Developing Mercy. One step forwards, two steps back

Photo of the week. The newest additions tp the valley

Highlight of the week: Karen and Alan arrive in Mfuwe

Lowlight of the week: We handover the reins to Karen and Alan. And bid farewell to the clinic for another 11 months. And then our souls are destroyed by the Argie-Bargies 

Maximum temperature: 32 degrees Celsius

Rainfall: Diddley Squat

Welcome to Zambia. A land of eternal optimism. Where the people are programmed with positivity. Bwino, or good, the only answer to their preferred greeting: Muli bwanji? How are you doing? But the reality is a little less palatable. Trying to get anything done here is bamboozling. You show up with your neat little checklist, a pocketful of optimism, and a burning desire to make progress, only to discover that progress here doesn’t move in a straight line. It moves in a dizzying cha-cha, where you enthusiastically take one step forward, only to be nudged two steps back. By a sudden nationwide power cut. Or a missing stamp that apparently only one man in Lusaka possesses.

The very phrase a developing country has now been cancelled. Not because it’s politically incorrect. But because it is not entirely accurate. The new taxonomy is now, more appropriately, that Zambia is a Low-to-Middle-Income Country. A country where it is possible to celebrate progress, so long as you can weather the stagnation.

It's August 2025. We are having a standard day at the Kakumbi clinic. Patients milling around outside. Two consulting rooms going at full pelt. More patients arriving as the treated ones leave. A commotion arises. A car pulls up. Noises. Shouting. The shuffling of feet, as a patient is carried in. Crying. Breathing hard. Guaranteed to summon Keith and I away from the humdrum of the screening rooms. Lickety split.

Salome* is 17 years old. She has short history of abdominal pain. She is manhandled to the ward. Lies on a bed. A place to assess. Despite the fuss, she doesn’t appear too unwell. But her tears and cries persist. Piercing my eardrums at times. The story doesn’t sound life threatening. Gases is her own take on the cause for her abdominal cramps. Bland nshima her staple food. Rarely punctuated with fibre or nutrition. Green or yellow, rarely seen on her dinner plate. Keith fishes in his pocket for some hyoscine. He gives her 2. And uses our favourite test. Time.

Two hours elapse. My assaulted eardrums healing. I sit with an alter ego of Salome. Smiling and almost unrecognisable. She wants to go home. But her friend Mercy* is keen to explore our magic pockets. To know why her ward has been poorly. And to know how we fixed her.

Mercy is asking all the right questions. She grasps the issues and shares them with Salome. Salome’s gut wrenching spasms almost certainly are caused by a lack of fibre. Fibre and imagination. But the prognosis is good. Mercy will support Salome to be less refined in what she eats. To choose roller meal, rather than highly processed breakfast meal. To eat greens, yellows and reds. To look after her gut.

We see Mercy’s good side. Kind and intelligent. We thank her and make to bid her farewell. Mercy turns. She hops. And only then does Mercy’s bad side present itself.

The bad side of 53 year old Mercy is now visible. Her right leg is twisted. Hanging limp. A limp useless limb. Her weight only supported unilaterally. Her right arm is held flexed at the elbow. Unable to offer any useful role. Powerless. Not even a worthwhile counterbalance. Armless you might say. There are two sides to Mercy, but not 2 faces. Her smile symmetrical and positive.

She is remarkably adept at hopping. For the past 41 years, it has been her only way of getting around. Our curiosity is immediately captured. Salome quietly steps out of the spotlight, and all eyes turn to the new star of the story: Mercy. Her story book opens up.

I was fine until I was 12. Then I got ill and I fell down. I never got up again. My sister was 13 years old. Naomi* had the same problem. But Naomi got up again.

 We still don’t really know what stuck Mercy down, all those years ago. Perhaps polio. But she looks as if she has had a stroke. No instructions are reaching her right arm, or leg, to say go. Her brain is scrambled, but her mind is sharp. But what would affect 2 girls in a family at the same time? In many ways our curiosity about the diagnosis is distracting us. We snap back to the present and to the future. Keith frowns as Mercy hops uncertainly around an uncarpeted world. What can be done to make her more mobile?

Mercy is quite the local figure. Not upwardly mobile, but she still gets around. Her good arm, and her good leg, power a 3 wheeled cart. Educated, accomplished and a leader of a successful household. Mother to 6 fine young people. Grandmother and role model. Mercy has already conquered many demons. Coped with her disability. Made the most of her life. We rashly aim high. We want to help Mercy. Naively, we offer her the hope of even more mobility. Mercy beams.

