He has passed waste through his stomach for 10 years

Far-flung from Kampala City is Kigo, a small town. It is tranquil and it blossoms with country side nature.

On our visit to the town, the windy afternoon got dust flying behind my photographer and I as we sped off on a boda boda to meet Solomon Kitaka, 52. On reaching his home, we found an elderly man, of medium height. Despite the frail look, he trotted with a slight limp towards us. He wore a yellow t-shirt. He withdrew a long cob of maize that he had been munching to catch his breath to welcome us. His lower dental formula had a gap like an isolated slum in the city.
“You are Wandera, mmh?” he asked with a smile.

“Yes! I hope I am talking to Mr Kitaka…?” I asked searchingly.

“Yeah man!” he answered as he led the way to his home. He walked while talking and showing us around the village. We nodded as we walked slowly behind him.
We got to a thin but long semi-permanent house, divided into four parts, that lay almost desolate, surrounded by a thick bush; he stopped at the first door of the four.
“Baana bange (loosely translated as my children), this is the house of the mzee, come in and find where you can sit,” he welcomed us. Along the way he had told us he is a father of many children but he only takes care of three. None of them were in the house though; neither was their mother.

The one-room house was occupied by one old-model chair with a few cushions. They cushions were covered by a cloth that must have once been white, but had now lost its pride. What made a separation between the bedroom and the sitting room was a flowery curtain. “My wife left me a few days ago but she will come back. All my children are married and living in their homes. They are many but an African man can’t reveal the number of women they have,” he said
As we sat to jump into the story, he requested to have a clean-up for at least five minutes. From under the bed, he reached out for a green basin, poured water into it and disappeared behind the house. After seven or so minutes, he reappeared wearing a pair of khaki shorts, a different shirt, a piece of cloth wound around just above his waist. He sat down. “Ok, now you can ask me what you want to know,” he said feeling comfortable.
For the last 10 years Kitaka has lived with an opening on the stomach through which he excretes his wastes and where his digestive system ends.

Sickness chips in
This part of the story of his life begins in 2000 where he started having some pain.
“In 2000, I developed feeling stomachache. I was sure I was having the normal abdominal pains so I bought Flagyl. The pain never went. It continued for months and I was not sure what the genesis of the pain was,” he says. In 2006, he left the army and he decided to lead a normal life. He got a wife. After a while, the conditions became unbearable for the two since he had no decent job and had contracted HIV/Aids.
“That woman I married killed me. She knew she was positive, she never told me. We got together, didn’t have any children with her and she went because of disagreements. But she had killed me already!”
At this point Kitaka was breathing heavily as his eyes turned red. A thin layer of sweat covered his forehead; he got up, licked his lips and stepped out. After we had waited for 10 minutes and were not sure of what to do, he appeared at the door.
“Mr Man, do not be worried, I cannot kill you like that woman killed me.”
I cast a few frantic glances at his door, to make sure he was not charging towards my direction as I was scared.
He entered and got his kettle of warm milk. He poured some into a mug for himself and then poured some into another and offered it to me. I declined. After gulping and leaving the mug empty, air started to puff out of the opening on his stomach.
Kitaka has a cow that provides him with milk as he was advised to take mostly milk.

He continued his narration. “When the pain persisted,” he continues, “I consulted the doctors in Nsambya Hospital and they told me I had ulcers. I started getting insurmountable pain and constant constipation. They gave me some drug to contain the pain, I eased myself well. Then there came a time when I took about 10 days without passing stool. The pain was unbearable! This went on for years and by 2008, I could not take it anymore.”
It was then that an organisation, He Intends Victory Uganda, which he worked for and which takes care of people affected by HIV/Aids came in to help. Kitaka worked with them as a projects coordinator at that time. The organisation collected money and took him to Mulago National Referral Hospital for further medication.

“They took me to hospital and a doctor I can only remember by one name, Ibrahim, told me that I had tumours around the rectum and I had to be operated on to get rid of the whole rectum and the anus. I feared and refused but since it was my only solution, the doctors did it anyway. They sedated me and when I woke up, a new me struck and dazed my eyes. I wondered how I could leave without an anus and using my stomach to ease myself,” he says.

