Daktari alisema kitovu kisiguswe kwa mikono michafu.

Alisema means he/she said.

It can be broken down as:

• a- = he/she
• -li- = past tense
• -sema = say, speak

So Daktari alisema = The doctor said.

Because daktari does not show grammatical gender, alisema can mean either he said or she said, depending on context.

In Swahili, the word kwamba = that is often optional after verbs like sema.

So both of these are natural:

• Daktari alisema kitovu kisiguswe...
• Daktari alisema kwamba kitovu kisiguswe...

The version without kwamba is very common and sounds perfectly normal.

Kisiguswe means something like it should not be touched.

It can be analyzed as:

• ki- = subject agreement for kitovu
• -si- = negative marker in this kind of form
• -gus- = root meaning touch
• -w- = passive
• -e = subjunctive final vowel

So:

• gusa = touch
• guswa = be touched
• kiguswe = that it be touched
• kisiguswe = that it not be touched

The ki- agrees with kitovu, which belongs to the ki-/vi- noun class in the singular.

In Swahili, verbs must agree with the noun they are connected to. Since kitovu is singular in this noun class, the verb uses ki-.

That is why you get:

• kitovu kisiguswe

If the noun were plural, the agreement would change.

The passive keeps the focus on the navel/umbilical area, not on the person doing the touching.

So:

• kitovu kisiguswe = the navel should not be touched

This sounds more impersonal and more like medical advice or instruction.

An active version would be:

• Daktari alisema msiguse kitovu kwa mikono michafu.
• The doctor said not to touch the navel with dirty hands.

Both are natural, but the passive sounds a bit more formal and rule-like.

It is not a direct command like Don’t touch it!
It is better understood as a reported instruction, recommendation, or indirect command.

After alisema, the subjunctive often expresses what someone said should or should not happen.

So the idea is:

• The doctor said that the navel should not be touched...

It means with dirty hands.

Here, kwa shows the means or instrument used to do something.

So:

• kwa mikono michafu = with dirty hands
• literally, by means of dirty hands

Because adjectives in Swahili usually agree with the noun class of the noun they describe.

• mkono = hand
• mikono = hands

Since mikono is plural, the adjective also takes the matching plural agreement:

• michafu = dirty

So:

• mkono mchafu = a dirty hand
• mikono michafu = dirty hands

The sentence does not say. That is exactly what the passive does: it leaves the agent unspecified.

So kitovu kisiguswe does not tell us who should not touch it; it only states the rule that it should not be touched.

In context, the understood meaning is usually people should not touch it with dirty hands.

No, not if kitovu is the subject of that verb.

The agreement must match kitovu, so ki- is the correct subject marker here.

• kisiguswe = that it (the kitovu) should not be touched

Forms like usiguswe or wasiguswe would agree with different noun classes or subjects, so they would not match kitovu.

No major meaning change.

• Daktari alisema kitovu kisiguswe kwa mikono michafu.
• Daktari alisema kwamba kitovu kisiguswe kwa mikono michafu.

Both mean the same thing.
Adding kwamba just makes the sentence a little more explicit, like saying that in English.