In memoriam: Jonah Lomu

 

_86786152_jonah_lomu1_getty[1]One week ago today, we woke up to the news that one of the greatest, if not the greatest, rugby players of modern times, Jonah Lomu, had died in his sleep at the tender age of 40. His death came nearly 3 weeks after his native New Zealand national team, the All Blacks, won Rugby World Cup (2015) for a 2nd consecutive year. During the tournament, Jonah was promoting and commentating, and even led the All Blacks in a display of the haka in London’s Covent Garden a few days before the games started. So for his family, friends, team-mates, rugby fans the world over, and probably anyone who knew his story, his death came from the rear, unseen, unexpected, like a side-blow. As I take my obsessive-rugby-fan-in-awe-of-excellence-superhero-loving hat off, and replace it with my MD cap, his unexpected death was sadly, a real possibility. Let me explain why.

 

A bulldozer, a bullet, and a ballerina

Jonah Lomu exploded on the international rugby scene when I was in my final year at medical school. I’d been living in England for about 7 years and up until that time, I have to be honest, I’d tried but failed miserably to engage with the sport. Growing up in the Caribbean, we were all raised on a staple diet of fast and furious American sports. If a game didn’t feature scores in double and triple figures like basketball, I wasn’t interested. If the pace wasn’t fast and furious and agile like American football, don’t even bother me. So with the ‘real’ football, where at the end of a 90 minute game the score could easily be 0-0, I often had to ask the question, ‘what was the point of all that?’ And as for rugby, with its heavy sluggish players where it was very possible that a game could be won without a touchdown, I mean a try, well…

But in that summer of 1995, as I was just coming out on the other side of my final year exams, this superstar giant of a man captured the world’s, and my imagination, at the World Cup in South Africa. That summer, because of that one man, I fell in love with rugby. Though built like a bulldozer, on the pitch, he displayed bullet-like speed and at times the daintiness of a ballerina. When you watch the playbacks of his tries that year, you can easily forget that the All Blacks didn’t even win the Cup in ’95.

 

A new journey

Later that year, when the news broke that he had been diagnosed with a kidney disorder known as Nephrotic Syndrome (NS), I grieved, because I knew what that meant – theoretically anyway. The grief lasted but a split second, because not having done practical training in the kidney diseases as a junior doctor yet, I hadn’t seen first-hand what the real consequences were. So my optimism kicked in, and I felt reassured that he would continue to take rugby to dizzying new heights, higher than those of the ‘fake one-country world championship of American football’; you see I kid you not when I say that I fell head-over-heels in love with rugby. I was fully converted.

About 8 years later, when it emerged that he was on dialysis, it was hard to remain optimistic, even though in the intervening years he’d continued his rise the upper echelons of global sporting superstardom. By then I had completed 9 months of training on a kidney unit specialising in the care of patients with kidney failure, so my knowledge was no longer just theoretical. I had met so many patients with NS – from the newly diagnosed, to those on dialysis, to those fortunate enough to get a 1st kidney transplant to those even more fortunate enough to get a 2nd transplant, and to those who had sadly died along that journey. And what struck me the most, was how this was truly a disease of the young, and of young men in particular. You see in most of the other adult medical specialities, it feels like the average age of patients is near 70; but in the kidney unit, it felt like 30 – it really did, though in reality it’s probably in the mid-50s – itself still young. We medics always have patients we remember vividly: I will never forget the first patient I saw with NS. He was a white man, in his early 40s, who was running his own business up until the day before he came into the unit, swollen like a Michelin man from head to toe. He spent weeks in hospital undergoing treatment. His life was transformed forever. Seventeen years later I still wonder how he fared…for sure.

