| Coles Chronicles |  |
Out with the Palliative Care Team
Oct 20, 2008 |
Introduction
On the ship, HR oversee what is called the “Minor Jobs” scheme. The purpose of the scheme is to allow those who are not normally working in what we call a “Programs” role to get involved. Programs include our Hospital and Healthcare functions, Construction, Water & Sanitation, Agriculture, Mental Health Program, Community Health Education & Palliative Care.
The idea is that by permission of your department head you are released from your primary job for period of time to get involved in one of these areas. The most typical release is half a day per week or at best a full day per week. It is so important for many to be able to get involved in this way and I’m no exception. I love my work in HR & alos with the Orphanage at the weekends but also wanted to get involved in one of our off ship programs. I had heard about the work of the Palliative Care Team and really felt this was something I would like to be involved with so I join the team just one day per month. It isn’t an easy option, but what a privilege to be able to come alongside people in their hour of deepest need. Currently the Palliative Care Team comprises June – PC Coordinator, Jim (one day per week, minor job) – PC Nurse, Jerry – Liberian day worker employed by Mercy Ships as our Translator, you’d be surprised how difficult Liberian English can be to understand! This is Jerry pictured below!
I go out with the team one Monday per month & Barbara – works in Hospitality and does PC as her minor job also.
These are some stories of those we visited on my last day out with the team last week.
Robert 6 yrs bilateral Burkitts Lymphoma - new referral (no picture)
We left the ship at 8:40am and already it was beginning to get hot. The official last day of rainy season is the 15th October and the soaring temperatures are testament to that.
We drove for about 30 minutes through the morning traffic of Duala Market, renowned for being particularly hectic at this time of day, but were pleasantly surprised by a reasonably speedy journey. You have to be here to really appreciate the sights sounds and smells of an African market place and Duala is no exception. We had arranged to pick up 6yr old Robert and his mom Lucy at the last filling station before St. Paul’s bridge. From there we were going to take them to St. Josephs hospital to get Robert started on chemotherapy. First we drove to their home to pick up a few small possessions, including a straw mat for mom to sleep on during the time Robert was to be in hospital. The journey was about 50 minutes, back through Duala Market, through the centre of Monrovia and out towards Elwa.
Robert is a lovely little boy with a wonderful smile. He has two large swellings either side of his face, making both his cheeks protrude. In addition his left eye is also affected and beginning to swell. These swellings only appeared a month ago and this type of cancer is extremely aggressive but the success rate is reasonable IF treatment is started early enough. It was imperative to get Robert into hospital and get the treatment started. Concern was etched on the face of Roberts’ bewildered mother as we entered the hospital.
The hospital was crowded with people. It seemed very sparsely equipped with stone floors and wooden benches. Even at 10am it was very busy. We registered Robert, which for us, being Mercy Ships didn’t take too long as he had a referral from one of our Mercy Ships doctors. Once registered, we sat and waited for him to see the doctor and have blood taken for lab work. The doctor was unexpectedly in the Operating Room so we had to wait. There was no air conditioning so it was hot and noisy and very busy. Eventually Dr. Roberts arrived and Robert was sent to have blood taken. Once that was done we left Robert & his mom to see the doctor and have the admission process completed. He should start on Chemo tomorrow. We pray that it has been caught early enough. Four days later when June revisited Robert the signs were very good & he seems to be responding well to treatment.
Levi 9 yrs – Burkitts Lymphoma, possibly in remission
From St. Josephs we drove back towards Monrovia to the home of 9 yr old Levi. Levi & his mom Grace and younger brother Ivan have come to Monrovia from up country so Levi can get treatment, leaving the rest of their family behind. We pulled off the main road and travelled about a kilometre through a small market town and then pulled the Landrover off to the side of the road. We crossed and headed through a clearing in the trees to a small village. There were maybe 6 – 8 houses that I could see. Some were the more traditional mud houses, others were very derelict and war torn concrete houses. Children played in the dirt, men sat around and chatted and the women of the village were engaged in a variety of chores; washing laundry by hand with a wash board, sweeping floors, braiding their children’s hair, bathing babies and cooking over the open fires. A typical African village scene. As we approached, laughing children ran to greet us and threw their arms around our waists. Such open displays of affection and welcome are common here in Liberia. The children called out with smiles “Hello white woman”!
