by Sr. Marian Scena MMM                     USA/ Tanzania                            18.07.2023

We first met ‘John’ on 19 January 2015 after his wife contacted us and asked us to visit her sick husband.  He had been diagnosed with cancer of the colon that had already spread through his abdomen.  John was 55 years old and had worked in the market selling chickens.  He was married with four children, the youngest was still in primary school and the oldest was married with a child.  John had spent a year and a half travelling around to various hospitals, dispensaries and local doctors trying to find out what was wrong and get treatment for his abdominal pain.  Eventually he was told he had cancer of the colon and that there was no possibility of curing his condition. When his pain got severe, he was admitted to hospital and a nurse there told his wife about our Faraja Palliative Care Programme in Singida.

His wife came to Faraja and asked us to visit her husband after his discharge.  When we examined John at home, we found that he had very severe pain and needed morphine.  Fortunately, this was available from the Regional Hospital and, after receiving oral morphine solution, John relaxed, slept, and was able to eat again.  Before this he had been too distressed to do any of these things.

We soon found he had a great sense of humour.  He was extremely grateful for the pain relief he was now experiencing.  Initially we thought John had only a few weeks to live but, once his pain was controlled, he experienced new life and joy in being alive and with his family.  His wife was very grateful because now John was able to enjoy eating again!  Before this she had tried to tempt him to eat various foods, but he had not been interested as eating had increased his pain.

As the weeks and months passed, John needed higher and higher doses of oral morphine, but when he used the medication, he was able to walk around and live a fairly normal life.  In April, our Programme had a visit from the National Director of the Tanzania Palliative Care Association.  He wanted to evaluate the progress of our Programme and visit some of our patients.  So, we brought him to visit John.  He was amazed at how well and positive John was, even though he was using a very high dose of morphine.  When he listened to John telling his story and how grateful he was to our Programme, the Doctor encouraged us to make a video of this patient.  We would be able to use the video for educating others about the importance of morphine and its benefits in a patient with severe pain.  John and his wife agreed to be interviewed for production of a video which we made that week. We were afraid John might die soon.

A palliative care doctor from the Regional Hospital agreed to conduct the interview and a local videographer was hired.  In the interview, John explained the history of his illness and the pain he had experienced before he received morphine.  He continued to describe the relief from pain and how the medication had given him new life and hope.  He encouraged anyone who had severe pain due to cancer to contact us at Faraja so that they too could experience the benefit he had received from morphine and the visits from the Palliative Care Team.

After this John continued to be mobile for four months before his condition deteriorated on 26 August and he died on 29 August.  On 2 September, the palliative care team went to the family for the bereavement visit.   John’s wife, children and extended family expressed their feelings of appreciation for the visits and treatment John had received and how they had felt very supported and included in John’s journey. We, the Faraja Hospice and Palliative Care Team, felt very privileged to accompany this family through their difficult experience.