Jonah received a kidney transplant from a live unrelated donor in 2004, but his body rejected the kidney 7 years later, a somewhat typical scenario; and so, he went back on to dialysis. Though he retired in 2007, he still lived life to the full, becoming a young statesman of and ambassador for the sport. At the World Cup this year, he looked a picture of health to many, but to ‘us’ the signs of kidney failure were there – complexion a little off colour, grey even, big but not as bulky, and looking older than a 40 year old should. The extraordinary effort, on all levels, from so many people, that would have gone into accommodating a trip half-way round the world when he needed to be connected up to a dialysis machine for up to 6 hours 3 times per week cannot be underestimated. It seems unfair that even after the military precision behind that planning, he still died, cheating himself, his family and us, out of another 30 years of his sparkle and dazzle.

 

But this is where the tragedy of NS and kidney failure in young people lies. These patients and their families and their doctors and nurses know that they won’t live as long a life as they should, but many still die too young. The week before Jonah died, I interviewed another giant of a young man with the same illness, on a weekly online radio show* I host on health and medicine. He is now on dialysis, and like Jonah he lives purposefully, as he awaits a kidney transplant. He spoke about the uncertainty of his future, and because of that he wastes no time. To say it’s not easy to live with this fact is an understatement, and one cannot imagine the will and strength and faith that goes into taking on that purposeful mind-set when faced with your own mortality – a mortality that can come from the rear, unseen like a side blow.

 

Twelve facts about Nephrotic Syndrome

  • Nephrotic Syndrome (NS) is a combination of signs and symptoms that indicate kidney damage. The damage is in the filters of the kidney. These tiny filters normally get rid of excess salts and fluid, but in NS, they become very leaky and so huge amounts of protein leak into the urine.

 

  • It can come on suddenly.

 

  • The symptoms of NS are weight gain, tiredness and poor appetite.

 

  • The signs of NS are swelling around the eyes, or of the whole body which starts from the feet and moves upwards, frothy urine because of the protein, low protein in the blood because it’s all leaking out into the urine, high blood pressure and high cholesterol as the kidneys aren’t working properly.

 

  • It can affect both children and adults and is the cause of kidney failure in about 12% of adults (about 1 in 10 adults with kidney failure) and 20% of children (about 1 in 5 children with kidney failure).

 

  • Males are more commonly affected than females.

 

  • NS is caused by specific diseases of the kidneys. For some reason the immune system decides to attack the kidneys but no one really knows why. This is the type that Jonah Lomu had, though it is rare.

 

  • Other conditions like diabetes, cancer and lupus, as well as some medications, can also cause NS. Diabetes is the most common avoidable cause of NS in adults.

 

  • Some types of NS are more common in those of African, Indian and Asian descent.

 

  • It is treated with drugs like steroids to dampen down the immune system.

 

  • People with NS are more likely to get blood clots as their blood tends to be thicker. A blood clot can lodge in the lungs suddenly and if this clot is big or blocks a major blood vessel, it can cause the person’s heart to go into cardiac arrest. It’s possible that this is what happened to Jonah Lomu.

 

  • If the kidneys fail altogether, people with NS need to have dialysis. They are connected to a machine, and their blood is diverted into this machine through a tube connected to one of their big veins. The machine does the work of the kidneys by filtering the blood before it is diverted back into their body.

 

*Matters of Life and Health airs online @Powerxtra Radio via Tune In radio app, Tuesdays 7-9pm GMT

 

 

 

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In the week where the world remembered the mass kidnapping of young girls in Nigeria, as the savagery that is ISIS and the murderous tendencies of US police simmered on in the background, we were hit with a side-blow – xenophobia: South African style. I’m just going to think aloud on this one, as an outsider not privy to, or fully cognisant of the intricacies involved in the evolution of this nation:

We all like to think that when Nelson Mandela was freed in 1994, to declare SA a ‘rainbow nation’, all would surely be well. But in reality nearly 21 years later, South Africans, black, white and every shade in between, are basically just breaching through the perimeter of the misogynistic bubble that is apartheid. As xenophobia again rears its ugly head in SA,  the wide-reaching ramifications of this system again come centre-stage; this is just one of many chapters of the story of the rebirth of a broken nation.

