Neela is 60 and has been a widow for many years. She lives alone and has 3 surviving adult sons, however her only daughter pre-deceased her. Her neighbours care for her.

She has longstanding diabetes and developed low abdominal pain 5 years ago. She was diagnosed with cervical cancer and treated with radiotherapy at the Black Lion Hospital in Addis Adaba. She has been re-referred for further radiotherapy but is unlikely to receive it as there is only 1 machine working in Addis Adaba and the waiting list is lengthy.

She was referred to Hospice Ethiopia just over a year ago with significant pain issues. Her pain level was then successfully reduced with paracetamol and amitriptyline (free of charge). Her mobility has now deteriorated and she is sad that she can no longer attend her Orthodox church. However, she is pleased she is still able to make injera-the traditional Ethiopian flat bread.

Sister Filigot from Hospice Ethiopia spent significant time exploring her concerns and she agreed to continue taking regular paracetamol 4 times daily and to increase her amitriptyline tablet at night. Sister Filagot planned to ring her in 5 days to review the effectiveness of increasing the amitriptyline.

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.