Our Burkitt’s Patient

Although the vast majority of Burkitt’s lymphoma patients are found in the Malaria belt around equatorial Africa, it is still a relatively uncommon illness, especially when compared to HIV or Schistosomiasis. The number of patients in a small region such as Shirati varies greatly, and it just so happens that there was one Burkitt’s patient when we arrived. When we asked about his history, we found that he had not responded to treatment as had hoped (with typical cases, the tumor almost disappears after the first dose of chemo). He was diagnosed just a few weeks before we arrived, and he had already undergone four doses. The tumor shrank a little with the first dose, remained stagnant for the next two, but had started growing again last week. His demeanor reflected his history. When we went to visit him and interview the mother, the 8-year-old boy was drained. He seemed to be in pain with each movement and had to lie down with each exertion. There was little more the Shirati clinic could do for him since he was not responding to the chemo and was referred to the regional cancer center in Mwanza.

Getting the boy to Bugando is almost another story. It is amazing how differently some people can react when given similar circumstances. In our interviews, we’ve talked to parents who went to great lengths and sold half their fortunes to bring their child to treatment facilities across the country when treatment at Shirati wasn’t working. This boy’s father, however, had spent his money paying the dowry for another wife. When confronted with the need to send his son to Mwanza four hours away, he lied about how he could catch a ride with a friend. It seemed clear that his only intentions for the boy were to take him home and wait for the cancer to take its course. Unable to accept such inhumanity, Dr. Kawira insisted he contribute any amount. My friends and I were happy to donate the entire cost, but we wanted the father to take some responsibility. Grudgingly, the father offered a small sum.

With this ugly episode behind, Dr. Kawira arranged for the boy and his mother to be taken to the hospital at Mwanza and start treatment. He arrived last Wednesday and was given IVs to rehydrate and prepare him for the taxing chemo. Unfortunately, we got word on Saturday that he passed away that morning right before his treatment was scheduled to start. Dr. Kawira assured us that we did everything we could to help, but the question still looms: would he have survived if he had gotten to Mwanza sooner?