The Reality of Home Based Care

Two weeks ago, Adao and I returned to Nyero Nyero to see the patients we saw on our first visit. Because of our rotation, there was 3 weeks between our first and second visit. All but one patient said that she had greatly improved, and many gave thanks to the Lord. It was a great day.

Last Thursday was an exceptionally hard day. It began at 7:30. We went to quickly pick up a patient on our way to Gondola. He was too sick to walk to and from the taxi, so we scheduled to take him directly to the hospital in Gondola. When we arrived Lazero said that he did not want to come with us. He had already been to the hospital several times and he did not think that they were helping him. His volunteer and his mother pleaded with him, but he was not going. He died the following Sunday.

Later we saw Louisa. She found out that she is HIV positive about a week ago. Her body was a skeleton. Over the past 2 weeks she became progressively weaker to the point where she can hardly walk. We suggested to the family that she go to the hospital. Immediately she and her sister agreed. Immediately, we loaded her into the car. It was very important that her sister come to help to care for her in the hospital. Basic care is provided by the nursing staff, but bathing, feeding and toileting is the responsibility of the family.

Finally we saw Jaoquine. As soon as we saw him, it was evident that he needed to go to the hospital. Upon negotiation with the family, they told us no. No one is available to go with him, so he cannot go. There were women who could have gone, but he would likely be in a men's ward and his father said no. It was very hard to leave his house, especially to see the faces of his children who might soon be orphans.

I understand someone wanting to die at home with their family, rather than in a hospital. It is harder to understand the family saying that they do not have time to escort him to the hospital. How can someone become as thin as a skeleton before they or someone else recognizes that they are sick and need to get help? Many difficult things to process.

Aside from being an emotionally exhausting day, it was physically exhausting as well. I think it was the hottest day that we had experienced.

We visit. We love. We hope. We grieve. We keep walking.