The silence was palpable, almost overwhelming, you could have heard an ant breathe. In the doctor’s small consulting room were three generations of the same family ÔÇô daughter, mother, and grandmother. The youngest of the trio was the subject of the visit, and her mind was on a spin as the news sank in.
“I believed cancer was for heavy drinkers and smokers, and I neither drank nor smoked,” she recalls. “I kept asking why it should happen to me.”
Bontle Modige was aged just 13, and in her final year at primary school when she was diagnosed with a cancer of the throat known as nasopharyngeal carcinoma.
The signs had begun the previous year, when she experienced a constant swelling of the lymph nodes in the neck. Whenever she presented to the local clinic, the nurses would put it down to tonsils, prescribe some tablets and discharge her. The inflammation would disappear, only to reappear later on the other side of the neck. Ultimately the swelling got so bad that her neck tilted to one side, and she couldn’t look sideways or backwards without turning her whole body. The condition got so bad that her class-teacher suggested that she see a doctor.
Quite intriguing, I make a mental note, that it was an outsider whose concern led to the intervention that saved her life. Later, I learn that at home the swelling was taken lightly. At one point, the family concluded that she had probably fought at school, and was concealing the transgression.
Acting on the teacher’s counsel, one day she decided to sneak out of town, and travelled to Ramotswa to seek consultation at the local hospital. Without much effort, the doctor managed to get the truth out of the little girl in his consulting room. She had travelled from Gaborone without her family’s knowledge. He managed to have the family summoned to the hospital instantly.
It is possible that, if nothing else, the call from Ramotswa was the signal that what had hitherto been casually dismissed as the result of an adolescent’s mischief was actually something more serious. To the awe-struck family members, the doctor spelt out his initial suspicion ÔÇô TB of the tonsils. But he needed to do a lymph node biopsy to ascertain if indeed it was TB ÔÇô or even cancer.
“I refused to undergo surgery,” Modige says, and so the little party went home without knowing the true state and extent of her condition.
In fairness to the family, they were convinced that they had a medical case, but it was the next course of action that was somewhat eccentric.
“We went to different traditional healers,” she states. “Even when my condition did not improve we stuck with them. Then my eyes crossed and it was it was at that point that we decided to go back to Ramotswa.”
It was four months after she had refused the biopsy. And they found the same doctor ÔÇô still waiting. This time he decided to operate straight away.
The results came after two days. The three were up early, and the youngest, as it had become a recent ritual, had missed school. As they trooped into the consulting room, nothing would have prepared them for the news that the test had come back positive for nasopharyngeal carcinoma. If there was any glimmer of hope amid the gloom, it was that the cancer was still at stage two. This meant that it was still growing, but had not spread throughout the body, and therefore could be controlled.
The year 2000 was just drawing to an end ÔÇô and it seemed fate and irony were the two protagonists in a Greek tragicomedy of sorts. Wasn’t this year we had been promised health for all? And of the three generations in the room, why would it have to be the youngest to carry the burden?
As the doctor enquired about the family history, it soon came to light that Modige’s maternal grandfather also had cancer.
“If it was a genetic factor at play, I wondered why the cancer had skipped everybody else in the family and decided on me,” she recalls. “At that point I didn’t even think of death; that came later.”
A week afterwards, she sat for the Primary School Leaving Examinations. Her treatment was scheduled not to interfere with the examinations, so in November she reported at Princess Marina Hospital to start chemotherapy.
She was not yet done with the comedy of errors. Her first treatment was an overdose. Somehow the doctor at Princess Marina Hospital had misread the prescription of five doses over the same number of days, and administered the all medication in a single day. Inevitably, the body reacted. She had sores in the mouth, tongue, and throat. Once again, her eyes crossed. Unable to eat anything, she was fed by a drip and was confined to a bed. So bad was her condition that she was isolated from other patients.
One day, he summoned whatever strength she could and yanked herself off the bed. Barely managing to stand in front of the mirror, she did not recognise the image of skin and bones. The only sign that this was her image was the long and copious hair, though disheveled after days of neglect. As she ran her fingers through the mane, as if in a bad dream, chunks of it came off.
“It gave me such a fright,” she recollects. “Nobody had taken the trouble to explain to me what to expect as I went through chemotherapy.”
As her condition did not improve, one day the doctor was confronted by the increasingly worried mother who wanted to understand what was really happening to her daughter. It was then that he revealed what he had previously concealed from the family ÔÇô that he had overdosed the medication.
He proposed a deal: to underwrite the cost of Modige’s treatment at Gaborone Private Hospital, which the family quietly accepted. After a week’s treatment at the private facility, she did come round, except for the deafness on the right ear, an impairment she carries to this day.
After second round of chemo, in February 2001, she felt strong enough to go to school for the first time since being admitted at junior secondary school. She managed to attend school for just a month, and was off again for more chemo. She wouldn’t come back that term.
While at home one day, she was visited by a friend since primary school, who happened to be at the same secondary school. As the pals played catch up, Modige learnt the latest classroom gossip that was doing the rounds.
“She said, ‘at school they say you have died’,” she states. “I was hurt.”
As if to prove that she wasn’t about to lie down and die anytime soon, when the second term began, she was in class.
“It was so harsh because people didn’t want to sit next to me or share anything with me. One or two teachers also displayed the same attitude. I could see that they avoided me,” she says.
That term she went for the last round of chemo, and graduated to radiation.
At the end of treatment, her body was eventually rid of the cancer. She now goes for regular checkup. She is also on a lifetime hormonal replacement treatment for thyroid, which was infected during radiation.
You could say the battle has been won, but there was a lot of collateral damage. She had missed out on a lot of school time. Against the teachers’ advice, she sat for Junior Certificate Examinations, which she failed.
At a social level, a lot of friends drifted away because the treatment had turned her into a recluse. Then she had to give up on her much-loved game of tennis, very painful for someone who had featured in tournaments outside the country while still at primary school.
While assessing her options, Modige decided to volunteer her time at Reach for a Dream, an organisation that catered for children aged below 18 who had cancer. Through the organisation’s coordinator, she learnt of scholarships offered by different private schools such as Maru a Pula, New Era, and Rainbow. She was accepted at New Era, where was able to complete senior secondary education.
Last year, she joined the Cancer Association of Botswana (CAB) as a volunteer, with the intention to use her life story to educate the public about cancer, and send a message of hope to people who are diagnosed with the disease.
“I survived an overdose,” she says. “Anybody can pull through if they don’t give up hope. Treatment can be very painful, but I told myself that I would not allow this illness to put me down. Even when I was supposed to be resting in bed, I used to insist on walking about.”
She recently met a cancer survivor of Indian origin, who got all his treatment at Princess Marina ÔÇô a positive indication, she says, that though some cases are still referred to South Africa, Botswana’s capacity to treat cancer is improving. Where she feels there is still a long way to go is in public awareness, as evinced by the many who still prefer traditional and faith healers.
“The outward symptoms might disappear after consulting traditional doctors, but the cancer would be spreading inside the body, and by the time someone decides to seek medical attention, it would have progressed to stage four, where it is difficult to control,” says the 25-year-old.