Each folder holds a pile of x-rays, biopsies, blood analyses and hand-scrawled notes from doctors across the country, all pleading with Dr S to treat the disease that his ward alone, in all of Mozambique, is capable of treating.
This maddeningly short word rips irrevocably through countless lives, hopes and futures. Within its two small syllables hide uncountable and unnervingly subtle symptoms. Massive variances in biomedical approach and a maelstrom of different subtypes all demand their own clinical diagnoses, treatments and care.
And Dr S heads the only ward capable of intervention in his nation of nearly 26 million people.
I’ve found myself sitting at the conference table too, looking at the pile of brown paper folders with him. He motions at one semi-organized stack and explains that this group is made up of Mozambicans waiting… waiting for a bed to open in the Oncology ward of the Maputo Central Hospital so they too can drip the venom that is chemotherapy into their veins in the hope that it prejudices their cancer more than their bodies.
There are many folders in that stack.
Dr S looks back at me and we begin dialoging about the next patients Casa Ahavá can take from his ward so that that stack can be relieved of four more folders.
Four more folders. Four more patients who can battle the dark disease growing in their bodies.
Casa Ahavá, the only hospice and convalescence care centre in Mozambique was opened two years ago in April 2013 due to the increasingly difficult job Maputo Central Hospital faced in feeding and housing each Mozambican who came with cancer, desperate for the hope that was offered in the Oncology ward in the country. With only 35 beds, and an ever increasing number of patients, the job has grown ever more tenuous. Despite heroic efforts by Dr S and his staff, they need help.
Because the unique geography of Mozambique places Maputo at the extreme south of a very long north-south nation, patients often travel more than 1000 kilometres with late-stage cancers to reach the Maputo Central Hospital’s Oncology ward. This means that patients arrive from very rural areas, completely isolated from anyone or anything familiar, facing six months or more of intensive chemotherapy treatments and all the physical, emotional and spiritual hardship that comes with fighting cancer.
Casa Ahavá reaches out to these patients and offers family, home, love and support to those sorely lacking in each. Where a patient knows only an uncomfortable hospital bed during a sweltering Mozambican summer, Casa Ahavá offers a spacious air conditioned room. Where a patient knows the nausea, pain and unrest after a chemo drip, Casa Ahavá offers a cool washcloth to a fevered brow, and a hand to hold through the agony. Where a patient knows only a clinical hospital room surrounded by strangers, Casa Ahavá offers privacy, dignity and peace.
Missionary founders Jon and Layne Heller, run Casa Ahavá each day from their home. Along with their four daughters, ages four, three, two and three months, they spend each day creating a family with the four patients who stay in Casa Ahavá.
Between managing chemotherapy treatments, blood draws and doctor consultations, they spend time conversing, cooking, singing, or simply sitting together in the shade of their small yard with each patient. Some patients with necrotic cancer wounds need daily wound cleaning and bandage changes, so Jon and Layne offer a tender hand to the task and ensure that comfort is not sacrificed for cleanliness.
A trip to Mozambique’s coastal sands to dip toes in the temperate waters of the Indian Ocean, a walk through Maputo’s bustling markets looking for a special capalulana (Mozambican traditional wrap), or an afternoon trip to one of Maputo’s public gardens, each day Casa Ahavá gives reasons to remember life, hope, family and faith instead of the fear and pain that all too often shroud a battle with cancer.
Casa Ahavá offers to interview and film each patient about their sickness, their family and their story. This is primarily for each patient to give to family and ensure that young sons/daughters can hold a video of their father or mother who smiled and spoke fondly of memories and never ending love for their children. Some patients have given their permission to publish these interviews.
Each patient comes with their own story, their own faith, and Casa Ahavá offers support and family in every circumstance.
Each patient comes with their own fear, their own doubt, and Casa Ahavá offers peace and hope to calm broken spirits.
As Dr S and I walk through the corridor of his oncology ward, talking about potential candidates for Casa Ahavá, I see the stress and frustration in his eyes as he worries for his patients. He knows he hasn’t the resources to care for every person those brown folders represent. Some days his stress manifests in dark moods, short tempers and lost patience, some days his hope overcomes the stress and his smile offers hope to those Mozambicans who depend on his care.
This is one of those hopeful days.
He smiles and mentions four patients who have recently arrived from Northern provinces of Mozambique and for whom he has no space in his ward. I smile back and inwardly rejoice that I can support him and his team by offering space to four of his patients.
This is, indeed, a hopeful day.
Jonathan Heller is Director of Casa Ahavá, Hospice and Family and Missionary to the Sick and Dying in Maputo, Mozambique.