Author: alicemumford

Haiminot is a 36 year old lady with HIV diagnosed 15 years ago, and cervical cancer diagnosed 8 months ago at the Tikur Anbessa Hospital. She has been on the waiting list for radiotherapy since diagnosis, but has not had any cancer treatment to date. A single parent, her 15 year old son is in the care of her sister, who is also of very limited financial means. Her son visits about once a month. She is renting a single room (about 3m X 3m) for ETB 1,800 per month (about £28). Apart from the monthly grant from Hospice Ethiopia of ETB 1,000 she appears to have no other source of income. She had previously spent 2 months living in a church near Dessie (400 km north of Addis Ababa) hoping for a cure as someone had told her the Holy water there was good for cancer sufferers. She was referred to Hospice Ethiopia by the Tikur Anbessa Hospital.

The Hospice Ethiopia team had previously successfully treated her odorous vaginal discharge with metronidazole douches, along with tramadol for pain and bisacodyl for constipation. However, she then stopped taking all her medicines apart from her antiretroviral medication, believing that her religious faith would bring about a cure; her odorous vaginal discharge then recurred. She is now house bound with very limited mobility as she likely has nerve damage affecting her leg muscles, probably caused by the tumour. Other medical problems include anaemia for which she had previously been prescribed an iron supplement syrup which she had stopped taking and she had declined a blood transfusion on religious grounds.

Nurse Filigot spent much time listening to this lady exploring her health beliefs and emotions. She looked low in mood. Filigot negotiated for her to resume the vaginal douching with metronidazole for the odorous discharge but otherwise she continued to decline further treatment aside from her antiretrovirals. She remains on the Tewolde Medhane fund (monthly grant). She will be reviewed in a month unless she returns to the church at Dessie, and has Filagot’s phone number should she need to be seen sooner.