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His Life

Sickle Cell Anemia: the thorn in Godfrey's flesh

December 22, 2012

In his many letters to the Corinthians (1 Corinthians 7:12), the Apostle Paul spoke of a thorn in his flesh, which if it was in his powers, he would have willed it away. We don't know what that thorn was. In the case of Godfrey, we know he had a thorn and we also know the thorn: sickle cell anemia.

Sickle cell anemia is a genetically acquired disease that is common in areas where malaria is common. It is caused by genetic changes at different regions of the genome (the blue print that makes us who we are), and it arose due to evolutionary pressure from malaria. Put it simply, persons with the abnormal gene had a better chance of living to adult life and bearing children, so more children with these abnormal genes were more likely to be born and also to grow and have their own children. All human beings have two copies of the same gene. In the case of the genes causing sickle cell anemia, having one copy of the gene is good, but having two copies is not good. Since we get one copy of the gene from each parent, having two copies means that both parents have the gene, while having one copy means only one parent has the gene. With one copy, people are able to resist severe malaria infections than those who don't have the gene, while having two copies causes other problems.

Godfrey had two copies of the gene (the exact genetic abnormality is not known to us. About 5-40% of people in Uganda carry the abnormal gene, depending on where they come from. This tells us something about his parents. More importantly, this caused him to suffer from the negative effects of the double abnormal gene. In Godfrey's case, the complications were anemia and kidney failure. Many people know of this and dubbed Godfrey "omusawo" or "doctor" because of his dutiful attention to his health to maintain kidney function through artificial support through peritoneal dialysis. Daily, Godfrey would interrupt his schedule to go and administer peritoneal dialysis to himself.

Why kidney failure in sickle cell anemia? The basic functional abnormality in sickle cell anemia is that red blood cells, which should be nice and round change to become sickle cell shaped when they don't have enough oxygen. The round cell shape is good for circulation; the sickle cell shape is not good for circulation and causes blockage of the small blood vessels supplying body organs. In the case of the kidney, failure to get enough blood causes the kidney to fail to perform its crucial function of keeping our blood clean- have you never wondered why you pass urine? You are merely passing waste products cleaned from your blood by the kidneys.

The use of peritoneal dialysis was revolutionary because it allowed more independence to the patients, including Godfrey, but it also has complications, which became apparent in Godfrey's case. Infection of the abdomen prevents proper function of the intestines. Ultimately, this great success story had an "Achilles" hill built in, fated to lead to this sad day. So what can we say? Like Paul, Godfrey was powerless to will away his thorn, so he lived with it to the last day of his life. We celebrate his life for it tells the story of survival of human kind against adversity, as well as the triumph, even if ephemeral, of medical technology.

Godfrey would have appreciated this.

Godfrey's Biography

December 21, 2012

Godfrey Kimera (1962 – 2012)

His Education:

Godfrey went to Namaate Primary School in Entebbe, formerly Mpigi District, for his elementary and middle school education.

He went to Old Kampala, Kampala high school for his Ordinary and Advanced Level education, equivalent to high school in the U.S.

 

Impressed on the principle of building personal wealth, Godfrey started a business, preferring to employ himself rather than be employed. His initial business was importing merchandize, mostly from Dubai, but also from other countries.

This was an important phase of his life because he met Barbara at this time and embarked on a lifelong journey of love.

In the early 1990s, Godfrey relocated to the U.S., settling in Washington D.C., where he began work in humble but very happy circumstances. According to Barbara, these were special days of their life.

His employment at this time included work with the Eastern Connection Courier Company, a relatively small company. He was , however, to stay a short time here and then moved to  a much larger company, Adcom Courier Company. This surprised those who had preceded Godfrey, but also showed his entrepreneurial spirit.

Armed with enough experience, Godfrey struck out on his own, starting a company called Ssebintu LLC, focusing on courier business. He has been working in this business for the last 10 years. In addition, he was able to fulfill his lifelong dream to start a hotel – opening a trendy hotel in his home toen Entebbe called Executive Airport Hotel (http://www.eahuganda.com/index.html) in 2009. He was last in Uganda to supervise his work in September 2011.

In 2008, Godfrey became a United States Citizen. A long cherished dream of his.

Health

Godfrey, like many African was born with a genetic abnormality called sickle cell anemia. This abnormality is vital to surviving malaria-related deaths in Africa, but it is also associated with complications. One of the complications is kidney failure. Godfrey suffered from this ad the condition became severe in 1996. His kidneys simply failed. He was placed on a strict treatment called peritoneal dialysis, which was performed 4 times a day. This procedure cleaned up his blood, a job the kidneys could no longer perform. Amazingly, Godfrey kept an active work schedule throughout this time. The flexibility at work allowed him to get treatment (dialysis) and work at the same time.

