Sunday, December 10, 2006

Two months in...

Hello Again from Lubango,

It has now been 8 weeks since the hospital opening. And, no surprise, we have been quite busy. For the first 3 weeks we saw only outpatients. Then we opened up the inpatient ward and the operating rooms. Inlcuding ourselves, there are 4 full-time volunteer doctors, about 30 nurses (with various levels of training and experience), and a handful of ancillary staff. During this time we have seen over 1500 outpatients, performed over 250 major and minor operations, and have admitted about 300 inpatients. Over the weeks and months to come, I’d like to tell you their story, one person at a time. All patient pictures have been taken and published with permission, all names are included with permission, or have been changed for privacy.

I met Dona Cristina, a woman of 56 years, looking tired and weak in our ‘banco de urgĂȘncia’ (emergency room) a week ago. She was brought in by her very worried son, who flew in from the northern Angolan enclave of Cabinda, because of nausea, vomiting, weight loss, and failure to thrive.

Cristina was born here in Lubango. Shortly after her birth her mother left her, to be raised by her aunt and her father. At that point an only child of a very poor father, he would strap her to his back (as African women do with their children) and take her to work with him. By the age of six, she was working herself, digging and moving rocks to help pay for her own clothes and food. Her father eventually remarried and she became the oldest of a family of 10 children. It soon became clear, both from her diligence and servanthood, as well as the mantle passed down from her father, that she would be the head of this household. Hard manual labor characterized her adolescence and young adulthood, as did her simple and vibrant faith. She prayed and sang as she worked, and never missed Mass on Sundays.

At 20 she married and they soon were parents to 5 children. He became an alcoholic and left the family when she was in her 3rd trimester with the last girl. This child died 2 years later. Left to raise her children alone, not uncommon on the Continent, Cristina committed to never let her children go hungry or without education. She worked long hours to accomplish this. Her children succeeded in their pursuits: a nun serving in a Catholic order in provincial France, a nurse serving in a referral hospital in Paris, an entrepreneur in Cabinda, and a businessman here in Lubango.

In the last few years, she lost many of her brothers and sisters. Six months ago, her youngest son died. Her extended family looked to her for emotional, spiritual, and financial support. Untiring, she served and loved without complaint. Her fortitude was such that no one noticed, perhaps not even herself, that she was slowing down, loosing weight, not eating well.

Her children wrote and called often, but home was far away and difficult to get to. She acknowledged that she felt alone. She wondered if her 2 year old had not died – she’d be 21 now – if she wouldn’t be so alone. Two weeks ago, when her son called, she sounded weak for the first time. He flew down right away, and brought her to the new hospital on the hill. She has been vomiting most days, had diarrhea, intolerant to many foods. The doctor met her in the ER. When he felt her abdomen he looked concerned, pointed out findings of a very large liver to the nursing staff and pre-med students. He said her liver tests were all quite high. Finally they took her to the ultrasound room, where there was much discussion in English. There was a very large mass in her liver. As we prepared to admit her, she said to me:

“Doctor, I am very happy with the treatment plan. I am at peace. I trust that God has me in His hands, no matter what happens.”

Over the next days Dona Cristina and her family, who started flying in from around Europe and Africa, came to realize that she has a terminal disease. Though our diagnostic technologies are limited, she appears to have advanced hepatocellular carcinoma, infiltrating both lobes of her liver. The only treatment available anywhere is palliative – to give her comfort, dignity, and quality of life in her final days and weeks. She has been home now for a week. Her children are with her, her family is grieving, yet united… here is one of Angola’s heroines who has given everything for those she loves.

“Doctor …. I am at peace. I trust that God has me in His hands, no matter what happens.”

As we rush about this season straddled by Thanksgiving and Christmas, please remember Dona Cristina, her family, and the thousands upon thousand of others with their unwritten stories of suffering and loss. And also, if you will, look into those eyes with me, and see the abiding faith and sustaining grace that even still gives hope and health to this hurting world.


[Beth is currently in central Angola on an 18 day eye surgery trip. More news on that when she returns.]