I can’t believe that it’s the end of my third week and the end of April! It seems only yesterday that I was preparing to come out to Togo.
I have seen two new patients this week. I was wondering why I was seeing so many people with just facial tumours and no one with any other type of cancer. Then I realised that it is probably because so few people know what cancer is and how to recognise symptoms. The access to health care here is so restricted that unless there is a visible tumour, many people just do not get seen or realise what they have. How many people in Togo are dying every day in pain and fear just because of lack of resources, education or understanding? Everywhere you look there are billboards advocating safe sex and the reduction in HIV/AIDS but nowhere do you see adverts about the risks of cancer. The scale of the problem often seems hopeless but I am reminded of Matthew 5:3,4 where it says, "Blessed are the poor in spirit, for theirs is the kingdom of heaven. Blessed are those who mourn, for they will be comforted.”
I am getting used to driving on the crazy African roads though it is a very tiring process. One of our patients lives 1 ½ hours away. Even once the madness of Lome is left behind you cannot go into auto pilot and just drive. Due to the large amounts of pot holes and stretches of unpaved roads, it requires constant gear changes and African style swerving/driving in the middle of the road to avoid all the obstacles!
The patient in question has a large fungating (growing through the skin) tumour to her face. We sat and talked to her and her daughter in a dusty courtyard surrounded by chickens and goats (which made several attempts to eat my medical bag!). Sylvie pointed out to me that she had beads around her knees and that there was a shrine in the courtyard which could possibly be due to ju ju (the predominant religion of Togo, a form of witchcraft). When questioned, the family said that they were Catholic. This may be the case however many West Africans choose to follow spiritualism as well as Christianity to cover all bases! It is common to find that neighbours have suggested ‘traditional’ treatments for wounds even when they themselves are Christians. Spirituality is seen as a huge deal here and you are looked upon strangely if you do not believe in any God at all! This lady also said that she thought that her tumour was because of a spiritual battle that she has with someone. For me the most difficult thing is the constant re education of people and the fact that the same issues come up time and time again.
Our other lady lives about ½ hour outside of Lome. Her family run a guesthouse next to Lake Togo so we arrived and were ushered to chairs under palm trees next to the lake and given coconuts to drink from. If the reason for our visit hadn’t been so sombre, it would have been a wonderful experience (we left armed with a gift of 6 coconuts!). We spent the next hour talking with the patient’s father as it is traditional here to talk with the head male of the house even if the patient is a female. She has a large tumour where her right eye should be and was clearly in a lot of pain. It is difficult for me to see that as I feel like the pain relief that I gave her would be woefully inadequate. My dilemma is that I have very little access to morphine based pain relief on the ship. If I started her on strong pain killers, she may still be alive when the ship leaves Togo. The family are not well off, so it would mean that they would not be able to afford pain relief. I will see at the next visit if what I have given her has helped. I pray that it has.
On Monday and Tuesday I was questioning why I am here. I began to feel disappointed that I had come this far just to try and find things to occupy my time (as I only have 4 patients which take up only two days of visits per week). However during my prayer times this week God has reminded me that I am here for His purposes, not for my own. I have also realised that even if I help the one or two patients that I come in to contact with then I am fulfilling what God has put me here for. I was reading a book in the library and came across this quote from Mother Theresa which really grabbed me - ‘God doesn’t look at how much we do, but with how much love we do it.’ I feel like if I can only make a difference to the few patients I have and bring them peace and hope then my time here has fulfilled what God has planned me to do.
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