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Dr Sekai Nzenza

WHEN the men in our village get sick, they do not go to the clinic until we force them to get into a wheel barrow or a scotch cart. By that time, they are too ill to resist. That is what happened to our neighbour Bornwell. He was very ill for a long time. My friend Bhiya kept on telling him that he might have HIV, cancer, a kidney disease or some other serious illness. He should really get into a kombi and go to the clinic 10km away.

But Bornwell said no, he was not dying yet. A real man must endure pain and hardship till his last breath. That is what he had been taught by the elders.

Back in the village, when we were growing up, boys always knew that they were going to be strong men. From the moment they were born, the elders celebrated and called the new baby boy by his totem. They called him Shumba the lion, Nyati the Buffalo, Mhofu the Eland, Soko the Monkey, Nzou the Elephant, Hungwe the Bird and among other names. Each boy was called by the animal of his totem, linking him to the ancestry going back for generations. He was the man, the hunter, farmer, provider, head of the family and protector.

He would go to war and over there, a man must fight to the end. The elders said kufa kwemurume hubuda ura, meaning that during war a man only accepts death when his intestines are all out and he can see them lying there on the ground. Only then, does a man accept that death has finally defeated him. Not only that, men must always stand to together. Kutsva kwendebvu tino dzimurana. When one man’s beard is on fire, all men must  rally together and help  put out the fire burning the beard.

At the men’s court, padare, young boys were given some key lessons as introduction to manhood by the grandfathers, the uncles and other male members of the extended family.

They were taught to be tough, competitive and aggressive especially when they are herding cattle out in the valleys. Lesson number one when herding cattle was  never to let anyone call you a woman. If that happens, you must fight like a man to protect your honour and that of all the men of your totem. Lesson number two, you must never let anyone say a bad word about your mother. Mother is sacred.

When that happens, fight to protect the  honour of the mother who gave birth to you.
The strength of a man was everything. Men were told to avoid zvechikadzi, meaning activities women do like cooking washing, cleaning and caring for children. They were taught to do male activities only, zvechirume. The boys hunted rabbits, trapped mice, climbed trees to get the highest fruit and did not fall, fished, killed and skinned goats with sharp knives.

They helped kill big beasts too, skinned them and ate the reproductive organs to increase their virility. They could have more than one wife and have as many children as they wanted right up to the time they became very old. A man’s strength to procreate remained until old age.

When they left the village, the men got jobs to work on the roads, operated machines, drove lorries and buses, worked on farms and in mines, doing all the hard work meant for strong men. Even though some became cooks and washed the lingerie of European women, they still returned home and took their positions as men.

In my memory, village men were lean, strong and tall. In those days, we did not see sick people. Occasionally, an old person got quite ill from old age. They pasted cow dung on his or her back to stop the old skin from cracking. Vaidzurwa ndove kumusana. Then they were taken out of the main village compound and nursed in a camp just outside the home, kumusasa. My own maternal grandfather, VaMuchabva lived till very old age and they kept him at the musasa for a very long time because he was refusing to die. Up to this day, they call that place, Muchabva’s Musasa. There were few illnesses then.

Until recently our neighbour Bornwell worked on the new Save river bridge for many years. He was a very strong tall guy, wiry and lean. A long while ago he married a woman from Chipinge and they had four children. Then his wife got quite ill and she walked the 10 kilometres to Mufudzi Wakanaka clinic to seek treatment.

Bornwell did not go with her because he hated health clinics, hospitals and the smell of medicines, especially methylated spirit. The only time he ever got near a needle was during the colonial immunisation program when he was in the same class with us at St Columbus School.

When the distance to the clinic got too much for  Bornwell’s wife, and her health was weakening, she  went back to her village in Chipinge. They said she died over there. Bornwell could not afford to bring her body back here. He went there to bury her.
Last year, Bornwell started getting ill too. He did not stop drinking.

He lived alone and his nephew’s wife  came daily to look after him. This was not proper because she was not meant to see his nakedness when Bornwell was no longer able to wash himself. One day, when Piri and I were visiting the village, Bhiya said we should visit Bornwell as his health was getting worse.  When we saw him, his face, stomach and legs were swollen.

He said there was water in his chest forcing him to keep his body bent over with his head almost touching his knees. In his little hut, there was nothing to eat. The fire had since died down.

We brought  him fat-fried broiler chicken with rice mixed with peanut butter.
“Now, this is what I call visitors. They bring me love and food. There is no point in coming to see me with your love and no food,” Bornwell said, trying to eat the food slowly.

He always had a sense of humour. Still hunched over, he chewed the drumstick with such delight and licked the dripping fat from his fingers.

“When did you last go to the clinic?” I asked him. In between breathlessness, Bornwell said he had never been to the clinic. He would not go there either. Turning to Bhiya, who was Bornwell’s cousin and therefore responsible for looking after him as well, I said it was not proper to keep a man that ill at home without taking him to the clinic. When he dies, Bornwell was going to become a ngozi, the bad spirit that will seek vengeance for not having died properly.

