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ON BEING A PATIENT

Hafiz Ali Goes Home

right arrow H.J. Van Peenen, MD

1 August 1998 | Volume 129 Issue 3 | Pages 249-251


The Dutch doctor had been with the ECWA hospital at Jos, Nigeria, for a long time, but he still had trouble deciding exactly when a patient would die. And that was always a problem with someone like Hafiz Ali.

The doctor had admitted Hafiz Ali and grown fond of him, but he had not yet worked out the pathogenesis of his disease. The spleen, he could feel, was huge, too big for malaria in an adult. And there was a fever that might indeed have been malaria, but no organisms showed on a thick blood smear. Intravenous antibiotics seemed to help at first, yet, day by day, the old man's conjunctivae and oral mucosa showed increasing evidence of coagulopathy. Still, Hafiz Ali was astonishingly tough. On certain days, he would rally. The intravenous site would stop oozing, and the doctor would hold out a little hope to Hafiz's twin sons, Rashid and Hamid, who attended their father devotedly. Don't take him home yet, he would say on these "good days." Miracles do happen. But then the next day would be a "bad day," and the oozing would spread to the old man's gums, which were purulent and rotting around his last decaying stumps of teeth.

The doctor knew that his patient had not wanted to come to the hospital at all. A bush aide had held out the hope of a cure, so his family had insisted. But if there could be no cure, he wanted to die at home or, failing that, in an open field, a palm shelter, any place where he could go in peace with no more company than his two loyal eldest sons. Definitely not in the hospital. The doctor had promised to tell him when there was no more hope.

And so the day came when even he could not deny that Hafiz Ali had less than 2 days to live.

When the foreign hakim told them that their father would not recover, Rashid and Hamid counted their money and looked at each other. Because they were identical twins, they hardly needed to speak, but Rashid did so anyway: "Not enough."

How were they going to get their father home? Their village, Mallum-fashi, was more than 100 kilometers from Jos, and they had only 120 naira, far too little to hire a private car.

"There is enough for three if we ride the taxi."

The doctor objected. They should hire a private car with air conditioning. A crowded public taxi, with its heat, its fumes, its jolting, and its constant starts and stops, would certainly kill Hafiz Ali long before he reached home. And then what? A funeral car, with a tree branch wrapped in its grill to evoke the respect of passersby, would cost even more.

Rashid nodded. Everyone knew that public taxis would never carry a dead man, or even a dying one, because any dead man might have died from witchcraft; the curse could leap to other passengers or even make the vehicle unusable. But the young men felt they had no choice. If Hafiz Ali died on the way, it would be the will of Allah. They put their thumbprints to the paper the doctor insisted on and went to their father.

Hafiz Ali was barely conscious. The sweat of fever seeped from every pore, and his hands could not help them as they sat him up on the edge of his cot and dressed him for the journey. Clumsily, but tenderly, they removed the white smock of his illness, stained now with jaundiced sweat and the involuntary release of thick, brick-colored urine. They clothed him in a fresh white cotton riga brought from home and set his fula on his head, covering a nearly bald pate fringed with tufts of crinkled white hair.

"Father," they asked. "Can you walk? Can you walk at all?"

There was no response, only the labored stridor of the old man's breathing. They would have to carry him to the field where the public taxi waited. It was more than a kilometer away, but their father had always been a small man, which was unusual for a Hausa. They made a chair with their hands, and the hospital porter helped them out. "Go with Allah," he said, although he was a Christian, "and may he live until you get home."

The rain had just ended. It was cool, which was an unexpected blessing from God. The harmattan, with its horrid, dry dust, was over; with luck, the trip would not be too uncomfortable. If only Hafiz Ali could live a few more hours, all would be well.

Rashid and Hamid proceeded down the dirt road with their burden. Once, the old man's calloused feet dragged in the mud when they were forced to jump out of the way of a heavy truck. The angry horn blasts and the cursing shouts of the driver's assistant on the running board drove them to the soft shoulder with the small flocks of goats, the herdboys, and the basket-hauling market women. Then, gravely, silently, patiently, they waited until the vehicle passed in a torrent of countercurses from the market women before they stepped back into the rutted roadway. But when they arrived, the taximan was reluctant to let them in his car.

"He is already dead. I will not carry the dead. Perhaps he is accursed."

"No, no, it is only old age. How can there be a curse? It is Malum Hafiz Ali of Mallum-fashi whom everyone knows and respects."

But the taximan was a townsman. He had only recently bought the taxi, an old Peugeot station wagon, and did not know Hafiz Ali. Still, his vehicle was nearly full, there were only three places left, and the passengers already loaded were becoming noisily impatient.

"Prove to me he is not dead."

At that, the old man opened his eyes and spoke for the last time.

"I am alive."

