Makda’s story

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’s Story

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.

Negasi in his bed at home, free from pain and able to swallow small amounts of liquid again

aisha’s story

Aisha* was a 40-year-old woman recently diagnosed with breast cancer. She was divorced and lived with her son and daughter. Her illness progressed rapidly and she developed a fungating breast wound. She refused all treatments for her cancer and preferred to use holy water. Aisha used to work as a prostitute but could no longer earn money this way. Her children worked as daily labourers but they did not earn enough to cover their daily living costs and their mother’s medical care costs.

 Aisha was distressed by her breast pain, fatigue, constipation, bed sore and her breast wound when the hospice team met her. She was also sad, anxious and ashamed of the odour from her breast wound

The Hospice Ethiopia team provided her with advice and medication for her pain and other symptoms. They cared for her wounds and provided wound care supplies such as gauze, cleaning solution and gloves along with a small monthly sum of money from the Comfort Fund. The nurse taught Aisha and her children how to care for her wounds at home. Furthermore, the nurse provided emotional support and reassured her that Hospice Ethiopia would keep providing the care to the end of her life. This care and support helped Aisha to have comfortable days, maintain her dignity and feel much better. Her symptoms were managed, the smell from the wound was controlled. Aisha died with dignity and relief a few weeks later.

*Not her real name

Patient Story: Seni

Seni (not her real name) was a 30 year old married woman who lived with her husband and four children in Addis Ababa. Following the diagnosis of cancer on her left jaw she underwent surgery. Unfortunately, the mass was exceptionally large, and left her face disfigured and she had difficulty eating and drinking. In addition, the wound became infected resulting in an unpleasant odour.

She received chemotherapy at the Black Lion Hospital, but her condition worsened with severe pain around the wound and headaches, resulting in poor sleep for both her and her husband.  She felt sad, hopeless, and unworthy and blamed herself for putting her family in such a difficult situation. She became depressed due to the unmanaged pain and believed her disease was a curse and lost hope; she wished God to take her life.

The Black Lion Hospital referred her to Hospice Ethiopia (HE) for palliative care. HE nurses and care givers started to visit Seni at her home on a regular basis. Her physical pain was controlled with medications. Regular wound care was carried out and Seni and her family were relieved when the bad wound odour subsided and she was no longer in pain.

Even though she was not cured from her illness and the cancer progressed, her living conditions were greatly improved as a result of the overall support from HE. Seni and her husband started to sleep better which they had not done for a long time. They were both grateful for all the treatment and support that Seni received from Hospice Ethiopia. Seni recently died due to the cancer, but she did so with dignity, peacefully, and without suffering.

Patient story: MS

Hospice Ethiopia cares for patients like M S who is a 55-year-old lady who lives in a very low cost ‘Kebele’ (government subsidised) house with her sister. She sought medical help at a private health centre when she developed symptoms of a constant headache and visual disturbances. The doctors diagnosed a brain tumour with an abnormal build-up of fluid in her abdomen. Subsequently she suffered from a stroke leaving her paralysed.

MS was referred to Hospice Ethiopia to manage her symptoms. Initially she was unconscious due to a stroke, had a tube via her nose to allow the intake of food and medication and had a sacral bed sore. The team treated her pain and wound with basic medications. They also provided her with other medical supplies such as a urinary catheter, pads, gauze and wet wipes. Until the trained Hospice Ethiopia nurses started their support, MS was cared for at home by her sister so the team provided her sister with basic information on how to take care of her. She appreciates their support and says “I was lonely in supporting my sister before you came to see her. I was buying medications and was paying for wound care from the little money I had. Now you are doing it freely with dedication and happiness. I am grateful for your service and always thank you.”

MS and her sister have encountered serious financial hardship due to MS’ illness, as they have no daily income, so they receive the Comfort Fund from Hospice Ethiopia.

Patient Profile: subira

Our fundraising is used to care for people like Subira (not her real name) in Addis Ababa. Subira  is a 49 year old Muslim lady with a carcinoma affecting her left eye, which was diagnosed 2 years ago. She has been HIV positive for 19 years. Prior to the diagnosis she noted a discolouration around her upper nose. The Health Centre referred her to the Black Lion Hospital (BLH), where she underwent surgery and subsequently received 6 cycles of chemotherapy and 6 radiotherapy treatments. She now has no sight in her left eye.

