Wednesday, June 20, 2012

Palliative care in West Africa

Now, that the 2012 Togo Field Service is officially finished, all the different departments are busy writing their reports. I picked up a few stories written by the ship's writer to give you a better understanding of what else we do here besides running a surgical hospital.

"Mercy Ships, a global humanitarian organization, operates the Africa Mercy, a state-of-the-art hospital ship that provides free medical care to the poorest of the poor in West Africa. This medical care targets conditions that are especially feared in the often superstitious culture of West Africa. Cataracts, disfiguring tumors, hernias and goiters are removed, and burn contractures and misshapen limbs are corrected.From time to time, Mercy Ships encounters a sorrowful reality – a medical condition that is beyond the reach of treatment. But, when healing is not possible, crew members offer help through our Palliative Care Program.

For those with terminal illnesses, the Palliative Care Program offers information and understanding about how to cope with inoperable conditions. Patients are freed from futile searches for non-existent cures that cost precious resources and cause the heartache of disappointment. They are shown ways to maximize comfort, minimize pain and spend their remaining time in a joyous manner.

Volunteer palliative care nurses make regular visits to patients’ homes. During these visits, patients receive further advice about their care, and their health status is reviewed. When terminal illnesses are highly visible or debilitating, patients are sometimes abandoned by their families and friends. In these dreadful circumstances, Mercy Ships volunteers are a vital lifeline to needed medicines, nutrition and other personal needs. And, most importantly, they shower desperately needed love and care on these fragile patients.
An overall goal of the program is to raise awareness about palliative care. Training and encouragement is provided to community members so they can carry on after the hospital ship moves on to its next field service.

A perfect example of the holistic nature of palliative care is the personal mission taken on by Sylvie Agobia. Sylvie, a day-worker onboard the Africa Mercy, helped in the palliative care program in Togo in 2010. Sylvie describes her experience: “The patients I visited were always so deeply grateful to see me. Many of them said that my support was the reason they were still alive.”

When the Africa Mercy left Togo in 2010, Sylvie found new employment, but she continued with her volunteer mission of visiting palliative care patients. “I prayed to God to give me the strength and courage to do the visits on my own. The patients I visit need the emotional support so much, and I am so blessed to be there for them,” she explains.

One patient that Sylvie visits is Abayavi, who has an inoperable facial tumor. Abayavi’s children provide very little support or care due to their superstition that their mother’s tumor is a curse. Abayavi, a woman of great Christian faith, is deeply touched and grateful for Sylvie’s love and companionship. Out of her own pocket, Sylvie purchases medications and food for Abayavi, thus providing much needed comfort.

The need for the palliative care services offered by Mercy Ships and volunteers like Sylvie are huge. Medical treatment in West Africa is in severely short supply and financially out of reach for the vast majority of people. As a result, people endure their illnesses over longer periods of time with little relief.

One of the most important on-going needs of the palliative care patient is having sufficient income to support themselves and their families. That is why another component of palliative care support provided by Mercy Ships is so vital. Small grants are provided to patients who are physically well enough to start an income-generating business. Camilla Borjesson, a volunteer palliative care nurse, explains how the grants have helped. “One patient who received a $100 grant is now supporting their family as a vendor of vegetables and groundnuts. This income has given them self-sufficiency and the means to manage their illness and family to the best extent possible, given the circumstances,” she says.

Palliative care patients are great inspirations for hope and healing. For example, Halou has demonstrated a mountain of courage to rise above her difficult medical circumstances. She underwent extensive radiation therapy in a local hospital to eradicate a squamous cell carcinoma in her throat. Unfortunately, in the course of eliminating the cancer, Halou’s ability to breathe and speak were negatively impacted. Halou was given a trachaeostomy, which provided a new breathing airway, but she no longer had the ability to speak. When the Africa Mercy came to Togo in 2012, Halou was referred to the palliative care program as a possible patient.
Mekenzie Williams, the Team Leader for the Palliative Care program, swung into action. “We arranged for Dr. Heinz Reimer to examine Halou. He confirmed that her vocal chords were not functional and that the trachaeostomy tube would have to stay in for life. We didn’t want to give up, though, so Dr. Heinz consulted with his network of speech therapists and physicians by email. The result was a series of voice-building exercises for Halou,” Mekenzie explains.

Dr. Heinz accompanied Mekenzie and Camilla on their next visit to Halou to show her the exercises. After one month of dedicated practice, Halou had regained her speaking ability. She was so excited with her progress that she recorded a voice message for Dr. Heinz that the palliative care nurses joyfully emailed to him.

One of the on-going challenges that Halou faces is her difficulty swallowing food. Mekenzie and Camilla do all they can to ease this situation with supports that are readily available to Halou’s family who keep loving watch over her. “In our most recent visit, we brought moringa sticks that can be planted so that Angele can harvest the moringa leaves to make a wonderfully digestible nutritional supplement for her mom,” Mekenzie adds.

Despite her day-to-day medical trials, Halou remains joyous and caring. She graciously welcomes all of her visitors with a warm smile and her trademark energetic hug. She loves to share her most emphatic hugs with the palliative care nurses, who have found a permanent place in her heart.

While the Palliative Care Program will shortly move on to its next field service, efforts for the program’s continuation are already underway. Sylvie Agobia is exploring the possibility of developing a farm operation to generate income to establish a formal palliative care program that she would lead. As well, Camilla and Mekenzie are hosting a Palliative Care Training Course for Mercy Ships day-workers. The hope is to increase awareness of palliative care while motivating interest in others to providing palliative care as a personal mission, like Sylvie does. There is still much to be done, but, thanks to the efforts of Mercy Ships and people like Sylvie, the hope and help offered by palliative care is growing in West Africa."

Halou and her daughter Angele look forward to the regular Mercy Ships Palliative Care visits that bring hope and comfort.

Mercy Ships palliative care patient, Halou, demonstrates her new speech capability. Dr. Heinz Reimer taught Halou the exercises that she faithfully performed to build up her voice.

Mercy Ships Palliative Care is truly a partnership of education, support, and encouragement, shared between volunteer and patient. This medical service enables a patient to cope with an untreatable illness in the most life-sustaining and comfortable manner possible.

Halou, a Mercy Ships palliative care patient, demonstrates her wonderful spirit and energy by carrying the platter of food and medicine she received from Mekenzie Williams, a Mercy Ships volunteer.

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