In memory of beloved Zainab Aliyu

With a heavy heart and tear filled eyes, I summon the courage to write this eulogy to my brave and courageous daughter, Zainab Aliyu, who lost the battle to Hodgkin’s Lymphoma on May 7, 2015. Zainab was diagnosed with Cancer when she was 20 years old. Her ill health started in 2003, between the ages […]

With a heavy heart and tear filled eyes, I summon the courage to write this eulogy to my brave and courageous daughter, Zainab Aliyu, who lost the battle to Hodgkin’s Lymphoma on May 7, 2015.

Zainab was diagnosed with Cancer when she was 20 years old.

Her ill health started in 2003, between the ages of nine and 10 years. I remember she first broke out in a cough accompanied by catarrh and high fever which ended up being Tuberculosis infection. She observed the free nine months TB treatment at Dantsoho Memorial Hospital, Kaduna, and at the end of the treatment, she was certified TB free and advised to return to the hospital for any complaint.

Few months after, she came up with lymph nodes which her doctor thought to be residue of the TB treatment. But when it didn’t go, he referred her to the Hematology Unit of Ahmadu Bello University Teaching Hospital (ABUTH), Shika, Zaria, where some lymph nodes were extracted and tested and showed Non Malignant but Positive to Brucellosis (an infection spread from animals to people, mostly by unpasteurized dairy products). The doctors were not convinced with the results though.

About a year after, she started experiencing ear pain and like the lymph nodes. In 2008, when more lymph nodes appeared, she was taken to the Nasir Institute in Egypt and after all tests, she was given a clean bill of health. But not up to a week after she returned to Nigeria, lymph nodes came out on both sides of her neck and she was sponsored back to the American hospital in Dubai. There, the Doctor vowed to prove Nigerian and Egyptian doctors wrong about her condition but when the results came out negative, he was speechless. He then advised that she should be examined from time to time as not all lymph nodes are a good sign.

In late 2012 when the ear pain persisted, a surgery was performed at Ear Care Centre, Kaduna, where part of her lap was removed to mend an opening in the ear. All went well and she went back to school only to be brought back home due to excessive leg pain and body numbness. She was then taken back to her Ear Doctor, who advised she takes a Physician’s Assessment.

A kind hearted person again sponsored her to Iranian Hospital, Dubai. There again, all tests proved that the Lymph nodes were non-malignant, although the Doctor suspected Tuberculosis of the Spinal Cord, but lab tests proved negative. As there was no precise diagnosis, she returned to Nigeria with a deteriorated condition. At this point, we knew Zainab’s health was at stake as all symptoms of being  seriously ill had started prevailing – her legs got swollen, then lethargy, night breathlessness, chest pain, headache, back pain, fatigue, vomiting, lack of appetite and weight loss. She also broke out in small itchy rash all over her body.

A kind relative who pitied Zainab so much sponsored her to International Medical Center (IMC), Cairo, Egypt, in late 2013.

At IMC, it took three weeks of lab testing, City Scan, MRI and a PET scan before the team of Doctor Mahmud Salla determined her illness. 

Accepting the fact that Zainab was a cancer patient wasn’t easy at all. I always wished the doctor would call us back and apologies for wrong misinterpretation of her blood tests. 

One surprising thing about Zainab was that you could never catch her feeling bad or crying over her condition. 

The best of times for Zainab was when she had her first successful Stem Cell Transplant which, as part of the treatment, made her stay for one month in isolation. The day she came out was one of our happiest days – the whole family was overwhelmed with Joy, we prayed and even made sacrifice to thank God. We received many congratulatory phone calls and text messages from Nigeria. 

I still have in my memory, the big smile on her face when the doctor announced the good news that she was cancer free after a salvage intervention protocol. 

Our joy didn’t last long however, as she didn’t even get to achieve any of her plans when she started complaining of back ache again and rapidly losing a lot of weight. After series of checks, her doctor confirmed a relapse.

I was devastated and saddened by the news but Zainab was calm and believed that she will overcome it as she did the first time. She was so determined that she joined an Arabic class, which she attended in between her chemo breaks.

Sadly, her health kept deteriorating and admission into Hospital became more frequent with longer days and huge bills. Eventually, she started getting tired easily that it reached a stage when she could not walk within the hospital premises or any long distance, so the use of a wheel chair became inevitable and this stifled her hope of learning Arabic.

I remember a day she asked me why she was suffering so much at such a young age. It was a difficult question, but looking at her beautiful face, I mustered the courage to explain to her that God has reasons for  everything, good or bad, and that her illness was nothing but Allah’s trial, and for any adversity,  Allah erases one’s sins and no human being escapes Allah’s trial, everyone faces it in his/her own way.

The whole treatment reached a static point with only the care of pain management unit. Painfully, the Brentuximab we had so much hope on wasn’t effective as expected. Her first dose made her develop breathlessness and swashe had to be put on oxygen, her lips and ears got swollen and she had patches of blood all over her body but she perked up almost immediately. In spite of what happened, her chemotherapy continued after three weeks of interval. I was still hopeful, especially as she was eating, walking and ‘gisting’ normally except when she was in pain. But then, I noticed a change in Dr Mahmud’s attitude towards her case as he seemed to pity her so much that he gave flimsy excuses for skipping her room during ward rounds.

