Neela’s Story

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’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: 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

Patient Story: Fetle

Fetle is 24. She was diagnosed with breast cancer 6 months ago. Sadly the disease had already spread and could not be cured. When she came to us she was suffering with pain in her breast, spine, underarm and left leg. She had no pain killers. The breast cancer had spread through the skin, causing an open wound that was infected. She had become incontinent which, with other symptoms, suggested she had cancer in her spine and was at high risk of becoming paralysed.

Fetle was born several hundreds of miles outside Addis Ababa and been abandoned at birth. She had been brought up by a non-governmental organisation. At 18 she was raped by one of their workers and she subsequently had twins.

Fetle used to work as a cleaner but can’t anymore, due to the pain and other symptoms. As there is no welfare system in Ethiopia she had become entirely reliant on neighbours for food and support.

So what can Hospice Ethiopia do for Fetle?

We are giving Fetle pain killers, antibiotics for her infected wound and steroids to try and prevent paralysis. We will phone her and visit her each week, to review her symptoms and the effectiveness of the medicines.

We are also providing ongoing psychological, spiritual and financial support. £10 per month will be enough for her and her twins to eat properly. We will also help Fetle make plans for her twins, once she cannot care for them herself.