She is a widow and lives with her 2 daughters and son. Her eldest daughter used to work in Saudi Arabia, until she developed renal problems and was sent back to Ethiopia. Her younger daughter is still at school but is HIV positive. Her son earns very little doing menial jobs. She receives support from the Comfort Fund.

Her first visit from an HE nurse was on 15/4/19. She complained of swallowing problems and had an oozing wound on the left side of her neck. The nurses also wondered if she had developed a fistula (an abnormal opening) as the oozing was worse when she drank fluid. Her eye had a crusty discharge which had become more painful 3 weeks earlier, when her father had died as she had been very weepy.

Patient Profile: Maaza

Our fundraising is used to care for people like Maaza (not her real name) in Addis Ababa. She was a 30 year old lady with cancer of her lower jaw. Following surgery, the wound became infected so it didn’t heal. Her face became distorted by the mass which did not respond to chemotherapy. By the time the Hospice Ethiopia nurses met her, she hadn’t had a proper might’s sleep for 3 months. The pain & distress were overwhelming. The nurse reported Maaza “felt sad, hopeless and unworthy”.

The nurses visited her frequently at home; they provided medicines & dressings to control the pain & infection. They also gave her information about her illness as she previously had no understanding about it.

Although her illness could not be cured, her quality of life was greatly improved and she and her husband were able to sleep at night. Two months later, Maaza died peacefully at home with her family, free from pain & distress.

Patient story: K

K is a 65-year old married man with liver cancer. When the nurse first saw him, he was suffering from severe back pain, anxiety and a debilitating insect-biting type pain in his legs which meant he slept badly. The nurses prescribed pain killers, explained what was happening to him and he is now sleeping much better. He said “I would like you to come and see me again. I know you have many patients to care for and many responsibilities, but I would like to see you as often as possible. When I meet with you, I feel at ease and get relief from my pain & sickness.” Patient

Feedback such as this shows how the care Hospice Ethiopia provides makes such a difference to the lives of their patients. It’s easy to forget how even basic care such as the provision of pain killers, something we take for granted in the UK, is not available to the vast majority of terminal cases in Ethiopia.

Patient story: M

Your donations have helped transform the life of Patient M, a 30 year old married woman with two girls. She has HIV and colorectal cancer for which she has had surgery and the formation of a colostomy. She was suffering from the worst possible rectum pain, with a foul smelling wound on her bottom, anxiety, sadness, poor sleeping, and a poor appetite. She used to survive by doing daily labour work and her husband the same. She became bankrupt when bedridden and suffered a lack of adequate food for her and her family. Her husband was struggling to taking care of her because of the bad smell, lack of his nursing skills and lack of wound dressing materials.

The Hospice Ethiopia nurse has seen M in her home and delivered holistic care and support (after a thorough assessment) including pain management, wound care, psychological support, financial support (Comfort Fund), food support, gauze and solution for wound care and has taught M’s husband how to care for her wound.

Patient Story: Hewyot

Hewyot was referred to Hospice Ethiopia by an Elder Leader. 70 years old, she had extreme pain in her right lower leg. Her distress was palpable, she was shaking uncontrollably, breathing rapidly, confined to her bed, her pulse was sky high, she was dehydrated and her mouth was sore.

She was also a diabetic and had been referred to the government hospital for control of the disease, but hadn’t gone as her son was busy at work. Nothing had been prescribed for her pain, and its cause was difficult to ascertain; it might have been a prolapsed disc.

Our medics visited Hewyot and gave her two different types of pain killer (Tramadol and Amitriptyline) and an antifungal gel (miconazole) for her mouth. We encouraged her to drink lots of water and go to hospital for control of her diabetes.

We returned two days later and found a completely different woman, smiling, relaxed and able to walk around her home. She had no pain and had been to hospital for management of her diabetes. She is receiving ongoing follow-up from Hospice Ethiopia.

Heywot-after