Out of respect for illness and old age, the other passengers rearranged themselves and their baggage so that the two young men and their father could crowd into the back seat. They shared it with only one other person, a heavy-hipped Ibo woman in a voluminous dress and headcloth streaked with orange, purple, black, and green. Rashid and Hamid propped their father up between them, and the taxi sputtered off in a cloud of diesel smoke that leaked through the eroded floor. At that moment, Hafiz Ali took one long, strident breath, his head lurched, and his fula fell off.

Everyone knew what had happened, but no one said anything. Death unacknowledged is not real. The Ibo woman looked straight ahead. The driver did not look back. Rashid joined in the pretense. "It will not be long now, Father," he said. "Lay your head on my shoulder and rest."

Hamid reached to wipe the cooling sweat from the old man's unheeding face and spoke in his turn.

"Remember ... ," he said, and then, as though talking to his father, he raised his voice so that it could be heard over the motor and began to recite the old man's life: his ancestry three generations back, how he had slowly put together his little plot of land, how many goats he had paid for his wives, the names of each of his children, the offices he had held in the village, and his charities and hospitality.

The nine other people crammed into the Peugeot listened but acted as if they did not. Knowing what would happen, Hamid finally faltered. They approached the first village, the first scheduled stop, in silence.

After the Ibo woman and two others got out, the driver worked his way to the back seat. He reached over Hamid, lifted Hafiz Ali's eyelid, and let it drop.

"He is dead," he said. "You must get out. I do not carry the dead."

Rashid protested that they had paid the full fare to Mallum-fashi.

"Out!" he ordered, but he refunded part of their money.

They were still 70 kilometers from home. A small crowd was gathering; it was actively sympathetic because the people of the village did not like the Ibo woman, who had already shouted that these ignorant Muslims had brought a curse on Fangani's taxi. As though he heard her, Hafiz Ali opened his eyes. They closed again immediately, but the crowd shouted with glee to have the Ibo woman proved wrong.

"Wait for James," they counseled Rashid and Hamid. "He is an educated man and does not believe the old superstitions." But James drove the Kaduna route, and his taxi stand was at the other end of the village.

Once more, the young men made a chair with their hands and carried their father. It was only 300 meters, but little by little they felt their burden stiffen. They could no longer tell if he was alive or dead, and that was how James found them 3 hours later. Like Fangani, he flicked Hafiz's eyelid.

"He is dead. You find me at a good time. I have dropped off all my passengers and my car is empty," he told them. "Otherwise, I would not take him. It is true I am not superstitious. But my passengers are."

Rashid and Hamid knew what that meant. If others signaled to be picked up, they would be turned out again.

But, once more, they were lucky. By now it was the time of the evening meal, and although the road was still heavily populated, no one signaled. Young men with ballpoint pens and combs stuck in their hair squatted around small fires. Heavy women sweated in small vendor's shelters where hot oil sizzled and spattered. Others held up a few bananas or a yam. The taxi lurched slowly past, honking constantly. And soon they were in the high savanna, the bush, with its crumbling red earth, rock outcroppings, and tufts of dried grass.

Despite his professed lack of superstition, James did not want Rashid or Hamid to talk about their father. He had a tape deck that worked and kept it going. The loud, thumping, popular music was an affront to Islam and to the dead, but the sons had no choice but to listen. Although they had paid James, it had been only the public rate per passenger and not the 300 naira a driver could legitimately have demanded for a private trip. They felt like objects of charity. At least their father was dead and could not feel the shame.

Luck always runs out. Ten kilometers from Malum-fashi, a Birom man with two basket-burdened wives hailed the taxi. James stopped before he could come up to them.

"You must get out here. They must not see the dead man, your father."

Rashid and Hamid obeyed. It hurt to lose their ride, but, once more, there was no choice. They, too, would have objected to riding with a corpse that was not one of their own.

Now it was completely dark, lighted only by a moon that was neither full enough to show their way nor thin enough to allow them light from the stars. They feared the night, as do all countrymen. Night is a time for witches, hyenas, and savage bird cries that come menacingly close.

There were huts nearby, but they dared not approach them. The people here were not of their tribe, and even tribesmen could not be expected to willingly shelter another's dead. There was no choice but to brave the night and walk.

It was slow and exhausting. At first, each of them tried carrying Hafiz Ali on his shoulders, but the body wouldn't balance. They tried rigging a tumpline, like the women used for baskets, but that didn't work either, so they finally ended up carrying him dead as they had carried him alive: both together, forming a chair with their hands.

And that is how Hafiz Ali returned to Mallum-fashi just as day began to break. He would have preferred to do it cured, on his own two feet, but he was no longer capable of preference. He was dead, or so nearly so that nothing mattered.

The young men did not grieve for him. They had done all that sons can do. And everyone knows that old men must die. Their father had been sick a long time, and he was very old, 48 at his last birthday.


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Ponca City, OK 74604-2513
Acknowledgment: The author thanks Drs. Steve and Jan Arrow-smith for providing ethnographic details.
Requests for Reprints: H.J. Van Peenen, MD, 1414 East Hartford, Unit #9, Ponca City, OK 74604-2513.





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