. With only one nephrologist in the country, expensive dialysis treatment only in the private sector and no current transplant program anywhere in Ethiopia, it’s easy to see why. The only option for people like Miftah is to travel abroad for a transplant, and when the average annual income of a family is less than 400 USD, this seems like no option at all.
Yet Miftah had one miraculous gift that could save him: a close and loving family. Upon hearing of her brother’s condition, Miftah’s older sister took the initiative to raise the 60000 birr (35 000 USD) that would be needed for her brother to have a transplant in India. She helped Miftah write a letter to potential donors explaining his situation and together they explored every fundraising option available.
It was from the students of Arbaminch University that half of the funds were to be raised. For a few months his fellow students went vegetarian and donated any money that they would have spent on meat to Miftah’s surgery. The rest was raised from community members and the public. “People gave whatever they were able to give,” he says, “even if it was only 1 birr (7 pence)”.
Over the months it took to raise the money Miftah went on dialysis. “When I was on dialysis I met many other patients who later died because they could not afford to continue.” Fortunately, Miftah was not to be one of them. It took a total of 8 months, but eventually brother and sister reached their goal: 35 000 USD was theirs.
The money, however, was only part of the challenge. Finding a suitable donor was another difficult task to undertake. Here too, however, his siblings stepped up to the challenge. Miftah’s younger brother, Abdurakman, proved to be a match and without hesitation agreed to donate his kidney.
In 2008, the three siblings – Miftah, Abdurakman and their sister – travelled to India for the life-saving operation. “It was my first time in an airplane,” said Miftah, which was a rather exciting experience. When they arrived in India the three rented a room, which was to be their home for the next two months.
In India, Miftah met many other kidney patients from around the world who had come to India for their transplants. From these patients h learnt a great deal about the operation and what to expect, removing some of the anxiety. The operation itself turned out to be a great success. “The doctors were very friendly” says Miftah, “and everything went well”. Despite the amount of pain he experienced in the first week after the transplant and an infection he caught 10 days later, which cost him an addition 25000 rupees to treat, Miftah’s new organ appears to have made itself comfortably at home in his body.
And how does it feel to have to have part of his brother inside of him? “No words can describe it” says Miftah. No doubt it has brought the two closer together. In fact, Abdurakman’s brotherly generosity doesn’t end with an organ. He is also helping to fund his brother’s medication through his business selling trousers in the market.
The cost of medication is in fact one challenge which Miftah and his family still face. Being a transplant patient is hardly cheap. For the rest of his life, Miftah will have to fork out 25000 birr (1560 USD) a year for immunosuppressant medication that ensures his body does not reject his ‘foreign’ kidney. Add to this the 100 birr (7 USD) he pays for every nephrology consultation and the 350 birr (22 USD) for every blood test (monthly expenses that will also continue indefinitely), and you can see why Miftah was forced to drop out of university in order to work and fund his medical expenses. Even now, he can’t afford the monthly check-ups required; “I don’t really go for check-ups until Dr Yewondwossen calls me and tells me to get my blood checked. I go only about every 2 – 3 months” he says.
Apart from the expenses, Miftah’s transplant has also meant huge changes to his lifestyle. Most importantly, Miftah has to be careful with the food he eats. He eats mostly vegetarian foods now and only those that have been cooked so as to avoid infections. Because of his restrictive dietary requirements Miftah has had to move to Addis-Ababa; “There is no food I can eat in the villages,” he says.
Miftah plans to stay with his brother in Addis and help him with his business. He’d also very much like to continue his studies one day. This time, however, he’d like to try his hand in the healthcare sector: “I think I’d like to study nursing now,” he says, “My life is related to it”.
Indeed, as a transplant patient, Miftah’s life will probably always intertwine with the healthcare sector, often in ways that are not altogether harmonious. Yet, with the help of his loving family, his own resilience and shining smile, I have no doubt that Miftah will rise to the challenge.