The Twilight Years

‘Old money’ is a term reserved for families who have accumulated wealth over several generations. Their affluence, often inherited, is evident in the way they carry themselves; a mixture of class of elegance with none of the haughtiness and brashness of the ‘Noveau rich’ or like Nigerians like to call them: ‘Pepper dem gang’.

The first time I met Alhaji Kabiru, I recognised those features immediately. An elderly man well into his eighties, who spoke the lovely Hausa accented colonial English, much like the late Tafawa Balewa, well-travelled and with a vast knowledge of the arts and sciences; who had presented to the clinic with his son. He was one of those patients who liked to converse and as he was my last patient for the day, I gladly obliged him. While he regaled me with tales of his various travels, I went through his medical records. Past history of trauma to the eye from a fall. A known hypertensive and diabetic whose blood pressure and blood glucose were not controlled. Past history of stroke and evidence of chronic kidney failure. The patient had been seen by various specialists in the hospitals and seem to be on several expensive medications but all did not seem to be working. When I asked if he came with his medication, his son answered saying he had forgotten them at home. I ordered a fresh batch of tests and asked him to return with his medication and results. He gave me a sad smile and prayed for me in the way only African elderly people do.

The second time I met him was seven weeks later in the emergency room. He had lost a great deal of weight and looked emaciated, gloomy and miserable. He did not recognise me and when I went through his records, realised that the tests I asked for had not been carried out. It seemed he had defaulted from hospital visits and medication, hence the hospital admission. He was not his usual talkative self and when I asked why he did not return to the clinic; he turned his face away and kept quiet. A glance at his drugs showed a mismatch between what was prescribed and what he was taking. The quality of drugs he was consuming did not tally with the impression of him I had; old money. His slippers were Salvatore Ferragamo and his wristwatch was an Italian brand I could not pronounce, yet he was consuming the cheapest brand of antihypertensives and antidiabetic drugs. Different strokes for different people, I mused.

The third time, I met him; it was a random meeting in the hospital corridor. He was being wheeled in for dialysis by his youngest son and I stopped to exchange pleasantries. A nagging feeling teasing my senses accompanied by an unpleasant sensation in my gut made me follow him into the Nephrology unit. His son was asked to stay back in the waiting area. As the nurse set him up for dialysis and I observed his rich, white, Getzner fabric and the situation suddenly became clear; Elder Abuse.  He narrated his story amid tears of bitterness.

The injury he had sustained to his left eye, months ago, was not from a fall; his youngest son had punched him in the face. Alhaji had caught him forging his signature and transferring money from his account and confronted him. It was his only son, his youngest child, who did not deem it fit to buy the prescribed drugs, but instead resorted to cheap alternatives when his health began to fail. Since his last stroke, his son had convinced his older sisters to allow him to take sole custody of their father. Alhaji Kabiru was thus denied access to his money and therefore could not go abroad for treatment. As a result, his kidneys had failed and he had been threatened by his son, with violence, if he ever revealed the true nature of his illness. His son had moved into the family house with his wife and children and bragged to all that would hear, the sacrifices he made taking care of his aged father.

Sadly, Elder abuse, a type of domestic violence, is not readily recognised in this part of the world. It is often underestimated, as only 1 in 54 cases of elder abuse is reported worldwide (WHO). In Africa, where culture translates heavily into our lifestyle, reporting is even lower. Because how do you explain the fact that a highly educated and wealthy businessman would beg us to keep his secret safe? To vehemently deny us the right to report his son to authorities for theft? To plead with us to allow him to live the rest of his life suffering in silence?

Alhaji Kabiru claimed to have accepted his fate in life, but as he concluded his story, I heard him muttering: “Allah ya isa! Allah ya isa!’

He passed away several months later, and the guilt like a pulley still wears me down.