Pamela Achieng: Removal of my lung eased 24-year pain

It is a bright Monday afternoon and I am driving to Katito, about 30km from Kisumu City.

After nearly an hour’s drive, I arrive at the home of Pamela Achieng, a 55-year-old mother whose cheerful smile greets me at the gate. At first glance, she looks radiant, the kind of woman whose laughter could fill a room.

But behind that warmth lies a story of unimaginable pain — a story of resilience through 24 years of suffering, hospitals, and near-death experiences.

Pamela’s story begins in 1999, when life as she knew it changed forever.

“Life has not been easy for me for the last 24 years,” she begins, seated on the couch inside her modest home. “But for now, I can say things aren’t bad.”

She recalls how it started with a persistent cough that wouldn’t go away. “I kept coughing, sometimes bringing out blood in my sputum. That’s when I decided to go to the hospital. The doctors told me I had tuberculosis (TB),” she says.

“Back then, when you heard you had TB, you thought it was the end. It was a big monster that spared no one.”

Pamela began her eight-month treatment regimen, hopeful that the antibiotics would help. And indeed, for a short while, they did. The coughing subsided, and she began to feel better. But within months, the symptoms returned, this time more aggressive.

“I started coughing again, this time with clots coming out,” she explains. “I was tired all the time, had no appetite, and felt like my body was failing me.”

Years passed. Hospital visits became routine. Antibiotics became her lifeline. And with each passing year, the pain grew worse. “For 24 years, I have lived under pain,” Pamela says. “Every day was a survival story.

Early this year, Pamela made a life-saving decision to seek further medical help. She visited the Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH) in Kisumu after realising her condition was worsening.

“When I was admitted, I explained everything to the doctors, how I had been suffering since 1999,” she recalls. “From the look on their faces, I knew something wasn’t right.”

Tests were conducted, including an X-ray and CT scan, and the results revealed a shocking diagnosis. Pamela was suffering from aspergilloma, a severe fungal infection that had developed in her lungs as a complication of her earlier TB.

“The doctors told me that the infection had eaten up my left lung,” she says. “They said I needed surgery to remove it, a pneumonectomy. At first, I was terrified. Imagine being told that one of your lungs has to be removed.”

After weeks of preparation, Pamela underwent the surgery. “The surgery went well. I am now recovering at home,” she says, smiling. “For the first time in decades, I can breathe freely.”

During the interview, Pamela’s husband, Moses Otieno, sits quietly beside her. His eyes speak of both exhaustion and devotion.

“Life has not been easy since she fell ill in 1999,” he says. “When she was diagnosed with TB, we were devastated. She was our breadwinner, always on the farm planting vegetables and ensuring there was food on the table. Seeing her down was painful.”

Otieno’s own life took a turn when he was involved in a road accident that left him partially immobile. “I can’t do much now,” he says. “But I thank God for our third-born daughter, Anne Akinyi, who has been taking care of her mother. After the surgery, Pamela has improved a lot. She can breathe, talk, and even laugh again.”

Anne, who spent weeks by her mother’s hospital bedside, recalls the emotional toll. “My mother’s condition was so bad that at some point, she was admitted in the ICU for a week,” she says. “I almost gave up. Seeing her smile now makes my heart melt. I believe she will live a normal life again.”

According to the National Organisation for Rare Disorders (NORD), aspergillosis is a fungal infection caused by Aspergillus, a mould found in the environment. Most types are harmless, but in people with weakened lungs or immune systems, it can cause serious illness.

Aspergilloma, a form of aspergillosis, often develops when the fungus grows inside lung cavities left behind by diseases like TB. Over time, it forms a ball of fungus that can cause persistent cough, bleeding, and severe lung damage.

“Aspergillosis rarely affects healthy people,” NORD notes. “It mostly develops in individuals with prior lung disease, asthma, cystic fibrosis, or compromised immunity.”

The World Health Organisation (WHO) describes tuberculosis as an infectious disease spread through air droplets containing Mycobacterium tuberculosis. Though treatable, it remains one of the world’s deadliest diseases. In 2021 alone, 10.6 million people were diagnosed with TB globally, and 1.6 million died from it, making it the second leading infectious killer after Covid-19.

In Kenya, the Ministry of Health reported 90,841 TB cases in 2022, an increase from 77,854 the previous year — a worrying trend that underscores the country’s ongoing battle with the disease.

Dr Juma Odoro, a Cardiothoracic and Vascular Surgeon at JOOTRH, led the complex procedure that gave Pamela a new lease on life.

“Pamela came to us with a prolonged history of coughing, difficulty sleeping, and coughing up pus and blood,” he explains. “Her CT scan revealed extensive damage to the left lung, with a collection of pus that was contaminating the other lung.”

The surgery, known as a pneumonectomy, involved removing the entire infected lung. “We had to open the left side of her chest — a very delicate process,” says Dr Odoro. “Her lung was severely damaged, and the surgery took several hours due to dense scar tissue and adhesions.”

“After surgery, she was monitored in ICU for four days,” Dr Odoro says. “She showed immediate improvement, breathing better, sleeping well, and even gaining weight within a week. It was an incredible recovery.”

Dr Odoro explains that aspergilloma often occurs after TB because the fungus takes advantage of the cavities left in the lungs. “For patients like Pamela, the fungus grows inside the damaged area, forming a ball that erodes lung tissue and blood vessels,” he says. “In advanced cases, surgery is the only life-saving option.”

He adds that many patients in the region may be living with similar conditions without knowing it. “For a long time, cardiothoracic services were unavailable in Western Kenya,” he notes.

JOOTRH’s new era

The idea of living with one lung can sound terrifying. But Dr Odoro explains that it’s entirely possible to live a healthy life after a pneumonectomy.

“Most people can survive with one lung,” he says. “The remaining lung expands and takes over most of the breathing function. Before surgery, we always do tests to ensure the patient’s body can handle it.”

He adds, “There’s a misconception that life ends after one lung is removed. That’s not true. Most patients live normal lives. Of course, they have to be careful, but with good medical follow-up, their life expectancy is similar to anyone else’s.”

According to JOOTRH Chief Executive Dr Joshua Okise, Pamela’s surgery marks a new era for the hospital one that brings specialised, advanced medical services closer to the people of Western Kenya.

“This was the first successful pneumonectomy done here,” he says. “It demonstrates that JOOTRH is now capable of handling complex cardiothoracic and vascular surgeries that previously required referral to Nairobi.”

Dr Okise explains that the hospital is expanding rapidly, adding new specialists and equipment.

The hospital, he adds, has been training and retaining specialists in areas like maxillofacial surgery, gynaecology, and cardiology. “We have two maxillofacial surgeons, only five exist in Kenya — and both are in JOOTRH,” he notes. “Patients are coming from as far as Voi for reconstructive surgeries.”

The facility’s ICU capacity is also expanding, with five new ventilators expected soon, bringing total capacity to 18 with a goal of 50 beds within a year.

“Our breast surgery and neurosurgical camps have benefited dozens of patients,” Dr Okise says. “These camps also help train our young doctors and strengthen our local expertise.”

Back in Katito, Pamela’s laughter fills the air as her husband and daughter watch her move about slowly, still recovering from her surgical wounds.

“I never thought I would survive this. I used to cough up blood every day, but now I can breathe. It’s like being born again.”