Grace brought a couple of small wooden benches out for us to sit on and placed them in the shade of a large tree – a welcome respite from the scorching mid-day sun. We sat and chatted with her for some time before Levi arrived home from school with his younger brother Ivan. Grace was clearly weary and heavy hearted as we talked. As any mother would be, she is desperately concerned for her little boy who has already undergone previous surgery on the Mercy Ship and then chemotherapy treatment in JFK Hospital here in Monrovia. The original diagnosis for Levi was a condition called Fibrous Dysplasia and his surgery was for debulking of the large swelling, however after a biopsy it turned out to be Burkitts Lymphoma.
Levi – on AFM after surgery & in JFK Hospital
Not only is she worried for her child, she has no money for his treatment, or for his school fees. Leaving home, up country, meant she also left behind her means of earning an income from her small farm market stall. Mercy Ships Palliative Care program has some money within its budget to help support these families for the cost of medical care so we were able to give enough money to help pay the hospital bills. It was heartbreaking though to hear this mother’s plight as she is struggling to feed her children on next to nothing. She explained that sometimes neighbours take pity on them and gave them “small small” bits of food. As she was telling us this Ivan who is probably 6yrs old stretched across his mothers lap and cried for some bread, which she couldn’t give him. It took all the strength I could muster in that moment to hold back the floodgates as I observed this family’s plight. I thought about my own children on the ship, healthy and strong, well fed and comfortable and realised again how blessed we are. Grace was doing her best for her children with almost nothing.
Levi has been told by the hospital to go back and visit in 3 weeks so they can see how he is doing. His mom has been warned that though his cancer has stopped growing for the moment, it could well start up again.
We asked Grace to find out what is would take for her to start a small market stall here, in Liberia while she is here so she could at least start to earn a little money. June (Palliative Care Coordinator) will return on Wednesday to talk more and see if we can help. Before we left we prayed for this family, for Levi who is the dearest boy, very bright and so appreciative of our visit. We prayed for wisdom for the way ahead for them and for God’s provision, for a miracle in this desperate situation. They walked with us back to the road and waved as we drove away.
Levi & Ivan his younger brother
Sarah 78 yrs – Squamous Cell Carcinoma
Sarah is a joy to know and this was to be my second visit with her. She has a sharp senses of humour mixed with a wonderful faith in God. Sarah’s house is a bit more challenging to get to, so we drove through the village as far as we could and then walked for about 10 minutes to her house. She lives in a room in a fairly large house covered in corrugated iron sheeting and shares it with probably 6 families. She has her own room at the back.
Sarah – on Screening Day
Sarah has a large tumour on the side of her face which is constantly oozing. Last time I visited she had a veil draped around her head, today the dressing was off, the veil was gone and the tumour (which had grown since last time I went), was dripping down the front of her clothes.
Sarah – on Screening Day
June bathed the tumour and added a fresh dressing advising Sarah to keep the dressing on. The trouble with having it exposed is that it will attract flies and other insects which could lay eggs and bring all kinds of extra problems. We topped up Sarah’s supplies of swabs, sterile water for bathing her tumour and extra dressings. We also gave her a further supply of pain medication and multi-vitamins. Then we sat and chatted. Sarah loves to tell us all about what God has been speaking to her in the last week and she talks easily about the things he tells her. Things like; that He will never leave her or forsake her, that He will help her in her pain. It was inspiring to hear her and then June asked me to pray for Sarah. It struck me how blessed I had been hearing of God’s faithfulness to Sarah and I asked God to give me the right words as I prayed for her and that I could be a source of blessing in return.
Odette 4 yrs – Burkett’s Lymphoma
Odette lives in the same village as Sarah. She is only 4 years old and today’s was just a brief visit as its her birthday on Thursday & June wanted to let her mom know that she would return on Thursday with Cake for Odette and the children of the village in celebration of her birthday. The swelling on her face is clear evidence of this awful disease.
Odette - taken the day we visited
We only stopped a very short while with her at the end of a tiring day, but it was great to end the day with her. Odette smiled broadly and leaned in to me as we chatted and made plans for her birthday.
Palliative Care is all about showing love and care for those we are powerless to bring physical healing to, other than chemotherapy treatments, pain management medication and wound care. Most of the patients are terminally ill, except for a few who are able to start treatment early enough. We have cared for over 30 during this field service and only a handful of 10 – 12 are still alive. Palliative care is also about loving and supporting the families as much as possible as they struggle to look after their loved ones in their last days and then with the eventual funeral arrangements and a little help with expenses.
Please remember Robert, Sarah, Levi & Odette in your prayers and each of their families as they care for them.
Brenda
