A Bicycle for Mariko

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Malawi is a country of raw beauty but it is among the world’s least developed countries with a low life expectancy and high infant mortality. It is the 7th poorest country in the world and 54% of its people live below the poverty line. There is also a high prevalence of HIV/AIDS. In the Salima district close to the shores of the magnificent Lake Malawi, you will find a place giving life …Ndi Moyo Palliative Care (NMPC).  

NdiMoyo Palliative care, a centre of excellence offering holistic palliative care, was officially opened in August 2007 in the Salima district, 112km east of Lilongwe the capital city of Malawi. Salima is a lakeshore district with a population of 350 000 and has 12% of HIV prevalence. NMPC has a dedicated team of 17 people, of which 5 make up a clinical team. The hospice was founded by Tony and Lucy Finch. Lucy Finch is Malawian by birth and a nurse by profession. After living outside the country for 38 years she returned in 2002 to offer the skills she had gained with Hospice Uganda from 1997 to 2002 to Community Based Organisations (CBOs) in the Salima District involved with Home Based Care (HBC).

On the 8th December 2012 a young Ndi Moyo patient called Mariko died at the age of 11, pain-free and at home, surrounded by his family. Mariko had had one of his arms amputated in an attempt to stop a cancer from spreading. Sometime after his discharge from hospital he contracted a very virulent infection and was in such terrible pain that he had suicidal inclinations when his parents first brought him to Ndi Moyo. They came from far outside Ndi Moyo’s normal catchment area and were desperate to find help. The liquid morphine dosage he needed to free him from physical pain was triple that normally required by an adult.

Throughout Mariko’s last two months of life he was too weak to walk or move on his own. He had loving parents who were very gentle and cared for him 24 hours a day. Most weekends Lucy Finch made a round trip of 85 miles to see him at home, taking him mangoes that were not available in his home area; and ensuring he remained comfortable. Having relieved his physical pain he was able to think again about living and his hopes of playing football once more in the village team; and of the bike he dreamed he would ride one day. Friends of Ndi Moyo rallied round to provide him with a smart new bicycle (well beyond the family’s wildest dreams) and in addition, a football and a special medal depicting a champion footballer to lift his spirits.

During those last two months the lives of Mariko and his family were transformed by the holistic nature of the end-of-life care that Ndi Moyo provided as part of its palliative care remit.

The original story about Mariko appeared in the December 2012 Issue of the Ndi Moyo Newsletter, written by Tony Finch. Christopher Mindiera has worked as a Palliative Care Specialist at NdiMoyo Palliative Care since 2008.

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