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Number 174 - June 2017
The month of June calls our attention to critical issues affecting our planet. The theme for World Environment Day in 2017 on 5 June is ‘Connecting People to Nature’. It encourages us to appreciate nature's beauty and importance, and to continue the call to protect the Earth that we share. Events organized around the world include neighbourhood clean-ups, action against crimes that endanger wildlife, and replanting forests.
The theme echoes that of Pope Francis’ 2015 ecological encyclical Laudato Si.
The day is officially hosted by a different country each year. In 2017, Canada will display the beauty of its natural environment on land and water. At a launch event during the UN General Assembly in New York, Hon. Catherine McKenna said, ‘We will blend Canadians' pride in our environment with our determination to address climate change challenges.’
On 21 September 2016, the United Nations Environment Programme (UNEP) Newscentre stated that ‘hosting World Environment Day, along with plans to ratify the Paris Agreement on Climate Change as soon as possible, shows that Canada is fully behind global action to tackle the biggest environmental challenges of our time.’
Death by plastic On 23 February 2017, a press release from UNEP announced ‘an unprecedented global campaign to eliminate major sources of marine litter: microplastics in cosmetics and the excessive, wasteful usage of single-use plastic by the year 2022.’ The #CleanSeas campaign is urging governments to pass plastic reduction policies, targeting industry to minimize plastic packaging and redesign products, and calling on consumers to change their throwaway habits – before irreversible damage is done to our seas.
According to UNEP, each year more than 8 million tonnes of plastic ends up in the oceans, wreaking havoc on marine wildlife, fisheries and tourism, and costing at least $8 billion in damage to marine ecosystems. Up to 80 per cent of litter in our oceans is made of plastic. According to some estimates, at the rate we are dumping items such as bottles, bags and cups after one use, by 2050 oceans will carry more plastic than fish and 99 per cent of seabirds will have ingested plastic. At present about 15% of species affected by ingestion and entanglement from marine litter are endangered. As many as 51 trillion microplastic particles – 500 times more than stars in our galaxy – litter our seas.
Ten countries have already joined the campaign: Belgium, Costa Rica, France, Grenada, Indonesia, Norway, Panama, Saint Lucia, Sierra Leone and Uruguay. Costa Rica will dramatically reduce single-use plastic through better waste management and education and Uruguay will tax single-use plastic bags.
On 23 February DELL Computers unveiled a commercial-scale supply chain using plastic fished out of the sea near Haiti. DELL says it will use the recovered material in product packaging.
Actions now are crucial. Today, we are producing twenty times more plastic than in the 1960s. By 2050 production will have to grow three to four times to satisfy our demand. About one third is used for packaging.
UNEP says that while much plastic waste ends up in vast mid-ocean rubbish patches, micro-plastics — tiny fragments less than five millimetres in diameter — are having a growing impact. Their ingestion has been widely reported in marine organisms, including seabirds, fish, mussels, worms and zooplankton. Transported by ocean currents across great distances, these particles eventually become a source of chemicals in our food.
There is increasing use of directly created 'micro-beads' of plastic in toothpaste, gels and facial cleansers. These tend not to be filtered out during sewage treatment, but are released directly into rivers, lakes and the ocean.
Peter Thomson, President of the UN General Assembly said, ‘The Ocean is the lifeblood of our planet, yet we are poisoning it with millions of tonnes of plastic every year. The time has come to turn the tide....Each country should do their bit to maintain the integrity of life in the Ocean.’
What we can do?
Enforce and strengthen legislation to stop marine litter
Ban smoking on beaches
Invest in research to develop non-toxic materials
Stop intentional littering
Ban plastic bags
Use reusable bags and water bottles
Invest in waste management infrastructures
Show the true cost of plastic disposal on products
Clean up beaches and shorelines
World Day to Combat Desertification and Drought, on 17 June, highlights the power that land has in giving people an opportunity to stay resilient on their home ground. According to the 2015 International Migration Report, the number of international migrants worldwide reached 244 million in 2015, up from 222 million in 2010. There is a link between migration and development challenges, as a result of environmental degradation, political instability, food insecurity and poverty.