Then the three of us, Bhiya, Piri and I had a brief discussion outside. Bhiya said there was no money to take Bornwell to the clinic. The clinic would only have paracetamol and what would paracetamol do to a man who was no longer passing water? She said other relatives had suggested taking Bornwell to Murambinda hospital because over there, the Sisters of Mercy ran an HIV and Aids program. There was a good chance that Bornwell might have contracted HIV.

It was a common illness. Bhiya said several men had already died in the village without seeking treatment. If she was not so open about her own situation, many women would have died too. It was easy to convince women to go to the clinic because that place was a familiar place.

Women went there during pregnancy, for delivery, check ups and baby immunisation. Most men often felt that they had no business being at the clinic. This was a place for women where mostly female nurses looked after them.
The hospital fee was $10 then. I offered twenty and Piri offered two. A day later, Bhiya and the nephew’s wife put Bornwell in a scotch cart over the hills, valleys and rivers to Murambinda, a good sixty kilometres away.

Bornwell did not get to Murambinda hospital. In the heat of the November sun, the cattle pulling the scotch cart struggled to climb up Dembwa mountain. The road was rough and bumpy. Bornwell said they should turn back home because he was not going to come back from the hospital. ‘Handidzoki uku,” he said weakly.

Bhiya spoke to the ancestors and prayed for Bornwell’s strength until they get to the hospital where the nuns would quickly put a drip up and pump medicines into Bornwell’s arteries or even make him pass urine using a kidney machine. But Bornwell insisted that they make a U-turn. They did.

Soon as they placed him on his mat, back in his hut, Bornwell died. I was not there when they buried him. But when his other relatives saw us the other day, they kept on thanking us and saying the  chicken we gave Bornwell was his last meal.

“But he really should have sought medical help earlier,” I said. Piri pinched me to keep quiet. Later on she said I really should not keep hammering the point about going  to the clinic. “What is the point of all that when a man is already buried?” she asked.
“Sis, varume  vazhinji vari kurwara vachifamba,” Piri said, meaning a lot of men are very ill but they keep moving along because once they stop, they fear being treated badly at the clinic, being stigmatised by others. As a result, they get depressed and do not seek treatment.

Piri then went on to lecture me about men’s health problems and the lack of places to get treatment without the men risking one’s privacy. She seemed to have  plenty of experience in the world of men’s health.

“Have you seen the way men avoid eye contact when you see them at a clinic? That place is not for men, mhani. It’s for women and children. Sometimes the nurse does not look at men with kindness. No wonder  men just run away. Also what man would tell you that he does not fully understand his health problems? If his body is too weak to raise the flag, would he go to the nursing sister at the clinic? No.

He will look for an old man with the indigenous knowledge of vhuka vhuka, the wake up, wake up medicine. If the man happens to have money, he will probably speak to a pharmacist and get the blue tablets. Now, that gives great energy ,” she said, pushing my shoulder a little and giving me one of those I know it all smile.

Piri said her friend Chandi, who has been on HIV treatment for a long time said that men on HIV medication often default treatment by failing to attend the clinic regularly for review and monthly consultations.  Also, it was very hard for a working man to queue up for counselling because he risked  being recognised as HIV positive.

Besides, deep down, he felt restrained and  powerless especially when he has to stand in queues for a long time  shoving and jostling with women.

At the same time, a man with HIV and Aids must eat well and quickly respond to  opportunistic infections, refrain from unprotected sex, smoking and drinking alcohol.

Men in general are not prepared for all these restrictions. They want to maintain the image of the man as the bread winner, the head of family and the strong husband, uncle, brother or the professional banker, teacher or farmer. As a result, they will sit back and avoid HIV testing altogether until they are so ill that they have to be dragged into hospital in a wheel chair.

But HIV and Aids is not the only disease affecting men. We live more affluent lifestyles with new diseases. The lack of places or clinics where men can feel secure and comfortable to seek medical treatment is not confined to the HIV and Aids fields only. The men are becoming subject to bad health, smoking, hemorrhoids, enlarged prostate,  kidney problems, sexual dysfunctions, excessive alcohol, and bad diet, and high blood pressure, lack of exercise, gout, diabetes, obesity, depression and stress.

Again, most of the men do not go to the doctor or clinic heath centre until they are really ill.
What then, shall we do to get men to seek medical attention for the new illnesses that we did not grow up knowing? How do you educate the men that you see driving in their cars, drinking in bars, working in the offices and sitting in front of the television watching soccer.

Who do they tell about their health secrets?
We have been talking for so long about women’s health.

Men are dying of preventive diseases because they fear losing that strong sense of traditional manhood when they confront the female nurses. Unless a man has enough money or a good medical insurance to see a private practitioner, he is unlikely to turn up at a clinic seeking to be tested or checked for other preventive diseases.

We need more affordable men only spaces where men can feel free to talk about their illnesses and not wait until they are dragged into hospital in a wheel barrow or a wheel chair. Times have changed. We have many  new illnesses affecting men. It is no longer taboo to speak of men’s diseases and weaknesses. When in pain, strong men do cry. Give them the space to do talk about it.

• Dr Sekai Nzenza is a writer and cultural critic. She holds a PhD in International Relations and works as a development consultant.