When apartheid was ratified by law in the 1940’s, racial segregation was already woven tightly into the fabric of SA’s society. The Dutch had kicked it all off in the 1700s, with the British duly perfecting the regime in the 1800s. Legislation in 1948 was a mere formality for a totally irrational system where Filipinos were classified as black, because whites worked out that they were…well…black. And yet Malays were classified as ‘coloreds’. Television was only introduced in the 1970s, and when it was, it too was segregated. One cannot believe how ‘nuts’ that system was…and is.

Apartheid means literally ‘the state of being apart’ – and the system not only kept the races within SA apart from each other, but also kept South Africans, especially black South Africans apart from the rest of Africa and the rest of the world. The concept of pan-Africanism is foreign to a significant proportion of black South Africans. Apartheid led to the evolution of generations who knew and still know very little of the great continent to which they belong. My own experience is that this ignorance and insularity is not limited to black South Africans alone either. I have a vague recollection of a conversation with some white and ‘colored’ South Africans soon after 1994, during which it became apparent that these seemingly enlightened individuals couldn’t tell you the first thing about any of the countries neighboring theirs – not a thing. You could argue the same about a lot of other people, but at least Americans could tell you that some Canadians speak French, and the English could tell you that the Germans speak German, and Indians could tell you how Pakistan became separated from India. These South Africans were totally blank when it came to anything about neighboring Zimbabwe, Botswana or Mozambique.

I read somewhere that 65% of the black South African population, is between 15-65 years old. Many in this age bracket have grown up in a world no bigger than their townships, physically and mentally. And some of the harshest acts of mass violence against black South Africans was meted out in these same townships, when this group were children or young adults, a time when thought processes and reasoning are heavily influenced by one’s environment. And their parents also grew up in a world of violence and all sorts of other social injustices – substandard education, inadequate health services, broken family life, lack of cultural evolution. This mass chronic dehumanisation would surely have a disastrous psychological impact. And there are lots of studies about the way in which apartheid affected the mental health of black South African children – some of these same children who are now in that 15-65 age bracket. And forty percent (40%) of this group are unemployed, compared to, and get this, 8% of whites, 18% of Indians and 28% of coloureds. And that 40% unemployment rate eerily matches the 42% rate for education to high school level only.

Surely the great Madiba’s release in 1994 was going to relieve some of this misery. But really, can 300 years of brutality against the souls of a people be reversed by one man, in less than another 300 years? Especially when followed on by a government run by individuals, who despite putting on the right appearances, are products of the same system? I’m going to be controversial here, but this is where you can kind of see where the Castros of this world were coming from, in principle; after your country is liberated from oppressive rule and you inherit a glaringly unfair system where the disadvantaged tip the scales upside down, your first priority is to fix that imbalance pronto. Because isn’t that injustice the reason why you took up arms and got your butts exiled in the first place? So how can you now squander the opportunity to fix that which you fought for? The new SA government should have tackled inequality aggressively from the start. This was an opportunity to show us a new kind of African leadership. But I guess that would have come with too much sacrifice…of self-gratification, wealth and power.

So now you have a sizeable sector of the society that is frustrated and angry because there is no sign of any rainbow as far as they can see. Frustration and anger mixed in with all the other social and behavioural pathologies that apartheid created is a ticking time-bomb. Because SA is still so segregated along colour lines, most black immigrants, the majority of whom are from Zimbabwe, live side-by-side with black South Africans. These immigrants have left their homes with the sole purpose of making a better life for themselves and their families. No one leaves their homeland because they have nothing better to do; when they land wherever they land, they will work hard to fulfil that purpose. Right-wing rhetoric may have us believe the opposite – of course some do not abide by the law of the land and spiral into a treacherous underground of devious behaviour, but this is not representative of the majority.