In rural areas where people depend on scarce productive land resources, land degradation is driving forced migration. Africa is particularly susceptible because more than 90% of the economy depends on a climate‐sensitive natural resource base such as rain‐fed, subsistence agriculture. Unless we change the way our land is managed, in the next 30 years a billion or more vulnerable poor people may have little choice but to fight or flee.
Improving yields and land productivity will increase the food security and incomes of land users and the poorest farmers. This could preempt unnecessary movements of people, and reduce current and potential conflicts over scarce resources in degraded areas. Sustainable land management offers young people opportunities for income generation in agriculture, food processing and tourism. The great numbers of people abandoning unproductive land can be turned into communities and nations that are stable, secure and sustainable. We are reminded that desertification can be effectively tackled with community participation and co-operation.
And so it seems appropriate that on 20 June we also mark World Refugee Day.
As Erik Solheim, Head of UNEP, said of World Environment Day, ‘It fosters a deeper appreciation of our connection to the natural world....[Today] we need environmental leadership more than ever.‘
In this newsletter you can read how MMMs have collaborated with other organisations to enable young people to realize their potential. In Uganda, we continue our involvement in programmes for people who need palliative care. We also pay tribute to Doctor Joseph Barnes, who brought hope and healing to countless people around the world.
Thanks to all who contributed towards the purchase of much-needed equipment for the work of Sister Doctor Martine Makanga, described in the last issue of this newsletter. We will keep you updated. Thanks for all the other ways in which you work with us. We remember you in prayer each day. Please pray for us.
Sr. Carol Breslin, MMM
‘Let ours be a time remembered for the awakening of a new reverence for life, the firm resolve to achieve sustainability, the quickening of the struggle for justice and peace’ (Pope Francis, Laudato Si).
Working for human wholeness
Sister Helen Aherne lives out her current mission in MMM at our Motherhouse in Ireland. Trained as a nurse-midwife, she spent many years in Tanzania and Uganda and did mission awareness work in the USA. She is now the contact person with our MMM Associates in Ireland. In June 2016 she wrote a story for this e-newsletter, thanking the supporters who helped to provide education and training for many young people in Uganda during her time there. Early this year, Helen received two special visitors. She told us enthusiastically about these men, who worked hard to achieve self-reliance.
‘I wanted to tell you about the visitors we had from Masaka, Uganda: John Bosco Lukwago and Robert Mukwango from the Masaka Association for People with Disabilities (MADPA). The aim of the group is to gather people with disabilities and raise their awareness of what they can achieve. They learn that disability does not mean that they have ‘no ability’ but that they still have many abilities.
‘They came to see me because I had helped the group to get started in 2001-2002. They also wanted to meet and thank the people in Ireland who helped them over the years. These were staff members of ElectricAid, the Irish Electricity Supply Board (ESB) staff’s social justice and development fund, managed by Mr. James Foley.’
Building true development ‘In the town of Masaka at that time, their only option was begging on the streets. This needed to be changed. They needed to become self-reliant. For this to happen they needed to learn skills like welding, carpentry, plastering, tailoring, etc. A few were already educated, like John Bosco, Robert and another young man, Bruno. They could see into the future. They wanted to raise awareness, not only among the townspeople, but among the people with disabilities as well. Bruno is now the treasurer and the District Representative for Disabled People in Masaka.
‘ElectricAid helped to put up a building for offices and a workshop. The building was no sooner constructed than it became a school, educating about twenty people each year. The students are children with disabilities, children of parents with disabilities, and young adults.
‘Electric Aid continued to help. Now some of the trainees have formed small groups nearer their homes and have meaningful and remunerative work. There are no longer beggars on the streets and many buildings and shops have been made accessible for wheelchairs with ramps. Church members and leaders, including Bishop John B. Kaggwa, have been very cooperative. Shopkeepers now come to their doors to talk with a person in a wheelchair because they know it is a person who can buy goods, who is not begging.’
