JACK ZIMBA, Lusaka
RECENTLY I returned to a place I had first visited 17 years ago in Kasempa, North-Western Province. It is a place with an unforgettable name and unforgettable misery.
After negotiating our vehicle between nondescript brick-and-mud houses, we burst into a small compound on a hillside with rolls of small brick houses.
Coming to a stop, our vehicle was soon surrounded by curious faces, children in tatty clothes peering inside the vehicle, while the adults sat idly outside their houses.
A one-legged man sat quietly on the door-step of his house, his chin cupped in his hand, while an elderly woman with crooked legs hobbled across the compound, supporting her body on a long stick.
Outside a nearby house sat a half-blind woman with her daughter and grandchildren, while at the next house sat a man and his wife.
The man had stumps for his feet and his right hand was bound in a dirty piece of cloth.
I had come back to Kikonkomene, one of the few remaining leprosy centres in the country.
I was accompanied by Bernard Kameko, a dedicated government social worker who works closely with the community.
Twenty lepers live in the secluded compound, which was opened in 1968 to take in leprosy patients that were being treated at the nearby Mukinge Mission Hospital.
But with the disease now rarely occurring, Kikonkomene is now a diminishing community.
In 2003, when Mr Kameko came to work here, there were 38 lepers living in this compound, now there are 20.
Three died last year, and one died at the beginning of the year, mostly due to complications that come with old age.
Some of the inmates are now old and frail.
Inside one of the small houses lay an old woman.
Upon hearing our voices, she dragged her frail body to the doorway, revealing her toeless feet.
She is 96-year-old Elesa Muselepete.
“She is going towards the end. Her condition has been worsening; the doctor did whatever he could do,” said the social worker.
Since her condition began to decline, two of her daughters came to stay with her in the compound, helping her perhaps to just have a dignified final moment.
Inside another house, an old woman, Enika Chilende, lay in a foetal position on a mattress. Half her legs were missing, eaten away from her knees down by leprosy.
Her wounds were fresh, filling her poorly ventilated room with the characteristic smell of open flesh.
It was a tear-jerking sight.
“My whole body pains,” the old woman said in a whimpering voice.
According to Mr Kameko, during the hot season, the lepers’ wounds usually become septic.
To a first-time visitor, Kikonkomene is a place of depravation, pain and suffering on a Biblical scale.
And with little support from Government, Kikonkomene offers little to alleviate the suffering of its residents, many of whom also suffer psychologically.
The list of needs here seems endless.
For the past 10 years, the residents have survived on the goodwill of Dr David Friend, a New Zealander who works at Mukinge Mission Hospital.
Once in a week, Dr Friend comes to the centre to attend to the residents, giving them medicines and health checks.
Mostly he treats their wounds.
According to Dr Friend, the lepers usually suffer from injuries because they have lost sensitivity in the areas previously affected by leprosy.
“The ongoing damage occurs from injuries they might receive, but they don’t realise because they don’t feel pain, so they keep damaging them. It is not the leprosy that is eating on their limbs,” he said.
But Dr Friend brings more than just medical assistance, he gives the residents food and other supplies, as well as rehabilitating their living quarters.
The doctor recently helped to build kitchens for each of the 20 houses.
He also assists in burials.
His name is on the lips of all the residents of the community.
Mr Kameko now worries what will happen when the doctor goes back to his native country.
“Government does not support the centre, there is no deliberate grant for the lepers from Government,” Mr Kameko said.
Although all the inmates are on social welfare and receive K360 once in two months, they complain the money is not enough. They usually borrow in-between and pay back once they are paid by the government.
The residents also live on rationed water – 60 litres of water per household from a communal tap – because the water company charges a fee for the commodity. The community has to keep the monthly bill at not more than K120 per month.
Dr Friend foots the bill, and sometimes a local church comes to the rescue.
Those that need more water have to walk down to the stream, a few hundred metres away.
There are a few communal pit-latrines for the residents that are not easily accessible, especially to some of those that have lost their limbs.
“It is hard for them to get there, but they just have to crawl,” said Mr Kameko.
This place also offers little hope for the lepers’ children and grandchildren.
The children don’t usually advance in their education.
“We have never recorded a success story from there,” complains the social worker.
Decades after leprosy was eradicated in most parts of the world and hardly ever makes headlines, one would expect the community around Kikonkomene to be less discriminating of its residents, but no.
The residents of this secluded community still face discrimination from the society outside.
The name Kikonkomene itself is a derogatory Kaonde word meaning ‘bent’ or ‘crooked’, referring to the nature of the people found here.
“There are some cases which we tried to integrate into the communities, but they were totally rejected by their own families. They refused to take them,” said Mr Kameko.
When I asked the chairman of the community, Misheck Miyanda, how he felt about the discrimination, he gave a depressing answer.
“It brings me a lot of sorrow. It is even better to die,” he said.
There are still some in the outside community who believe leprosy is caused by a curse or ndemone (demon).
But some are more accepting of the lepers.
For instance, Mr Miyanda married his wife from the outside society 18 years ago.
“When I was single, I used to have a lot of challenges collecting firewood, water and cooking, so I decided to look for a helper,” said Mr Miyanda, who is poorly-sighted.
“We are a happy family and I’m a very happily married woman,” the chairman’s wife, Migress Kabele, told me.
According to Dr Friend, the inmates of this compound have been cured of the leprosy and pose no danger to the outside community.
But he thinks leprosy has not been completely eradicated in Zambia.
Once in a while, Dr Friend comes across new cases of the disease at Mukinge Mission Hospital.
The problem is that it is hard to detect, he said.
“We don’t have experience these days to detect the disease because it is now very rare,” he said.
Recently, when the doctors at the mission hospital came across a case, they did not know what it was and so they sent images around the world to enquire about the strange disease. It was later confirmed to be leprosy at a laboratory in Lusaka.
STILL A REFUGE
But despite the hardships it offers to its residents, Kikonkomene is still a place of refuge and some even refuse to leave, maybe because they fear the discrimination outside.
I asked Noris Lumbwe, a young woman who had come to visit her aunt, why she can’t live with her at her home nearby.
“I’m ready to take her out of the centre and keep her in my house, but she will not accept. She likes being in the centre,” she said.
The old woman, Langster Makabakano, who is about 90 years old, lives alone in her dingy little house.
“I don’t like the conditions in which she is living, Noris told me. “I feel very bad, but she won’t accept to live with me.”
The following day, the lepers were visited by officials from the Zambia Agency for Persons with Disability (ZAPD), a government wing.
The residents used the opportunity to present their problems to the government.
They want water, farming inputs and a hammer mill as a priority.
Julian Mwape, who is acting director of the agency, promised to meet the needs soon.
“I wish we could do more,” she said.
The humanity and dignity of the residents have been brought to zero, she said.
She described the conditions at Kikonkomene as a “sad state of affairs”.
Maybe finally there is Government hope for the residents of Kikonkomene.
JACK ZIMBA, Lusaka