Betraying the poor

By Linda Soko Tembo

On an otherwise ordinary summer evening nearly two years ago, 13-year-old Mazabuka-based teenager was sleeping, when a bullet tore through his chest, and darted toward his heart.

As a survivor, he joined other Zambians who are wounded by gunfire every year. And with the bullet still lodged in his body, he joins a distinct group of Zambians: those who live with the metal inside them.

In Zambia, there are no statistics on the number of people living with bullets inside them, but in interviews, the family of one of the victims discussed what the bullet has come to symbolise for their child – a proud survivor, a traumatic reminder, and a fearful memory.

Charity Hanyanga, the boy’s mother, who sells vegetables grown in their yard to support her family, said her son’s unfortunate incident happened on the night of 23March 2020, coinciding with the nationwide gassing that rocked the country.

She lives at Nakambala Sugar Estate’s Nkabika Township with her husband, Phanwel Hanyanga a casual worker at Mazabuka Sugar.

“It was around 22:00hrs, we could hear gunshots in the township, and I heard my son crying in the living room, where he was sleeping with his older brother.”

“While I was still in my room, I asked my older son what was going on. He told me to come and see, because something had entered the boy’s chest from the roof and he was bleeding,” she said.

When she arrived to check on the son, he was lying on the ground, in a pool of blood, and in pain.

She said her husband, who followed her, quickly called out for help from the neighbours. In a short time, her brother-in-law came to see what was happening and other neighbours arrived too.

Mrs Hanyanga recalled that Zambia Sugar Company had sent an internal memo to its employees, instructing them to call the two numbers that were provided in the memo, if they had been gassed.

She quickly dialed the Officer-in-Charge at Nakambala Estate Police Station who arrived almost immediately, in the company of a male police officer .

“When the two police officers arrived, they asked us what had happened we explained and they quickly rushed us to a health facility within Nakambala Estate where the child’s wound was cleaned and stitched and we were later taken back home,” she explained.  

Mrs Hanyanga explained that a female police officer contacted her in the morning, instructing her not to sweep the house and leave everything in its original place.

Later, the two officers who attended to them the previous night came back around 10:00hrs to inspect the house.

“They asked if we had seen any mental object in the living room,” she said. “We told them, we had not seen anything.

Police spokesperson, Rae Hamoonga confirmed the boy’s family had reported the case of the ‘stray bullet’ that had wounded the boy.

“What we received was just a complaint that there was a gassing incident, so our officers responded and found the casualty,” he said.

He said nothing palpable came out of the police investigations that were started.

Mrs Hanyanga told MakanDay that when they arrived at Mazabuka General Hospital the next day, the X-ray machine was non-operational.

“As a family, we decided to go to Monze General (Hospital), and after the X-ray was done, we were handed a report that showed the presence of the bullet in the body,” she said.

Since then, they have been to the hospital, but have repeatedly been advised the bullet could not be removed.

“The doctors advised us that it was not possible to do an operation on the boy looking at the position where the bullet is, it is somewhere near the heart and that he is still young they did not want to disturb other organs,” she said.

Mazabuka General Hospital Superintendent, Dr Michael Mbelenga referred MakanDay’s reporter to the Ministry of Health for comment.

The Ministry is yet to respond to MakanDay’s press query sent to the Permanent Secretary in June.

Experts say, every bullet is different. Some, like a 9mm, may remain fully intact inside the body. Others, like a 223 caliber fired from a semi-automatic weapon, explode on impact, leaving pieces throughout.

Doctors have generally considered it safer to leave the metal inside bodies, unless they caused an infection or were stuck in a major organ, artery or joint. To dig the metal out is a risk that can cause extensive bleeding and scarring, and could potentially damage muscles and tissues.

But new research has raised questions about this assumption. A study published last year by the Center for Disease Control and Prevention (CDC) found that bullets and their fragments can be a significant, yet often undiagnosed, cause of lead poisoning.

MakanDay Centre for Investigative Journalism asked two medical experts to examine the X-ray.

One of them, a doctor said gunshot wounds are classified differently, depending on where the victim has been shot. He said although lead from ammunition is a controversial issue in the medical profession, it can be a threat to someone’s health.

He said the x-ray shows that the bullet was not near the chest or any of the “delicate organs” that surrounds the chest.

“It looks like the bullet is between a flat bone, behind and outside the ribcage, so it is not affecting any delicate organ,” he said. “If I were to classify this, I would say it is a minor gunshot injury and since the bullet has been there for two years, it has become chronic.”

He explained that the body has adjusted and accepted the bullet as a foreign body, but this does not mean that it may not cause complications, later in life as the boy grows. He suggested it needs to be removed.

“Although it is not urgent right now, if there is a medical expert who can help remove the bullet, that is the best alternative,” he said.

“Depending on the levels of lead in the blood stream, different people react differently. Sometimes you notice the change in behaviour, as the metal emits certain chemicals that may affect the brain, while others will end up with anaemia,” he explained.

Another medical expert, a general surgeon, said it is difficult to tell where the bullet is situated because only the anterior chest x-ray was done.

He said it would have been better if the lateral (side) chest x-ray was also done. However, she thinks the boy can live with the bullet and it might not cause any major problems.

Like the doctor, she thinks leaving the bullet in the body may cause lead poisoning.

“The reason why the bullet has not been removed until now could be that it is sitting on some nerves and may cause paralysis of the hand if it was to be removed,” she said.

The boy told Makanday that despite living with the bullet in his body, he does not experience any difficulties. He said he is able to play and perform household duties just like everyone else.

“I am not in any pain, and everything is okay, I don’t feel any discomfort but I want the doctor to just remove it,” he said.

 Ms  Mbewe, the auntie, who was the boy’s teacher at the time, said before he was shot, he was an average student in class.

“The time it happened, the boy was in grade six … his performance went down after the incident and he was really affected with what happened to him,” she said.