Happy Easter!

A momentous week - not only is it Easter – happy Easter all (!) but we have dispensed morphine! Three cheers hip hip hooray and all that!

Quite a whirlwind day on Thursday – Grace aptly described it as a delinquents school trip! Our aim to dispense morphine to 3 lucky (?) patients was hijacked on several occasions by various members of the team. Who knew for example it would be a palliative care mentors role to be wandering round a timber yard with running saw mills trying to locate the wood needed to buy the cupboard to store the morphine in safely. Very important - but not on our tight visiting agenda! Neither was the impromptu stop at the cash point - some of the poor hospital staff have not been paid for 3 months but continue to work in the hope they will eventually receive back dated pay and safe in the knowledge God will recognise their efforts. Oh and the ‘quick’ trip to the government hospital for the mzungus to greet some distant relative of someone else who’d had their appendix out… it seemed whenever anyone got out the car we had trouble regrouping and moving on! You really cannot do anything quickly here in Africa! Best laid plans and all that….!

So our first patient – I couldn’t wait to see. Saimon needed morphine. He had end stage HIV/AIDS with TB. He was symptomatic with pain and breathlessness and had pressure sores having not been out of bed for several weeks. He was 40 but looked much younger and had the biggest smile. He loved gospel music. I couldn’t wait to tell him he was special as he was the first patient in Shinyanga to be getting morphine. It was a real shock therefore to arrive and find his family in mourning. He had died the night before our arrival having deteriorated rapidly.

So from the highs of expecting to be dispensing morphine and even having a bottle of morphine with his name on it to the lows of joining his mother and father in their grief was quite odd. The custom here is for the community, family and friends to get together to support each other but the women and men remain separate. So we found ourselves sitting on the floor of Siamon’s family home crammed in with loads of other women and his mother whilst they sung and prayed (hard not to shed a tear) and then sitting with the men outside and his father sharing in a simple dish of rice and greens. I could never have imagined being exposed to such an experience in Africa – sharing in this families personal grief and yet we were made to feel so welcome. It was clear they were so grateful for everything the palliative care team had done yet inwardly it was hard not to feel that we had failed Siamon in some small way by not getting morphine to him before he died. I know that realistically we could not have achieved this as when we first met him we we didn’t even have morphine in Shinyanga but knowing what I know from home and knowing how much he would have benefitted it is hard not to feel somehow sad. Reassuringly his mother told us he died peacefully and I know her perception is all that matters.

So the next 2 patients were a breeze in comparison! Our lady with cervical cancer who we had  managed to get discharged from the regional government hospital and another young lady (36) with leukaemia who looked pregnant but in fact had the biggest spleen I have ever felt. Both got their 100mls of morphine, a little syringe to take it with, education on what dose to take, the side effects and a little hand held patient record to tick off their doses. The team got support in prescribing and dishing out their first morphine and 2 bossy mentors telling them what to do every 2 seconds!!

By 7pm as we were bombing along bumpy country roads in the dark in a pick-up with no rear lights I felt a mix of excitement and anxiety – not just due to the ride home but also due to the enormity of the responsibility of ensuring morphine is used correctly and safely not only now but also when we have returned to our surreal lives back home in the UK!

For now back to Mwanza to celebrate Easter and indulge in the odd chocolate nibble! I hope your Easter eggs aren’t melting in the unseasonably hot weather youre having! Enjoy the festivities whatever you may be doing. I am thinking of you all.

Loads of love

C x