Ongoing connections ‘For the visit to Dublin, Mr. Foley organised an Electric Aid committee meeting. John Bosco spoke and thanked the members, who were very impressed. The next day we visited the Irish Wheelchair Association and the Central Remedial Clinic. The visitors were amazed at all the government help that is available in Ireland because there is no social welfare in Uganda. They got ideas about different products they could make in their workshop to support themselves.
‘The next day they came to Drogheda, where Sister Ursula Sharpe was our guide. She showed the visitors many things that they found amazing, such as the sea at Bettystown. They could not understand the difference between the sea and a lake! Uganda is a land-locked country. They also could not understand why our days are so short in the winter; there is so much darkness.
‘We were warmly welcomed at our MMM Motherhouse. John Bosco talked to our Sisters about the organisation of MADPA - its aims and achievements so far, and what their hopes are for the future.
Then he told his personal story and how he has managed to educate himself. He went to evening classes in Masaka and did his A Levels (Leaving Certificate). Then he registered at the Uganda Martyrs Distance Learning and completed a Degree in Social and Developmental Studies.
‘Both John Bosco and Robert were mesmerizing as they told their stories. A word frequently heard from our older Sisters, many of whom are also living with disabilities, was ‘inspiring’. I felt the same, and I’m sure that was the experience of many others we met.’
'You matter because you are you.'
The ways in which MMMs and MMM Associates live out the gift, or charism, of healing continue to evolve in response to the changing needs of the world in which we live. This requires that we reflect and act creatively according to each situation. Sister Juliet Ezekwere, from Nigeria, is part of the MMM community in Makondo, Uganda. She described her involvement in palliative care, providing much-needed holistic services for people with life-limiting illnesses and their families.
‘Our MMM Congregational Chapter in 2015 called us to express our healing charism in prophetic ways, especially for the emerging needs of family life. Palliative care is one of those needs. I am grateful for the opportunity given to me to study palliative care so I can assist individuals and families faced with life-limiting illnesses, the elderly and the ageing.
‘I completed the Diploma in Clinical Palliative Care with Hospice Africa Uganda in 2016. I returned to our Health Centre in Makondo to practice as a palliative care nurse and morphine prescriber. Palliative care is much needed for the 85% of Ugandans who live in rural settings. Most families with members suffering from life-limiting illnesses are challenged with caring for them at home. They lack knowledge to seek medical advice at an early stage, which usually leads to late diagnosis and a poor prognosis.'
Raising awareness ‘Communities need education about the role of palliative care among people with chronic illnesses and their families. This will help them understand that suffering from chronic illness is not an indication of being bewitched or abandoned by their loved ones. Instead a holistic approach, which relieve a patient’s physical, psychological, social, and spiritual pain and other distressing symptoms, should be encouraged.
‘We use holistic care for our patients during home visits. The team assess and manage symptoms and administer medication. The family are offered advice and counselling to help them care for their loved one, leading to a more positive experience. We have also developed strategies to address the challenges affecting palliative care delivery.
'Services are still minimal, so patients and families must often travel long distances to the service-providing centres. Patients on morphine have been seen reducing their morphine doses to make them last longer, so their pain recurs.
'Patients have been helped to get their supplies, especially morphine, through collaboration with other palliative care providers. We have strengthened our relationship with Kitovu Mobile Home Care to continue to provide quality and comprehensive palliative care and to ask for advice. Collaboration is key to continuing this mission. At the same time, palliative care needs to be integrated into health care systems to bring services closer to the people.'
Reaching the most vulnerable 'Many of our patients and their families are poor. They cannot even afford transport to the Uganda Cancer Institute for treatment. They can hardly afford to buy food, which affects both patients and families. This leaves them dependent on people of good will for necessities. Some patients have been supported by linking with other groups.
