The Lord gives and He takes away

In Africa, birth and death are both intricately woven into daily life. There are so many medical problems that arrive on to the ship that we are just not equipped to deal with. Some people arrive who see the ship as their last ray of hope, only for it to be dashed. Some people arrive who see that hope fulfilled.

Kossi is only 5 days old and the youngest patient we have treated during this field service. He arrived with his parents from the north after a phone call from one of the hospitals asking for help. Luckily our current surgeon agreed to see him despite a full surgical list. Kossi was born with a large cyst on his tongue, leaving him unable to close his mouth, feed or barely breathe. In normal circumstances he would have suffered and died from starvation. He would have been branded as cursed just because his parents did not have access to the health care required for the simple operation. Now, post surgery, he is beginning to gain weight and learn how to breastfeed. We can’t let him go just yet until he is fully able to feed but with only a week to go before the hospital closes we are willing him on. Until then he and his Mama remain wrapped up in blankets in the corner of the ward, getting to know each other as this new chapter of their lives begin.

Kossi with his Mama

Having a CT, his whole body fitting into where the head usually goes

Almost the same size as the pump used to feed him

Having a nap with Mama

Mawuli spent several weeks on the ship, a tracheostomy having been inserted after she suddenly stopped breathing. A mysterious growth had been occluding her airway, cutting off her air supply. Despite several biopsies and two CT scans the medical staff, including an ENT (Ear, nose and throat) specialist surgeon from America, were perplexed. The biopsies kept being returned - negative for malignant growth, inconclusive results. Eventually they realised there was nothing else they could do. Mawuli had to go home. This was where I came in. To ensure that it was not a shock for her to cope at home with a trache, I was asked to visit her and provide support until she and her husband could manage on their own.

This was where the frustrations of living in Africa began. Over the past few weeks, her husband has been desperately trying to seek treatment for her in the local hospitals, with a Togolese surgeon who has been working on the ship and further afield to countries where the health care system offers more than here. All to no avail. I had not been in touch for a few weeks as I had been unable to get through. This is not an uncommon occurrence in Togo where the mobile network is at best variable. As I had not heard anything from them, I presumed that all was well. Until I got an urgent phone call on Tuesday morning from Mawuli’s husband to say that she was getting worse and he didn’t know what to do. By the time I rang back, she had passed away. My heart sank, bringing with it a range of emotions that I had never experienced before for one of my patients. An overwhelming sorrow washed over me. So many questions came into my mind. Why didn’t I do more? Why didn’t I push harder, explore more avenues for a diagnosis? If I had only been there with them in the final days I could have helped them to prepare for what was to come, be more at peace. I could have given her some medication to make her less aware of her surroundings, what was happening to her.

We visited her husband yesterday to find a man inconsolable with grief. He told us how he had taken her to the hospital over the weekend when her breathing got worse, how the medical staff had ignored her, done very little to help. How the promised doctor never came. He told us that she asked for me and how she asked him to look after their 2 year old little boy. It broke my heart and I wept with him, telling him to look to the future and his little boy who needed him now more than ever. He told me that we did all that we could. I wanted to tell him how sorry I was for not doing more but there were no words.

In this job I am so used to having control over someone’s final days, to be able to prepare, to help the patient and family be at peace. When this doesn’t happen it is the worst thing in the world. I woke up with a bang to the realities of sickness in a place where there is no help. I’ve spent the past two days crying out to God, feeling that guilt and despair weighing heavy on my heart. He reminded me that some of his greatest lessons are taught in the valleys of life, the places where you have no option to but to fall to your knees, broken and weeping. What is He teaching me from this experience? I have no idea right now but I am trusting that somehow in this situation, his glory will be made known.

Mawuli on board the ship with Claire, one of the nurses