Helen Cox tells a story from a doctor’s perspective.
My only first-hand experience of Inter Care on the ground (as opposed to in the warehouse) has been in Malawi, one of the poorest ten countries in the world, with few natural resources and a high disease burden, not least with HIV/AIDS and its associated cancers.
84% of the population live in rural areas, often at considerable distance from a health facility and many lack the funds for transport, even for a bicycle taxi. Doctors are few (one for 50,000 of the population) medicines in short supply and radiotherapy is not available.
Here, Inter Care’s first commitment is to small units close to the people, particularly health centres, often run by Catholic nursing sisters, and a pioneering palliative care centre called Ndi Moyo. Here is just one patient:
Nelson had been in Salima Government Hospital a few days when the Ndi Moyo team was asked to see him on the wards. He was 30. His mother looked after him, as his wife had left him. Pictured above, he looked young and strong. The hospital bed and bottles of morphine solution were the only hints of the cancer on his back. This had eroded the surrounding tissues to form a huge, sloughing, offensive ulcer. Nursing him was going to be difficult: the hospital could offer no more than dry gauze to pack the ulcer. Already his cancer was far beyond curative treatment but there was still much that could be done. Ndi Moyo were able to relieve his pain and confusion. Furthermore, they improved his nutrition and were able to support his family so that he could be cared for at home. This is where Inter Care came in. They had supplied Ndi Moyo with a wealth of high-quality dressings. This allowed us to clean the ulcer and restore some dignity to his last months. He died at home, without pain and with his family.
The heroines of Inter Care’s work in Malawi have to be the Catholic nursing sisters. All in the many small hospitals and health centres which we visited in 2015 and 2017. It is hard to describe our feeling of relief when emerging from a long and bumpy bus ride. And then into a sea of people to catch sight of a reassuring blue sisters’ habit, ready to guide us to our hospitality. And what hospitality! The generosity of these sisters was overwhelming. They moved their own beds to make room for us and fed us with far more than their daily rations would normally afford. Their warmth was infectious. They met us, fed us, patiently explained their situation and their needs and then laughed and cooked cake! I wonder if the cake ritual exists elsewhere. As pictured below, the cake was carried in with a song, then formally unveiled from its lacy cover.
None of these sisters showed any self-pity in circumstances where most of us would struggle. Power cuts were frequent. Which was a challenge when they needed to run fridges and oxygen concentrators. Even to see and deliver a baby. In the rainy season, poor roads would be washed away completely, isolating them to cope alone with difficult maternity cases or lack of supplies. Money was short and one sister had been beaten up when they were robbed just before our visit. Their gratitude for Inter Care’s help with medicines and dressings was palpable. It meant that they would not have to turn patients away due to lack of resources. To borrow CS Lewis’ phrase, we were ‘surprised by their joy’ in the work they performed. What a good partnership!