'We realized that awareness about palliative care was minimal and that people have myths and misconceptions about it. We started sensitization and education during outreach programmes. Some village health teams and community health workers got involved. We encourage them to be passionate in this work. While only a small percentage of the population has been sensitized, participants are able to identify and refer patients with palliative care needs to us. Families are encouraged to seek out services at an early stage.
'It is essential to offer the best possible care to our brothers and sisters, enabling them to die with dignity. As Dame Cecily Saunders, the founder of modern hospice and palliative care said, "You matter because you are you. You matter to the last moment of your life, and we will do all that we can, not only to let you die peacefully, but to live until you die."'
A life dedicated to healing: Dr. Joseph Barnes
Newly-arrived in Nigeria after an eventful wartime journey by sea from Ireland in 1945, Sisters Teresa Connolly, Philomena Doyle and de Lourdes Gogan set out from Anua to Ogoja, where Bishop Thomas McGettrick, Prefect Apostolic, had asked MMM to help with a new programme for the management of Hansen’s disease (leprosy). The three Sisters reached their destination on Good Friday and almost immediately Bishop McGettrick asked if they would like to see the site for their work. Also on hand to meet them was Doctor Joseph Barnes, who had devised the management plan.
Recalling that adventure, Sister Teresa said, ‘He took us up over a lot of yam heaps to the top of a hill. We thought we would see some kind of a building, but there was nothing at all. Imagine our dismay!’
Nevertheless, on Easter Monday the pioneering Sisters were on duty and eager to learn.
A man of compassion and vision Born in Belfast in 1914, Joseph Barnes attended school in Dublin and graduated with honours from University College Dublin in 1937. After a year as a house surgeon in the Mater Hospital, he went to Nigeria to work at the hospital run by the Missionary Sisters of the Holy Rosary in Emekuku. Not long after, he became involved in Hansen’s disease work.
He recalled: ‘I was medical officer to the hospital in Adazi. Doctors came from surrounding settlements to a site near my base for outpatient clinics. They asked me if I would be willing to help and I gladly did.’ He explained that, sadly, the treatment available at the time was later shown to have no effect on the underlying cause of the disease, a bacterium. During these years Doctor Barnes also did relief work at Saint Luke’s Hospital in Anua, and in 1942 he returned to Ireland to obtain his Master of Obstetrics.
Bishop McGettrick requested his help with Hansen’s disease work in Ogoja and in 1944 Doctor Barnes returned to Nigeria. Carrying out a survey, he estimated that there were about 47,500 people with the disease in a population of 750,000. With Bishop McGettrick, he also looked for suitable places for villages in which patients could live. At that time the emphasis was on separation of patients and their families from the uninfected. Doctor Barnes’ idea was to house them in small groups in their own clan areas, instead of in one huge settlement. Each family would have a house and a plot of land. A clinic with trained health workers would be attached to a central village. Ogoja was the first of these, followed by Abakaliki in 1945. In 1946, small clinics were started at Afikpo and Obudu, as more MMMs arrived.
Signs of hope Treatment of the disease was also advancing. Doctor Barnes wrote, ‘When I began to work on my own, further north at Ogoja after the Second World War, I was fortunate that treatment had now progressed to the use of the sulpha drugs. The first one available to us was known as sulphetrone. It had been tried in Carville, LA, USA.
‘This progress was not made without paying a price. I do not mean any monetary price, because in fact, sulphatrone and its successor, dapsone, proved to be very, very cheap. I refer to the side effects. In the high doses which were recommended at the time, we found that the incidence of side effects was quite unacceptable. After this unhappy experience the dose was started as a very small one and gradually raised to an effective level. It was really heartening to observe the improvement in the cutaneous (skin) lesions and to count the decline in the number of bacilli.’
His confidence was reflected in a letter he wrote in our MMM magazine in June 1950. ‘We received the supply of Sulphetrone safely and by now have some fifty patients being treated by it. The nodular cases are progressing favourably, although they have been treated for only three months .... Perhaps it is only our optimism, but we are greatly encouraged by our early results, sufficiently so at least to persevere.’