In 2025 our well-meaning promise to support Mercy coincides with our weekly visits to the brand New District Hospital, near the airport, nicknamed Velos. Velos houses a new vigorous physiotherapy department, headed by Mwansa Mubita. Mwansa optimistically agrees to work towards making Mercy’s bad side good.

It’s a sunny Tuesday morning. Bright and early. Mercy is waiting for us on the main road. With an ungainly shove Mercy mounts Mzungu. She now sits high on the back seat of our Toyota Hilux pickup truck. Her sunny disposition matches the day. Mercy has hope.

A wheelchair is borrowed from the emergency department at Velos and Keith delivers a special package to Mwansa every Tuesday. Mercy. That special package is returned, with interest, at the end of each Tuesday morning. Tight unused muscles and stiff joints are being challenged. But despite the challenge the mood is buoyant. Mwansa and Mercy develop a plan. Mercy will soon need some prosthetics. Mercy is to become bionic. Her arm and her leg will need held firm to function.

Time ticks on. Our routine and Mercy’s routine mesh and allow progress. Our hospital trips are her hospital trips. But we soon reach a crunch point. The sands of our work permits run through. We are due to leave Zambia. And now the Mercy / Mwansa dream team needs orthotics. Orthotics to make bad joints good. Bionic parts to make Mercy the bionic woman. But can we rebuild her? For sixteen thousand Kwacha the answer is yes.

But sixteen thousand Kwacha makes everyone’s eyes water. Keith fishes in his pocket to pay Mercy’s hospital bills, but his pockets aren’t deep enough for brand new prosthetics. He asks Mwansa to source second-hand kit to make Mercy good. Money changes hands and there seems to be a plan. As our hourglass forces us to leave Mercy and Zambia for another year, hope is still springing eternal.

But the blind optimism of 2025 is eclipsed by dismal news in January 2026. Mercy has fallen and broken her bad leg. From bad to worse. Two steps back.

April arrives and so do we. Mercy’s bones mesh and our lives start to mesh again with hers. With the healed leg we plot to fit Mercy’s new parts. To rebuild her. We contact Mwansa to check that her spare parts are on hand. But the second-hand splint has failed to materialise. The embarrassment is even evident on WhatsApp. The splint failed to make the journey from Katete. The splint is still 180 km away.

Keith restarts the conversation. An intake of breath through tight lips. Chins are stroked. Keith reluctantly reaches into his pocket once more. Complicated plans ensue. Taxis. Drop offs. A splint arrives. Further trips to the hospital with Mercy on board. What else could possibly go wrong?

Well, everything. The splint is the wrong size. And the wrong shape. With no foot support. Two more steps back. Perhaps 3. But Keith is tenacious. More sourcing. More WhatsApps. Another splint. Another size, but again the replacement splint is also the wrong size and shape. An echo. Mercy dejected. Keith dejected.

A conversation with Bruno. A man with a plan. Talk about 3D printing. Bruno is a biomedical engineer. He aims to take what we have and to resize it. Revitalise it. Personalise it. Mercy-style. Mercy me!

So Keith, Bruno and Mwansa make another plan. Bruno gives up his holiday weekend to repurpose the second-hand kit. Keith jiggles his wind-down timetable. Jam is packed inside of an already hectic schedule.

And repeat.

Two steps forward and one step back. The next foray forth to Velos gives Mercy a taste of verticality. Keith photographs the possibility of ability. Images imagine a replacement for disability. But the prosthetic frame is still not quite right. The straps too short. Mercy holds back her tears. So near but so far. Mobility still elusive.

And so it goes on.

Once again our time here runs short. Progress? What started as a desire to support Mercy has turned into a never ending saga. Perhaps Mercy is destined to hop for the rest of her life. And to get about on her trike. Watch this space. We are back next year. We imagine Mercy in motion. Doubtless her stiff resolve will splint her dodgy limbs come what may. Mercy will propel herself by hook or by crook. Whatever happens her optimism and stiff upper lip will see her through.

*Names have been changed to protect identity. Permission has been given to use the photographs. Mercy has read the blog and approved its publication

Remote can photo of the week. Its thirsty work being a baboon

A tower of giraffes

A gnu

Mercy on her trike