The perpetrators of this current wave of xenophobic violence see these immigrants creating the life that they should have without realising that the ‘foreigners’ are using skills and education and drive that they, these black South Africans just never had the opportunity to develop. These immigrants never had their psyche bound by the chains of apartheid so they are not subject to the same limitations. Yes, they have their own problems in their own countries, but they are not fresh out of something as sinister as that regime was and continues to be. Unfortunately, living side-by-side means that the immigrants are right in the line of fire of all this pent-up resentment – a mild term for this in fact. The privileged, of all races, are too far away to target, because the type of perpetrator dishing out this violence doesn’t really venture out of ‘his’ immediate vicinity. No, their immigrant neighbor is easier to get to, a soft spot; and besides harsh lessons have been taught in the past about lashing out at the real oppressor: when you revolt against that system, what do you get – the Sharpeville massacre and the Soweto uprisings…

Some have termed this brand of xenophobia, ‘afrophobia’ as a result. But you know, whatever we want to call it, it’s purely academic and just about semantics. What we are witnessing is just ugly and frightening and unbelievably tragic. Reactions have been largely based around calling out South Africans for being hypocritical, because many African countries took them in during their hour of need. That is true and we are free to point that out, but we cannot dwell on that because it will not stop the maddening crowd. The great majority of South Africans, black and white, do not support xenophobic crime – some may be racist, yes – but supporting these atrocious acts is another ball game altogether that they wouldn’t want to partake in.

Instead, it should be about calling out the current South African leadership to be aggressive in protecting the victims and anyone at risk, to bring the perpetrators to justice quickly so as to deter others from following suit; to speak responsibly and appropriately to their electorate so that there is no doubt as to where they stand on the issue of violence against ‘foreigners’; and to get pro-actively creative in addressing – no, fixing – the social and economic imbalance that is the root of this current evil. Apartheid and its creators are  where all this started – there is no denying that. But we cannot go back and undo history. Progress is about being focused on the now with a view to creating a new future that South Africa deserves…that Africa deserves.

 

Battlecry – stolen lives and lost dreams: our girls from Chibok 2015

Exactly one year ago today, 276 girls and their dreams were stolen from their Chibok community, in the dead of night, by cowards; this is exactly what cowards do: they perform their dastardly deeds under the cover of darkness, they prey on the seemingly powerless, and they count on the silence and fear of those left behind

One year later, whilst the abductors may continue on with their deadly modus operandi, those left behind on a local, national and international level have not cowered in fear nor have they been bound by silence, as they continue to be the voice for the stolen girls. The girls’ story may no longer be headline news, but the significance of this event hasn’t faded in the eyes of the countless many who continue to do what they know how to do best to ensure that the girls are not forgotten, and that their families remain supported.

The girls are not yet back home, but in their painful absence, they have shone a spotlight on war crimes on women, men and children all over the world, on the issue of rape in all sectors of society, on the convoluted relationships within and between ineffectual governments, and on the lasting legacy of misguided policies, greed and broken covenants. They have even been the driving force for a change of leadership!

Today, one year on, let’s continue to honor the girls and their families in any way we can. Any positive action is like a seed sown to bear fruit in future generations, so they are armed with knowledge and confidence to be their brother’s keeper in the true sense of the word.

We simply must not lose hope. Races like this are ‘not for the swift or strong but for those that endure to the end’. There will be tactical shifts, and changing of batons but rest assured victory will come and must come for these girls.

Finding clarity in the fuzziness that is Ferguson, 2014

On Monday 24th November, my Facebook feed reminded me that this was the day that a grand jury would decide on whether a policeman who shot a child dead will have to stand trial. Said plain like that, surely the outcome would be obvious; except, it’s not plain like that – the decision would be on whether a white policeman who shot a young black man in America will have to stand trial. Now, with those adjectives added, it gets all fuzzy.

Since the August 2014 shooting of Mike Brown and the subsequent riots in Ferguson, Missouri, I have read a plethora of articles and editorials on the saga, ranging from those written from a (both black and white) right wing, conservative perspective (read Fox News and Bill Cosby-like), a liberal perspective, a ‘new black’ (a la Pharrell Williams) perspective, a British perspective, an African-in-the-diaspora-perspective, an anti-US perspective, any angle that any argument came from, I  read it. I viewed the situation from what I conjured up to be that of Mike Brown. And after reading all those pages of Darren Wilson’s grand jury testimony, I viewed the situation from his angle. Of course my opinions and feelings about the events (note the plural) were not just formed and shaped by those of others. I viewed the situation from the angle of a mother of a little black boy who was picking up some of the snippets (we are news junkies in our house), and from the angle of a daughter of a man who when he moved to this country from the Caribbean in the early 1990-s, as a respected member of that community had to endure meaningless police stop and searches as a middle aged, working father and provider. I viewed the situation with memories of riots in London in 2012 after the shooting of a young black man by police. I viewed the situation from that of what I presume to be a well-adjusted member of 21st century society.