Facing setbacks Later Doctor Barnes commented, ‘Eventually, nature made its own response and the bacilli began to develop resistance to dapsone ....The small doses of the drug were gradually increased but this induced resistance. The only way - at least the only way we know of at present - of overcoming this problem is to give a number of drugs.
'When I was on leave in Dublin in the late ‘40’s I was introduced to Vincent Barry in the Medical Research Laboratory, who was working on remedies for tuberculosis. The bacillus of TB and [Hansen’s disease] are very closely allied .... It was hoped that a remedy for one would prove to be remedy for the other .... We were given supplies of the drug [B283] to try in [Hansen’s disease]. It was quickly superseded by the better, more effective and less toxic member of the same series know as clofazamine (lamprene), now a frontline drug, and is combined with others.’1
A life partnership Embarking on more postgraduate studies, Doctor Barnes studied Hansen’s disease and dermatology in Saint Louis Hospital, Paris and dermatology in Saint Thomas' Hospital, London. From there he went to study dermatology at The Royal Infirmary Leeds, where he met Doctor Elizabeth Allday. One day, back in Ogoja, Sister Teresa asked Joseph Barnes how he met Betty. He said, ‘We were both looking down the same microscope, searching for the same bug!’
They were married in 1949 in Weybridge, Surrey, on the feast of the Visitation. On their wedding day, Joseph and Betty were on their way to Ogoja - via Paris, Lourdes, Rome, Algiers, and Kano. They were to work for two years in Nigeria doing research in Hansen’s disease, skin diseases and general hospital work. Doctor Elizabeth Barnes took a deep interest in the care of children with malnutrition and the problems of providing artificial feeding for motherless infants. This concern continued after the Barneses left for Ireland in 1951, with their involvement in programmes for children affected by malnutrition around the world.
Joseph Barnes now took up a post as a consultant in dermatology at the Mater Hospital in Dublin. A man of wide interests, he put his belief in the benefits of exercise into practice by cycling to work every day from their home in Ballyboden. It had also been his main means of transport in Nigeria! When he retired from his consultant’s post in 1985, he was appointed as a Distinguished Lecturer in the Department of International Health and Tropical Medicine at the Royal College of Surgeons in Ireland (RCSI). He retired from the RCSI in 1989.
A tireless commitment Doctor Barnes’ humanitarian work included relief work with the Irish Red Cross during the emergency in the [Democratic Republic of the] Congo in 1960, hospital work with the Irish Red Cross in Biafra in 1967, and relief work in 1971 for refugees in northern India during the India-Pakistan War. He also assisted in Southeast Asia with the boat people in 1979, with the United Nations High Commission for Refugees.
In 1961, President Eamonn de Valera presented him and Doctor John Murphy with the Red Cross Medal for their services in the Congo.
With recent failing health, he moved to a nursing home, where his beloved Betty visited him daily. Joseph Barnes was mentally alert till the end of his life at the age of 102, on 4 May 2017. We express our sympathies to Betty, and to their seven children, their grandchildren, great-grandchildren and many other relatives and friends. We are grateful to have known and learned from this dedicated and compassionate man.
It seemed fitting that Sister Teresa Connolly, who first met Joseph Barnes so many years ago in Ogoja, was able to be present at his funeral. In a moving tribute, the parish priest asked Teresa and three other MMMs who came from Drogheda, to bless the coffin.
Post scriptum Joseph Barnes oversaw and played an important role in the advances in management of Hansen’s disease, from the days of palliative therapies to the development of effective drugs. His concern for his patients was holistic, embracing their medical, nutritional, educational, psychological and spiritual needs.
The treatment of Hansen’s disease now consists of two or three drugs together, resulting in cure. In 1986, Doctor Barnes wrote about his experience in our MMM Summer Magazine. There he indicated the motivation for his work in this and other areas. ‘If only you could see the remarkable result which can be obtained with treatment of this ancient scourge, you’d feel as gratified as I do.’
1This has also been shown to be the case in the treatment for HIV, in which a combination of drugs is used.
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