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“Nday Cham! Nday Cham!” A voice called out from just behind the car as we slowly passed by. We were new in this city, so how did this person know Deb’s Wolof name? Who was it? I stopped the car, and a thin figure came around to the passenger side. We immediately recognized the voice and face, but what had happened to her? She was emaciated and looked as if she’d aged 20 years in the three years since Deb had last seen her.

We’d known “Marti” when she worked as a maid for missionaries we knew, but it had been three years since Deb had seen her.

How did we “happen” upon her? How did she recognize Deb? We had just moved to a city of half a million people, and in a couple of hours, we would no longer be in the neighborhood where she was staying. This was the day we were moving to a different part of the city.

Marti had returned from her home village in southeast Senegal a few months earlier and lived on the streets and in a chicken shed. She obviously was not well.

Though she had friends and relatives in town, for some reason, she was not staying with them or receiving any help from them. That usually indicates relationship problems in this communal African culture that emphasizes strong family solidarity and interdependence.

Standing outside the vehicle that day, Marti said she needed help. We took that to mean she needed money or work, but in time discovered she needed much more. We fed her lunch and gave her food to take with her. We gave her money to find a room to rent.

Deb wanted to help her, so we hired her to do some light housekeeping (even though this was at the beginning of COVID restrictions and not wise to bring visitors into our house). She started coming three mornings a week to sweep and mop the floors, clean bathrooms and wash dishes. We knew she didn’t have money, so we paid her twice the going rate for house help. We bought her a mattress and other things she needed to take care of herself and for the room she found to rent in the city.

A week later, she lost her voice and her cough grew worse, so we gave her money to go to a clinic to find out what was ailing her. She was thin, slept and ate little, and coughed throughout the day. We assumed the coughing and hacking were due to bronchitis or pneumonia from sleeping on the streets or in the dusty chicken shed. At the clinic, the doctor ordered an X-ray and discovered a cracked rib (possibly from harsh coughing). He prescribed an antibiotic, pain killer and vitamins. Marti is in her mid-40s, so we didn’t ask many questions. We had been praying with and for Marti for weeks, but we didn’t want to be patronizing — acting as her parents.

At our house, Marti had access to healthy food and fruit at least three days a week. We prepared breakfasts and lunches full of protein and nutrients but knew it would take weeks or months to get her back to full health. Yet, over the next several weeks, we saw no improvement. She was thinner and weaker and told us she ate little or nothing when she was not at our house. We wanted her to go back to the clinic. She didn’t want to go but finally conceded. This time she didn’t get the new prescription filled because she said the medication didn’t work the first time, so it was a waste of time and money. She then tried rounds of traditional treatments with traditional healers — leaves with medicinal properties boiled and drank like tea, poured over the body or bathed in.

Three months after we’d reconnected with her, she was even thinner, weaker, coughing almost constantly and now vomiting and frequently running a fever. She wasn’t taking the pain relievers or fever reducers Deb was sending home with her, because she said they made her hungry. She sometimes stayed with us for two or three days at a time because she was too weak to go home to the room she rented across town. We began to see why she slept so little at night. She coughed throughout the nights while at our house.

Gradually we came to realize that Marti was slowly moving toward death. It became clear that she could no longer navigate this situation and had no one to guide and support her. We’ve been down this road with other Senegalese friends before. It brings up many questions. What if the diagnosis is AIDS or cancer? Will we pay for these long-term and sometimes costly treatments? Who will take her in if she is contagious? Will she end up living with us until she recovers or dies? Who will give her a funeral — and where?

We decided to take more initiative, or Marti would likely die in our spare bedroom or alone in her rented room. Deb went back to the clinic with Marti. There, to her surprise, Deb discovered that on Marti’s two previous visits, she had been told to go to another hospital to do a sputum test. They suspected Marti had tuberculosis, but protocol required it to be confirmed by a sputum test at a different hospital in the city.

In front of Deb and the doctor, Marti declared in her weak voice, “I do not give my saliva to anyone!” The doctor told her that if she had tuberculosis, she would die from it. We had also warned her for weeks that if she contracted COVID, it would probably quickly kill her, given her poor health and malnutrition. Upon returning to our house, Deb asked Marti why she refused to do the sputum test. She said she had been told that no one should give their saliva to someone else. “They can do bad things to me with it.”

Marti was terrified someone would use her saliva to put an evil curse on her. She feared her saliva would be used against her in the power of the spiritual world, so she refused to take the sputum test. (Some here also believe their hair or nails can be used to put evil curses on them, so they choose a barber carefully and quickly bury their hair and nails.)

Marti already felt cursed. When we met her a few years ago, she had already been married for several years but never became pregnant. Eventually, her husband’s family pressured him to leave her and find another wife who could give him children. In this culture, relatively few have health, unemployment or retirement benefits from an employer or even the government. There is no social security for most people. Adult children are the only social security and retirement option for the vast majority of people.

Without a husband and children, a woman’s long-term future is often bleak and insecure in this culture. Few men will support a woman who cannot bear children, so Marti’s marriage options are very limited, even if she is healthy. Many families have relatives who “give” children to barren women in their family — but living as a single woman for the last several years, Marti has struggled to provide for herself, much less for children who might be given to her by relatives. 

About two weeks ago, Deb convinced Marti to take the sputum test, explaining that tuberculosis or COVID would probably end her life within weeks or months without proper treatment. Five days later, we got the results of the sputum test. She has advanced tuberculosis.

Since TB is quite contagious, she must inform the family she’s been renting a room from that she is TB positive. They will kick her out. No one here wants to be near someone who has the contagious “bad cough.” In part, this is why Marti’s family and friends have had little to do with her. They seemingly consider her cursed or carrying a serious, contagious disease that they want to stay far from. So when we met her again in April, she was on her own—sleeping and eating wherever she could.

Marti’s paralyzing fear of being cursed kept her from the medication that will hopefully prolong her life. She should have started the TB treatment three months ago when she first went to the clinic. She may have some permanent lung damage, but we are praying she will recover enough to regain her health and work again. Malnutrition and this illness have affected her mentally, and she is not able to take care of herself and follow the treatment regimen on her own right now. So, she will stay with us for the next couple of months as Deb oversees her treatment and recovery. We pray she will also eventually be reincorporated into her extended family.

Though Marti has made claims to be a Christian (she is from the Bassari people group), her fears of the spirit world still have a stronghold on her life. She seems to have one foot still in the grip of her traditional religious past. It’s a common challenge here. Pray especially for Deb as she takes on this unexpected ministry to nurse and love Marti back to mental and physical health. Pray that Marti comes to a clear conviction that Jesus is her King and Savior, and that he will protect her from evil spirits. Pray for Deb as she disciples Marti to trust our Almighty God with her fears and needs.