The weeks that have passed...

Crazy how quickly the days can pass, how full they can be and how easy it is to become enveloped in the day-to-day. The last couple weeks have been quite busy and although my good intentions were to write at least a weekly update, obviously I have struggled. Here's to getting back to it!

The day after I wrote began my first day serving alongside the NGO I am assisting. I spent that week trying to figure out the goals they had for me while I'm here and it was evident that there were a couple things to sort out. All is now sorted and I will be spending the next two to three months researching the organization and all their programs, doing needs assessments and busying myself in each of the eight communities where they work. Last week (well 2 weeks ago now) I spent the majority of my time in the health care center, no longer a hospice as the patients who come do end up recovering quite well and returning to their homes where they will be cared for by family, most likely. A couple stories and food for thought...

Those who are terminally ill with a chronic condition are those who enter the health care center. On my first day observing, a new patient, Mr. A DeCock was admitted. He looked like a very gentle soul and was brought in on a stretcher. I felt a little awkward doing my observing, but I did need to learn the intake process and understand what each employee's job duties were. So I watched as they took him to a side room where they lifted him off the stretcher into a hospital bed, connected his fluid drip and tried to make him comfortable. The nurse, Vuse, explained to me that they would read through his paperwork, assess his condition and determine his treatment.

What I soon learned about Mr. DeCock was that no one in his family was very interested in providing care for him...maybe it was because it required too much physically to do so. He was pretty much bed-ridden and could no longer use the bathroom as his excretory system was shutting down.

The nurses continued trying to make him comfortable and were struggling to get the bed rail attached to the bed. While they struggled I smiled at Mr. DeCock and he smiled back to me as if he completely understood and was thinking exactly what I was. The nurses couldn't get the bed part attached and they left the room. I stood there for a few minutes longer and then left the room. That is when Vuse let me see Mr. DeCock's patient chart. I picked it up and began reading the letter from the hospital which had admitted him. The letter read that Mr. DeCock had had cerebral injury at some point that they thought was bleeding but he also had liver cancer and had renal bleeding. He had been referred over for palliative care.

My heart sank.

It is a rude awakening to realize that one has only a little while longer to live and that there is nothing that can help alleviate pain and suffering, that the only thing that can be done is to show compassion, try to alleviate as much pain as possible and provide the best few days, weeks, months left that one can. So there I was, awakened by this reality.

The time came when the nursing staff was to evaluate Mr. DeCock and try to get some information from him regarding his family and next of kin. It was just one nurse and myself. She asked Mr. DeCock if he had a wife. He nodded. The nurse asked him what her name was. He tried to say something but none of us could understand because he was deaf and it was difficult for him to speak well. The question was repeated once again. He tried to repeat himself...but we couldn't understand. We hung there in this moment of silent suspense, hoping and waiting for the moment we would realize what it was he was saying to us...we kept hanging there...a moment, a moment longer, another moment...it seemed like a complete failure of communication as though we wouldn't get the sender and receiver messages to connect.

Then Mr. DeCock's eyes sparkled and he began to move his hand and fingers...it took me a moment but I realized that he was signing the name of his wife. The only problem, no one knew how to interpret sign language. I wished immediately that I had learned. My goodness, I was so sad that here he was trying so hard to help us understand him but there would be no way that we could. We tried having him write, draw pictures, anything, but nothing seemed to work. The nurse gave up and left the room. I stayed. This time the question she had asked that he was trying to convey was his address.

He was exasperated from trying to recall it. He looked at me and said what I could make out as "It is going to take a very long time for me to remember." I told him that it was okay. He kept trying and finally looked hopelessly towards me and cried out asking, "Why am I so stupid!?!" I quickly told him that he was not stupid and that it was okay if he couldn't remember and that he had done a good job so far. He took the pen and began writing again.

He kept writing what looked like lower-case Q's. Finally, I got what he was writing...999, his house address. I asked him if that was it and he said yes. I patted him on the shoulder and said good job and went to tell the nurse. I spent a little longer with him later that afternoon and then had to tell him that I was leaving. I knew the next day I wouldn't see him because I would be out in one of the informal settlements.

Thursday I finally did get back to the health care center. I went to visit with Mr. DeCock who had been moved to the men's ward. I wanted to talk with him, but he was asleep. I was gone in the afternoon to another informal settlement. When I arrived Friday morning back to the health clinic I learned that he had passed away on Thursday at 4PM.

I was devastated that I hadn't another chance to sit down with him to talk, or try to talk. I had wanted to provide at least a little bit to brighten the day for him but that opportunity seemed to slip on by. It made me realize how quickly life fades when you get to a certain point. What was so wonderful to hear though was that Mr. DeCock's family had visited him earlier that day. I was grateful to hear that--that in the midst of his suffering they were there no longer distancing themselves. It was hard to lose another patient--to have felt the sadness of Nozipo's death and then another one so short a timeframe later. I can't imagine the work that the nurse and carers do and coping with the terminally ill and those in late stages of life. But they do such an amazing job and I was grateful they were there providing compassion when and where it definitely is needed.

There were other patients in the health care center that week that I chatted with. Many of them were HIV and TB+ and obviously suffering. Many of them will get better and return back to the community where they will continue their treatment regimine which includes ARV's and TB treatment. One such patient I met and got a chance to sit with for a while is Alletta. She has been HIV+ for 13 years and because of ARV's is doing quite well. She shared her story and told me about how her husband had infected her with the virus. Right now she is caring for a neighbor's little girl and has basically adopted this child as the mother is an alcoholic and would otherwise not care for this little one.

So there is Alletta, sick and caring enough to take care of a toddler. She shared about the passing of her brother a year earlier and how her parents do not know she is sick because they are still grieving the loss of their son. Alletta is afraid to tell them. Tears streamed down her face as she talked about her life and how difficult it has been. Then the social worker here asked if there was anything that the organization could do to help her.

Alletta responded, housing. She told us that her shack fills with water when it rains and how if it can't get fixed she doesn't think she will make it through the winter. And, I am finding that winters are harsh here.

Although there is no snow, the rain is heavy and the wind strong. At times it just howls. Imagine being chronically ill and having to live in damp, cold, wet, windy conditions all day long. My heart ached. All this woman stated she needs is housing. But the path to making that happen isn't easy. Yet, I wonder if there is something I can do? It seems that my long-term goals are aligning right alongside this area of need so it's just a matter of time before the two intersect...

I wonder if anyone wants to help???