Testing, Testing 1, 2, 3

“What’s troubling you today? How can I help?”

His badge read “ Dr. Ibrahim” and as she sat there in the cold room, the bare walls devoid of personality she could hardly contain her nerves. Her eyes darted across the room, until she finally found a plaque that would be the perfect ice-breaker.

“I see you attended the infamous University of East Africa?” she noted.

You see Dr. Ibrahim was an old man, an experienced doctor a credit to his many years in service of the public; from his time in a remote village in Emurua to his post-graduate studies in France, there’s hardly anything he had not encountered went it came to the female reproductive system. On first glance, one may notice the furrows on his forehead; an indication of his expressive habit while ingesting the sometimes unexpected symptoms, leaving him fuddled; often sending his head reeling.

But Dr. Ibrahim was well respected; his approach was methodological and sometimes unforeseen at least by industry standards. But he always seemed to figure out it. Either he knew his stuff or his God nudged him in the right direction. Dr. Ibrahim had a darkened spot on his forehead; an indicator of his reverence for God. He never missed any of the 5 prayers Muslims are required to make. He must have made dua for his patients.

This was the third doctor she would be seeing in 6 months. She was desperate and tired. She wished she was not alone. She hoped her husband would make it but he was pre-occupied. He was always pre-occupied.

She was alone, but by now she was used to it.

So there she found herself, gripping the chair as she consulted with the doctor. In any other occasion, she often gave off the impression of being in control, poised and self-aware. Here she was scared, worried and alone; she was a shell of herself. Dr. Ibrahim could tell. He offered her a glass of water, and as he handed it over to her his old hands passed over hers.

He looked up to her saying, “Everything will be alright.”

She wondered if he knew the Bob Marley tune.

Dr. Ibrahim has a waiting room full of patients but he always had a way of making every patient feel like they had his undivided attention; there was nothing more important than what was going on right there and then.

He asked, “What brings you here today?”

“Well, you!”

The tension, nerves seemed to overwhelm her and as the jitters got the best of her she could no longer hold back. Her tears streamed down her face, as she struggled to compose herself, get a sense of herself as she unraveled.

She was a well-adjusted individual. For intents and purposes one could say she had her wits about herself. She was a doting mother, supportive wife and a high-powered human rights lawyer who’s kindness for others meant that she never said a bad thing about another human being, even when that human being was her callous in-laws. She was no saint, but she did her best.

She said, “I bleed every time my husband and I…I have sharp pains that leave me in agony and chills. I’ve tried everything but nothing seems to help. I’ve tried meditation, I’ve been diagnosed and treated for a myriad of conditions, but no medication seems to help…this might be the end of my marriage…I can’t imagine he’ll continue to want… ”

As she continued to babble on with her list of concerns, she was more than glad to have a sympathetic ear in Dr. Ibrahim. He handed her a box of tissues and continued to question her on the lists of tests, examinations and medications she received. Silently jotting down everything on his notepad, he often interjected with “aah…I see” as if every piece of information would led him one step closer to a proper diagnosis. 

His presence was reassuring, he was gracious yet focused.

She handed him her ultrasound scans, previous test results and sat there, like a school girl waiting for instruction as she sniffled into the now large pile of used tissues.

He asked her, “I need to do an ultrasound…Datu will help.” He reached over his large, ornate mahogany desk and picked up the phone.

“Please call in Dadyu,” he said.

Delightful Dadyu walked in, baring a smile that bared sunshine. She gestured her to the examination bed and told her to roll up her sleeve. She pricked her skin and drew blood. She almost always winced in pain when having her blood drawn, but today the thoughts in her head occupied her, overwhelmed her so much so her fear for needles could not compare to the unknown that brought her here.

Dadju then asked her to unbutton her pants. “Please unbutton your pants and lift your top ever so slightly, we’ll place the gel on your stomach region, and pass the wand over it. It might hurt a little as we have to apply some pressure to get an accurate reading. But do not worry. Try to relax.”

Although  Dadju’s sunny demeanor and unusually broad shoulders would have been a welcome distraction, she was more concerned with what they might find; or if they would find anything at all. He proceeded to carry out the examination, and all Dr. Ibrahim did was to grip his pen tight as he stood not too far away but close enough to see the monitor. As she grimaced in pain, she wondered what would come next.

As delightful Dadju finished the examination, she wiped the gel off her stomach, collected her items and smiled at her. She proceeded to lead herself out, leaving Dr. Ibrahim to do the explaining.

“Well, there are two probable causes for your unrelenting frustrations, but I need to conduct further tests. We will know more when the results are out.”

Cervical cancer and pre-cancer lesions can be detected through a Pap smear test. For this test, your doctor/nurse looks inside your vagina using a device called a speculum. He or she will then use a small brush to collect cells from the cervix that will be examined in the laboratory. Depending on your age, the doctor will also do a test for a virus called human papillomavirus (HPV). Women between the ages of 25 to 64 are advised to have Pap smears every three years. However, HIV positive women are urged to undergo the procedure every year. The widespread use of cervical screening programs has dramatically reduced rates of cervical cancer in the developing world.

Dr.Khadija Warfa recommends, a well-proven way to prevent cervical cancer is to have testing (screening) to find pre-cancers before they can turn into invasive cancer and vaccination in pre-teens against the virus that causes the cancer. According to reports by Aga Khan University Hospital, Cervical cancer ranks as the fourth most frequently diagnosed cancer and the fourth leading cause of cancer death in women and yet is a preventable disease. According to WHO 2018, 33 per 100,000 women in Kenya have cervical cancer and 22 per 100,000 die from the disease.