Tomorrow is Another Day

Today was probably the most emotionally draining day both Jeremy and I have experienced to date in Tanzania. With only one week remaining at St. Lucia, we have been busy spending time with the children at the nursing home, finishing our “business” projects, and making many trips to visit patients living in the Arusha community.

Today we were out in the community, visiting people in their homes. I brace myself when we enter these homes, preparing myself for the worst. I have become used to the single room homes made of wood and mud. I am no longer surprised when I see rags and clothes plug the holes in the walls to prevent draft. I expect to see only one or two beds, even when I count seven or eight family members. I have stopped trying to imagine how everyone fits into the beds, and instead, I smile. I thank them for graciously inviting me into their home as they say over and over again, “Karibu sana.” You are very welcome…

First, we visited an old man with lung cancer. He travels 12 hours by bus to Dar es Salaam, the capital of Tanzania and location of the only hospital in the country that can perform radiation. His family can barely afford the treatment, but they figure out a way to do so. Unfortunately, they cannot afford any medication to manage his pain after the treatment. He speaks through a trachea, which is damaged and in need of prepare. He coughs blood and is wearing a winter jacket. I am sweating, but he is so cold. But he tells us that our visit brings him hope.

Next, we visited a 30 year old woman with AIDS. Five years ago, when her immune system was especially weak due to HIV, she contracted meningitis and became paralyzed. She has been in bed ever since. When we arrived, she was able to sit up. She has been working with a therapist who has helped her rebuild strength in her legs. We helped her stand today and walk several meters in the hall. She smiles through the pain, telling us she likes exercise. Her speech was slurred. Tired, we helped her sit down again and listened as she told us that she wet the bed before we arrived. No one was home to help her use the bathroom. We counseled her, asked about her family. But she started to cry, and sobbed for a long time. Winfrida reminded her of the progress she has made, and then lead a prayer before we concluded the visit. During the prayer, I noticed Winfrida’s voice quiver. And as soon as I left her home, I myself burst into tears.

I can’t pray. Because I can’t understand why God would allow disease like this to exist in this world. And I can’t accept that God would allow people to suffer like this, and for so long. There is no mercy in cancer, AIDS, or poverty. And I felt so helpless to being able to do anything to make these patients more comfortable as they try to endure the pain. Winfrida hugged me as I cried, and she thanked me for coming to work with her. She reminded me that I am giving these patients hope just by being here, so I pulled myself together.
We went on to visit three more patients, including an HIV+ baby with a tuberculosis infection that resulted in an abnormal growth on her chest. Next, a woman in her mid-forties with HIV and shingles. She no longer has an appetite, and her CD4 levels are dropping. Finally, we visit an HIV+ woman who at 35, has just come home from the hospital with a diagnosis of renal failure. Her hands and legs and feet are so swollen that she cannot walk. She has many drugs and is taking all of them, and yet she still complains of pain and discomfort. Nothing can be done to help her.

And nothing can really be done to help any of the other patients with whom we visited today. Unlike other people we have seen in the past, all of these patients ARE taking their medicine. But they need more. HIV/AIDS medication is free, but treating the opportunistic infections that stem from HIV/AIDS is not free. People don’t die from AIDS, though; they die from those very infections for which these patients cannot afford to treat. How is that fair?

I feel like everyone we saw today is waiting to die. So we discuss what we can do to help them be more comfortable. We will return with pain medication and gauze for the man with lung cancer and wound on his throat. We will arrange a trip for him to receive new tubes at a hospital in Moshi. We will provide training to the 30 year old woman’s sisters so that they can help her continue walking each day, and we will also try to obtain a new mattress for her. We will send the baby back to the hospital; and we will provide nutritional counseling for the woman with shingles, explaining that she must eat so that her body can fight off other infections that may come her way. For the woman with renal failure, we discuss leg exercises and how her family can help her attend services at the mosque for spiritual comfort.

Back home, Jeremy and I lie in bed holding one another. We have seen more suffering than we knew existed. And because I’m exhausted and overwhelmed, I feel defeated. I don’t think there is anything that can be done. But Jeremy reminds me of all the work that can be done to stop this cycle of suffering. Prevention education to stop the spread of HIV. Family planning to curb poverty and reduce mother to child HIV transmission. Nutritional and hygiene education to fight opportunistic infections. Community training to eliminate the stigma associated with so many life threatening diseases.Again, Jeremy is right. And tomorrow is another day.