From all these angles, the whole sorry tale can only but stir up mixed emotions. I doubt that few of us, if we were to be honest, can firmly fix our feet in the camp of Mike Brown, or of Ferguson, or of Darren Wilson; except for the families involved of course. Because it really isn’t all black and white. Very few situations are. Despite all the fuzziness though these things are clear to me:

As black people, it seems that we are wholly judged by the thuggish elements in our society. And without a shadow of a doubt, these thugs aggravate each and every one of us ‘non-thugs’; and by the way, in case no one noticed, we ‘non-thugs’ are in the majority. Though all social groups have these elements amongst them, rarely are these the benchmark by which the rest of the group is judged – not the triads for the Chinese, not the mafia for Italians, and not the cartels for Colombians.

This judgment can then lead one to believe that a young black man in America cannot deviate from the straight and narrow as he traverses through teenage angst, because he is then automatically a thug who deserves to be killed. He has no right to mature into a man, expand his worldview, and see his potential. I wonder what would have become of many uber-productive black men in my inner and outer circles, and those of others, if they had happened across a Darren Wilson in their teenage years. None of us know what Mike Brown was like or what his potential was to be, but you know, perhaps he should have had the opportunity to grow into himself and achieve his potential, whatever that would have been. As stories abound of rape allegations on college campuses across the states, when have we heard of a young white man, even with his identity known, to be judged by or worse killed for his abhorrent behavior?

Darren Wilson’s descriptives of Mike Brown: ‘it looks like a demon’, and ‘he made like a grunting’ and ‘he was coming at me’ and ‘I felt like a 5-year-old holding on to Hulk Hogan’ demonstrate that ingrained judgment against black men in particular – that they are anything other than human and so must be put down. Not by a mace or a stun gun (that he didn’t like to carry), not by a shot to the leg, but to be put down by a shot to the head. ‘They all kill each other anyway, so what the heck’ (my adaption of ex-New York City Mayor Rudy Guiliani’s comments). Of course in any community, you are more likely to be killed by a member of your own community. As the stats reportedly show however, white policemen in America are more likely to kill a black man than a man of any other race.

Mike Brown was a child. Trayvon Martin was a child. No matter how ‘big and black’ he was, whether he was legally a child or not, Mike Brown was a child. Surely that means something. And whenever a child dies, especially in a violent way, and whether at the hands of the ‘law’ or not, that warrants some sort of justice, something more than a dismissal by a grand jury. Looters aside, this is what most people from all backgrounds are protesting about – the lack of justice. I want to think that most parents, of any color or creed, get that.

Civic apathy in the black community, in any community, will land you nowhere but straight into a mess, if not immediately, then eventually. Ferguson, with a majority black community, is run by a majority white police force, and a majority white local government. Of course there are lots of intertwined reasons for why this set-up has come about. Whilst I do not support the notion of assigning the cause of all ills in the African-American community to slavery (or of Africa to colonialism), there are some far reaching consequences of slavery that we fail to acknowledge and in so doing cannot rectify. Two of these are our real struggles with taking on responsibility, and a lack of self-confidence. Voting and pushing for change requires these 2 community traits – it’s about saying, listen we are the majority here, let’s shape our community, and let’s have faith that we can choose the right people to lead us to that change. Responsibility and confidence must be regained. To achieve that, we have to exercise these characteristics over and over again, so that generations down the line can fight the battle in a different way to what we are seeing now. Then at least, our children can move on and deal with more pressing issues. We owe that much to our fore-bearers.