Makda is 40 and has breast cancer (the most common cancer in Ethiopia). Following her diagnosis, she received surgery followed by chemotherapy. However, the chemotherapy had to be discontinued as government funding for the Taxol was stopped. To control her pain she was prescribed tramadol and amitriptyline until tramadol also became unavailable for a while.

She is married with 2 adult daughters, living in their own home. Over the 2 weeks prior to our visit her husband and children had aggressively and abusively abandoned her. They had moved out but had returned the previous day and threatened to kill her to obtain the house for themselves. Previously they had also visited and broken the glass in the front door & tried to damage the “utilities”. Although Makda had called the police to report this there had been no response yet. She remained in a high state of distress and anxiety having being told by them that she was ‘worthless and dying’, and she felt she had been ‘thrown away’. Her only carer is her 8 year old niece living with her; the nurses from Hospice Ethiopia are visiting her twice a week and providing medicines, psychological care and the Comfort Fund as she now has no income. She has a strong religious faith and a moving prayer was said by Ephrem which she valued.

Negasi* was a 55-year old man living in a rented house with his wife and 7 year old daughter. He was referred by the Black Lion Hospital to Hospice Ethiopia with a diagnosis of nasopharyngeal (back of the nose and throat) cancer. On the nurse’s first visit to Negasi, he was bed bound and in severe pain causing poor sleep; he was also unable to swallow due to the mass, and had a huge swollen wound on his face causing gross disfigurement with accompanying odour. He was unable to work resulting in serious socioeconomic problems. and his wife was unemployed.

The nurse from Hospice Ethiopia arranged for him to receive morphine and other medications for his pain. The team gave him nursing care for example mouth care and wound care, and provided medical supplies, and taught his wife how to care for him. In addition, the team provided him with food support and emotional support.

After this care was put in place, he was able to sleep with his pain and other symptoms controlled. The food support helped to relieve their immediate basic needs. As Negasi approached the end of his life, the input from the team increased providing additional support for his wife as she struggled to cope with her husband’s deterioration and care for their daughter. Negasi died three months after the Hospice Ethiopia team became involved in his care. The nurses are providing ongoing bereavement support for the family.

*Not his real name.