In 2002, Godfrey received an emergency surgical operation to treat gallstones. Unfortunately, this operation was ill-fated. Lasting more than 4 hours, it could not be completed because of bleeding. Unfortunately, the bleeding into the abdominal cavity caused the peritoneal cavity to develop scars and could no longer be used for peritoneal dialysis. It also caused his intestines to stop working well.

During this time, Godfrey lost much weight and looked unwell. This was compounded by the need to get hemodialysis 3 times a week, each procedure lasting about 4 hours per day.  Amazingly, Godfrey continued working throughout this period.

Godfrey was a research volunteer at the NIH

Godfrey was always looking for treatments that would improve his condition. One place he always visited in search of those opportunities was NIH, the largest biomedical research center in the world. He was very interested in a protocol that was being tested there – in mice.

In 2006, when making a routine visit to NIH for evaluation of his readiness for a potential therapy involving bone marrow transplant, his NIH doctors were shocked at his condition. They admitted him for rehabilitation and reconstructive surgery. He underwent 11 hours of surgery to remove the adhesions and reconstruct the intestines so he could eat again. After 11 hours and 10 units of blood, Godfrey was weak, but essentially well. He made steady recovery, was able to eat for the first time and became well and went back to work.

In Dec of the same year, just before x-mass, he got a call from the Johns Hopkins Hospital informing him he had matched to a donor and was offered the opportunity to say yes to a kidney transplant. He said yes and was transplanted on Dec 23rd, 2006: a real x-mass gift made possible by the earlier surgery at NIH.

 

This was the best part of Godfrey’s life. He recovered. His moods soared. He had his life back again. He could eat, he could work all week, and he could even travel to Uganda and stay for long periods like before.

Ever eager to get on with his life and secure a brighter future for Barbara, Godfrey embarked on his plan to start his business –Ssebintu LLC and the Executive Airport Hotel in Uganda. 

The following experiences highlight Godfrey’s attitude towards adversity in life

When he was on peritoneal dialysis, he had to ship all his dialysate fluids to Uganda because he could not purchase them there – about 150-200L of dialysate for a two week period. After his abdominal surgery, every time Godfrey travelled to Uganda, he had to fly to Nairobi two times a week to get dialysis because there was no dialysis in Uganda. After kidney transplant, he was free to go without shipping bulky fluids or share his holiday with the need to get medical treatment. Godfrey continued working throughout this period of illness, whether in winter or summer Godfrey wedded his beautiful life during this period

Relatives

Godfrey was a lucky man. He lived in the U.S. surrounded by more than 15 close relatives (sisters, brothers, nieces and nephews). Of all these, only his wife and one sister came to the U.S. before him.  He was directly or indirectly involved in helping others join him in his adopted country.

Because of these many positive attributes, Godfrey was highly respected in the community.

Please feel free to sign his memorial to leave a tribute

Godfrey: A Young Man Finds His Soulmate

December 20, 2012

Under ordinary circumstances Godfrey would not have had any difficulty finding a mate. However, he was a man on a quest for the proverbial perfect match - or "soul mate" - the needle in a haystack.

According to those who know him, he was looking for "omulungi, akoola ebirungi" or the "beautiful one whose essence exudes beauty".

Acting as if he was forewarned, the day of his destiny found him ready. Dressed in perfect attire with matching stylish shoes, he set out to visit his sister, Jas, at her shop. There, he was smitten by another visitor to her sister - a young girl - Barbara- just turned 17 years and still in high school, whose color shone so brightly, outshining any other light in his life.

There is no indication that Barbara was as smitten, but, many years later she still remembers the spark and treble in Godfrey's voice. She remembered him as easily when his messages came. But what struck chord was his focus on her wellbeing, his determination that she should finish school, that she should follow the biddings of her parents, that she should finish school. Godfrey was a determined suitor and pursued Barbara with patient determination and eventually won her heart and hand in a fabulous wedding in 2000...more than 15 years after they first met.

Godfrey was so confident of his love that when Barbara came to the U.S., Godfrey was first to reassure her that he would be coming just behind her, like a few days later. It took him 9 months to join her, but the love that was blooming remained undiminished. This love has withstood the toughest of tests. Barbara will remain a tribute to Godfrey's love. He was devoted to her as she was to him.

He will be waiting at Heavens Gate for Barbara