Tough Day at Work

I went along on home visits today. Wednesdays the patients don’t come to the centre so we make our rounds to the homecare patients who are not well enough to leave their homes. Our first patient was not at home, we were told she had been admitted to Princess Marina (the local public hospital). She lives in a one room ‘house’ with 10 children who were apparently fending for themselves while she was away.

From there we stopped in to check on another patient who had severe kidney failure and was on dialysis, this was a secondary illness to HIV. As we arrive, it looks as though they are moving out and the nurses are concerned that she has passed away. Sure enough, an elderly woman approaches the car welcoming us to sit with her and tells us that her daughter, of 43, died last week. This was one of our new patients who had just registered at the Hospice two weeks before. We shared our condolences, (well, the nurses did in Setswana and I sat there and listened) and then left to see more patients after packing up the dialysis equipment to return to the hospital.
After that visit, I was feeling a pretty low. Hospice patients have died before but today it hit me a bit harder. From there we checked in on a man who was too weak to walk, his legs had gone numb from the ARV’s. He was so thin, his legs were roughly the width of my arm and I was told to do ‘physio’ on him. I went through basic movements with him, moving his joints for him, did a few strength tests with his upper body and then it was time to move on.

We continued on to see a woman who has cancer in her larynx causing her to lose her speech, she was too weak to move in her bed. A few other patients we stopped to see had also been admitted to the hospital. I asked about a particular man who I often do exercises with because I hadn’t seen him in over a week. He is the one I mentioned before with a fused hip. He had been taken to his village to stay because the landlord said he could no longer look after him and always move him to his wheelchair. Now we don’t have any access to him for treatment and who knows if he will continue taking his ARV’s.

By now I was in a defeated mood. Not one case today showed promise and I started to question what we were doing wrong, what our services were lacking. There is always something we can improve upon but not a lot changes due to lack of resources.
The case that ended our day was a potential new client. She lived with her mother and boyfriend. Her boyfriend had taken the car and refused to get her ARV’s saying she didn’t need them (as she lay there in bed looking like a corps). The woman’s mother stayed by her side watching as her daughter wasted away, it was evident who controlled the household. The woman’s boyfriend did not understand why we were there and flat out refused our help sending us away with no access to treat the woman.

That was our last case of the day. Everyone had been through enough for the day and it was time to head back. We stopped by the hospital on the way to the Hospice and stopped in to see our patients that had been admitted. Nothing to boost our spirits, two of the three were lifeless and a nurse mentioned they may not make it through the night.

The drive back to the Hospice was silent, everyone was drained. I have never felt so helpless and hopeless. When we got back to the centre, they told me to go home early. I spilled the entire day to Jen, the other Canadian volunteer at the Hospice who has been there since July. She said that’s why they only do home visits once a week, the staff cannot face that every day.

I have been exposed to a lot of suffering during my term here but there is also recovery so I took in the bad and the good. Today there were no success stories and it was too much. I am going to leave that day here and look forward to tomorrow because it is sure to be better.