12.6.09
Since so much happens here and it’s hard to decide what to share, I’m just going to tell you a couple stories.
The hospital recently added a Palliative Care Outreach program through the sponsorship of an NGO. Palliative care encompasses end of life care for patients with terminal illnesses. Here, a lot more illnesses are terminal because treatment isn’t available or patients can’t afford it. Tumors, lymphomas and other cancers, which would succumb to radiation and chemotherapy, are terminal here. The only treatment the team can offer are painkillers (oral morphine etc.), laxatives and vitamins etc.
I’ve gone on a couple of these outreaches, we see about three patients a day. It takes so long because the team travels to the patient’s house. They live out in the village where the truck can’t pass sometimes so we have to hike. Think steep mountains.
THOUGHTS ON BEARING WITNESS
Dr. Plarr was a good listener. He had been trained to listen. Most of his middle-class patients were accustomed to spending at least ten minutes explaining a simple attack of flu. It was only in the barrio of the poor that he ever encountered suffering in silence, suffering which had no vocabulary to explain a degree of pain, its position or its nature. In those huts of mud or tin where the patient often lay without covering on the dirt floor he had to make his own interpretation from the shiver of the skin or a nervous shift of the eyes.
-Graham Greene, The Honorary Consul
*I pray that in the midst of my helplessness and when I am in the depths, overwhelmed by the magnitude of suffering, that I will be a witness for those who can’t speak.
I’ll share a case I saw the other day. A 28 year old woman with three kids has terminal abdominal cancer. We found her in her father-in-laws house, on a bed of straw, smelling of urine, and too weak to sit up by herself. This was the second time I saw this patient and she remembered me from before! Most of the care that the team gives is emotional support and counseling. Although they do have funding to provide each patient with .5 kilo of sugar and some soap. This seems pretty pathetic considering the conditions they live in.
An old woman with another type of abdominal cancer started to dictate her will while the team was there. Her goat to her sister, her house to her daughter. I get all of this through a translator.
EXPLAINING VERSUS MAKING SENSE OF SUFFERING
When we come to you
Our rags are torn off us
And you listen all over our naked body.
As to the cause of our illness
One glance at our rags would
Tell you more. It is the same cause that wears out
Our bodies and our clothes.
The pain in our shoulder comes
You say, from the damp; and this is also the reason
For the stain on the wall of our flat.
So tell us:
Where does the damp come from?
-Bertolt Brecht, “A Worker’s Speech to a Doctor”
*Kagando Hospital (where I am) has the motto, ‘We Care and God heals.’ I can’t help thinking that with so much working against these people, that is the only way for change.
