Palliative care makes all the difference for a family in Bulawayo, Zimbabwe

Mary* (not her real name) is 62 years old and living with sarcoma of the spine. Mary had 6 weeks of radiotherapy and 8 cycles of chemotherapy and the cost of the treatment left the family bankrupt. As a result they have failed to pay the University tuition for their youngest daughter who is feeling both angry at having to leave formal education and helpless as she watches her mother in pain. Mary’s husband started to return home from work late and was not communicating with anyone.

Mary has undergone a series of surgeries on her spine and has been bedridden for three months leading to the development of deep sacral bedsores. She says, every movement she makes is agonizing. She explained the pain she felt in this way:

The pain is just too much sister, I am having this excruciating pain on the left leg especially at night and I get little relief from the oral morphine 10mg tablet which I take 12hourly. It is like hot, pins and needles It is 20 over 10’’

Mary’s morphine was increased and on follow up visits she reported that she was pain free. Once Mary was pain free we were able to address her other needs. Mary’s primary caregiver, her sister, was taught how to dress the bed sore. We also engaged a physiotherapist to assist with physical exercises and as a result two weeks later Mary was able to walk with the help of a walker.

Mary’s diagnosis was explained to the whole family when they were ready. Everyone was asked what role they would like to take to support Mary. Her eldest daughter offered to assist with food, her husband offered to drive her to physiotherapy sessions and assist with exercises at home. Mary’s younger daughter offered to cook and read motivational books to her mother per her request. Her sister suggested she continue to bath Mary and dress her bedsores.

The family was gently encouraged to express their feeling, fears and to share their concerns and listen to each other. In particular we encouraged Mary’s younger daughter to express her pain.  During counselling she cried a lot. After a few family sessions the daughter commented: “You guys are really good.” We noted on subsequent visits that communication between family members had improved dramatically.

With effective pain relief and following our interventions with the family, Mary expressed determination to return to her teaching job from which she had been given an indefinite sick leave, pending retirement on medical grounds.  After several months Mary returned to the classroom and has told us that this step has restored her self-esteem and had a positive effect on her health and wellbeing. Mary works part time now and her colleagues are supportive.

When we last saw Mary she was mobile, financially independent and her daughter has been readmitted at the University. Her daughter is writing a memory book with her.  Mary told us that she is a proud mother who witnessed her eldest daughter’s wedding a month ago – an event she was not sure she would make.

About Island Hospice & Healthcare

Island Hospice & Healthcare was established in 1979 as the first palliative care institution in Africa. Island has branches in Bulawayo, Harare, Marondera and Mutare.  In 2017 Island was chosen by the World Health Organization to be evaluated as a demonstration site for Africa. For more information please visit  www.islandhospice.care

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