But the fact that he never faced me to say that she had exhausted her treatment line, I was determined to take her to the end of the world for a second opinion so long as she was breathing. After contact with St. Jude’s Hospital in America for a free treatment failed, we settled to take her to BLK Hospital, India, considering proximity.

We arrived at BLK Hospital, India on the 1st of March and she was admitted on the 2nd of March, 2015, under the care of Dr Gaurav kharya, an expert in Bone Marrow Transplant. I had hope that she would get a different treatment, a Donor Match and would be well again, but in the end, I realised it was more  or less a continuation of the same procedure in Egypt, only with different drugs and same huge bills.

After rounds of Beacopp Protocol and all  search for a Donor failed, the doctor decided  to go for Haplo Transplantation, which is using her immediate brother on half match for the Transplant. Unfortunately, getting her Donor brother to India for the transplant proved difficult. The Indian Embassy officials were so strict despite all proofs that the trip was for medical reasons. We almost gave up before he arrived, accompanied by their father and my husband.

Eventually, Zainab had the Transplant on partial remission but looked fragile afterwards but at the same time, was extremely excited and kept smiling for a long time. When she got better, she asked me to buy a phone as a gift for her Donor Brother, who gave her a chance at life. Seeing she was stable, her father left for Nigeria.

We believed it was the end of the wicked Cancer and I was eager for her to be stronger and be discharged but I was wrong. Like the case in IMC, I noticed that the doctor started avoiding Zainab during ward rounds and Consultations, so also his team members, but still, that didn’t give me the inkling that Zainab was helpless and was at the verge of leaving me, until about 10 days after the Transplant when she started  having High Temperature, inflamed throat that she couldn’t swallow  her  own  saliva, vomiting, body coldness and  consistent hiccups. Still, I was hopeful until she developed breathing difficulty and was rushed to ICU.

When I went to see her at the ICU, I was shocked. For the first time in the two years Zainab battled intense Cancer, I realized something that hadn’t registered before-’The Severity of Hodgkin’s Lymphoma.’  Seeing her on life Support Machine really demoralized and saddened me and broke my heart. 

Still, I had hope. I still believed that the Dialysis, Insulin Injections, Platelets, Plasma and Blood infused in her will not go for anything. I prayed fervently to God to spare her for having suffered almost all her life and for being my only Daughter. She stayed in the intensive care unit (ICU) for six days, each day with a new case of  either High Creatinine, High Blood Pressure, High level of Sugar, and lastly, she developed Thrombotic  Thrombocytopenic Purpa (TTP), which is a rare blood disorder.

Night of the sixth day, when her Donor Brother was leaving us to go back to Nigeria, he was allowed to enter the ICU to bid her good bye and immediately he entered, he hugged me and asked me to tell the Doctors to remove all the tubes. I asked him why, he said “Can’t u see her Mami, she’s suffering, she doesn’t need them anymore.” Then it dawned on me that she could be dying. Immediately, with a feeling I can’t describe, I turned to Zainab and called her name and surprisingly, she nodded in answer. I asked if she could hear me, she nodded in the affirmative again. Then I told her to be supplicating to God, the kalimati shahada and if she can’t, she should call any of the 99 Names of Allah. I asked her again, can you hear me, Zainab, she nodded yes. Then I turned back towards her brother. Without a word, he left the cubicle.

On the sixth day in ICU, 7th of May, 2015, as I entered the ICU  in the morning, one  of the Doctors  immediately, held my  hand and  said “Ma’am, we are sorry, your daughter is a little sick this morning, we can do nothing more for her. If you can, go sit beside her and hold her hands.”

Like a zombie, I walked into her cubicle, sat by her side, crying, praying and reciting the kalimatu Shahada. God was my only hope at that moment. At that point, another Doctor called my attention and said “Sorry Ma’am, from reading of the Machine, your Daughter has few minutes left. Better call your people in Nigeria to decide where you want to bury her.” I was trying to control myself when another Doctor again came in and said “sorry Ma’am, we will help make it peaceful for your daughter.” Before I could say anything, he called one of the nurses and ordered her to sedate her.  Innalillahi Wa Inna Ilaihi Raji’uun (from Allah we come and to Him we shall return).

In between tears, I called her father in Nigeria and we decided to bury her in India. No sooner had I dropped the phone than the life support machine gave a straight sound which indicated that my brave and optimistic  Zainab was  gone. May Allah forgive her of her sins, ameen.

There’s no word strong or adequate enough to describe the pain of losing her. She was buried according to Islamic injunctions at the Firoz Kotla Muslim Cemetery in New Delhi.

To this end, I pray for Allah’s mercy on Zainab and her aunt and namesake, Zainab Jamaare, who also lost the battle to Lymphoma at the age of 22 in 1985.