We’ve had another wonderful day in Tanzania. This morning Mama Kyara made us French Toast, papaya juice and bananas. Also coffee – Sharmean, Becky and Marian are now addicted to an instant coffee called Africafe.
After breakfast we got on the road to the hospital and met with Mette Kristensen, Dr. Bakari and Tanya van Braekel, the new administrator of the hospital who replaced Jeremiah Saruni Kaaya. Tanya is from Belgium, and is looking at how the hospital might operate in a more efficient manner.
We then went to visit patients in the villages.
The first patient was Miriam Nnkini, a 65 year old woman who had endometrial cancer, has had multiple surgeries and now has adhesions. She has been on morphine for pain, but now that morphine is not currently accessible she is in severe pain.The Nkoaranga team either drives the medication to her or her family comes into the hospital to pick them up, traveling over extremely bumpy, rocky roads. She lives alone but her daughters alternate coming in to help prepare food for her. Her husband died 2 years ago of advanced cancer, and for a time the palliative care team took care of both of them. She is lonely but some members of her church visit periodically to pray with her. We were struck by the similarities that we observed – like some of our patients, she waited until she had been without tramadol for 3 days before calling to let the team know, and now is in severe pain and needed immediate medication.
We then stopped to see James, an 8 year old boy who has HIV and TB adenitis. Both his parents died of HIV and are buried in the yard of the home. He is being raised by his grandparents in a really dirty, dark hovel. His grandmother is also under the care of the Palliative Care team. Thanks to Gilchrist, GBMC and our generous supporters, the palliative care team was able to buy 2 goats to sustain the family and to generate income.
Next was Mama Nnko, a Meru woman who is over 80 years old (she doesn’t know her exact age because she doesn’t have a birth certificate). She is an amazing woman who recently constructed a kitchen house (even though she has esophageal cancer) putting mud on the walls. She is doing very well and keeps pestering her son to get married, because she wants to meet her grandchildren before she dies.
Our last patient was Eliafitia, a very sad case of a woman with squamous cell cancer on her head whose face was disfigured. She lies in bed and is very contracted. Her family does their best, but they are busy building fires to cook by, harvesting sunflowers to sell for oil, raising children, and managing the farm. What we were amazed by was the creativity of the palliative care team. Mette made saline solution using 1 liter of water and 4 tablespoons of salt. And Bartholomew taught the family how to take an unripened papaya, cut it open and scrape it to use it for a poultice for the wound. The daughter went out to the yard and knocked the papaya out of the tree. See www.drugs.com for why this works.
So what did we learn?
To be grateful, and not to complain about driving on home visits.
To improvise – Becky says “when you have nothing, God provides.”
To appreciate all that we have – we are so fortunate.
To be grateful – the patients didn’t complain of not having morphine, they complained of pain – there is not any sense of entitlement.
To recognize how fortunate we are with all we have been given, and that other people have to live off the land – papaya for wound care, goats for milk, banana husks to feed the goats…
Not to complain after seeing what people have to do in order to do their jobs here.
To be grateful for our driver Edward, who knows where the huts are located – “turn left at the banana tree.”
Then it was back to the guest house where Mama Kyara made us ugali, samaki, cabbage soup… and we stopped at the grocery where we found wine and Kilimanjaro Lager beer after a long day.
Thank you again for your support, thoughts and prayers. If you don’t hear from us, don’t worry – we’re really challenged by our intermittently functioning wifi.