Falling in love on the sick bay
After the surgery, he had no one to take care of him at the sick bay. So the organisation asked among its members who would volunteer to help him. There was no positive answer, until Noliyat Nakimbugwe, 38 willingly agreed. The disgust that was looming for the young lady then did not deter her from going out of her way to helping someone who would later become her husband.
“When I woke up, I saw her and she started talking to me and counselling me like she had been guided by the doctors. After, I got to accept who I’m through her, fell in love with her and she is currently my wife,” Kitaka notes.
For the three months he stayed in hospital, Kitaka was nursed by Nakimbugwe as other relatives kept in and out of the hospital checking on him. Kitaka says his only problem was accepting what had befallen him.
“It took counsellors continuously talking to me. My new found love in Nakimbugwe played a huge role in calming my nerves. I kept wondering how to cope in society,” says Kitaka.

Cause of the ailment
According to the documents given to Kitaka, the main cause of his ordeal was an infection called gastrointestinal infection. While they may not always be severe and may often resolve rapidly, they can be serious in specific healthcare settings or patient populations. The infection attacked him and due to delayed treatment, the colon was attacked by small swellings which later turned into tumours.
“Doctors told me it was an infection but all long I had thought it was ulcers,” says Kitaka.
Bacterial gastroenteritis happens when bacteria causes an infection in your gut. This causes inflammation in your stomach and intestines. You may also experience symptoms like vomiting, severe abdominal cramps, and diarrhoea.

Life after
Kitaka has to use toilet paper and pieces of clothes around the wound which keep the stool before he cleans himself. “It is a bad experience that I’m going through. I had lost esteem from the time I got the surgery but I have now learned to leave with it and I know it’s what I am now,” he says.
“I used to feel small whenever the grumbling started, I had to explain to people what I am and they slowly started accepting me. I am fine with telling people what happened but when I have not told, one might not be able to tell,” he adds.

Figures involved
During the time of hospitalisation, Kitaka used a lot of money, some of which he has since lost memory of.
“It was expensive, I used about Shs850,000 for the start and after that I had to use Shs340,000,” he says. Buying colostomy bags which are used to collect the waste, meant he would spend about Shs54,000 per week. In the long run it became overwhelmingly expensive and he resorted to another solution.
“I had to device other mechanisms. I bought toilet paper and tore pieces of small clothes and these are the ones I use up to now. I change them constantly because I cannot control myself when nature calls,” Kitaka narrates.
Kitaka has now learned to live with his condition and accept it. One can clearly see from his life story, that there are good days and bad days but he is trying to make the most of them.

Expert's view

Dr Peter Mbidde surgeon at Mulago Hospital says,
A colostomy is the process of externalising an intestine to the abdominal wall. An opening is made on the abdomen and through this hole, the person passes the stool.
When this happens, the patient is provided with the colostomy bags where the stool can be stored before it is disposed of. It is a very common practice among children who are born without an anus.

Causes
It sometimes is hereditary, caused by cancer and serious infections such as; diverticulitis and Crohn’s disease. It can also be caused by hatch sprung among the children.

Implications
Because this surgery might mean affecting one’s life permanently, they are always supposed to be counselled so they can be prepared of what they will be heading for.

Feeding
The person is advised to feed on mainly foods rich in fibre so that there is easy digestion such as rice, vegetables, pumpkin and Irish potatoes. They are also advised to avoid constant eating of proteins as they may cause ammonia in the stomach hence making the stool smelly.

Complications
Sometimes when it a colostomy is not done well, it can cause colon flow lapse where the rest of the intestines come out through the opening. The tissue may begin to rot and then eventually have the colostomy die.

Healing process
It takes about three days for the colostomy to begin functioning and if well treated, it takes 14 to 15 days to heal.

How the colostomy bags work
The cheaper ones could go for Shs500 to Shs1,000 and one you will need to use three of these per day. The more expensive ones which go for Shs10,000 to Shs20,000. These can be replaced after a day or two. In circumstances where patients cannot afford the bags, they could use clean towels and toilet paper.