A fictionalized compilation of real issues faced by millions of people
Bolebole is a region rich in alluvial diamonds, attracting migrant workers from surrounding areas. It has few functioning government services, there is chronic civil unrest and the region has a poor transport infrastructure. This situation is compounded by extensive environmental degradation – in particular, deforestation as a result of mineral exploitation. T he traditional communities that previously used to live in the area have been displaced by the mining activities and the threat of violence from itinerant rebels, while traditional ways of livelihood – such as hunting for bush meat and small scale farming in the forest – have died out.
The mining community is a largely male, transitory community dependent on imported services of private traders and providers. Christophe, in his thirties, has been working as a miner for several years. Living in the mining camps, he is separated from his family who live far away in one of the largest towns in the region (where he was unable to find work). The mining work is hard and hazardous but the pay allows him to support his wife, elderly mother and young daughter.
Recently, Christophe began to develop recurrent fevers. Believing that they were caused by malaria, Christophe bought antimalarial products from the local “shop” that services the miners. However, despite taking the medicine (which may have been past its sell-by-date or even counterfeit), his fevers continued. Eventually, Christophe’s fevers drove him to seek help at the health clinic in the nearest small town, some 30 km away. He spent most of his money sharing a trip on a motorcycle, but when he reached the clinic it was closed.
The following day, staff at the clinic gave him paracetamol for his fever, which he paid for with his remaining money. However, his fevers persisted; he became increasingly weak and soon he was no longer able to work. Eventually he had no option but to go back to his family home. There, his wife borrowed money to send him to a private doctor, who thought that although Christophe was most likely to have contracted malaria, further investigations were needed as Christophe’s working environment put him at risk of contracting a range of other infections, including HIV. The doctor also noticed that Christophe had some neurological symptoms and swollen lymph glands. Because the hospital had a working laboratory, Christophe was given a lumbar puncture and the sample fluid confirmed that Christophe had late stage sleeping sickness (trypanosomiasis), requiring expensive drugs and hospitalization. Other tests (blood films and stool analysis) performed at the same time revealed that Christophe also had tropical eye worm, hookworm and ascariasis.
Christophe’s wife attempted to raise the money that would be necessary to pay for his treatment by selling some of the family’s precious assets – a radio and a bicycle. She was also obliged to stop paying their daughter’s school fees. Raising the money for treatment took the family three weeks, during which time C hristophe’s condition deteriorated further. During that time his wife, who was his sole caregiver and was also providing care for his mother and daughter, became progressively isolated, tired and depressed. Their daughter was unable to go to school and further her education, money became increasingly tight, and Christophe began to feel that he was a burden to his famil.