Palliative care

Yesterday morning I went out with June from the Palliative care team. Basically, the palliative care team is similar to home health care/ home hospice care. June's background is a unit seceratary in a hospital in the Boston area. The nurse for the team had to go home, and since there is a shortage of nurses here now, they are not going to fill the position. She often takes a nurse with her, and she seems to have things covered--she knows what to do. She also has an assistant who is a Liberian man, who is helpful because he knows how to find places, and he acts as a translator when needed. The patients are refered to her from the ship. These are patients that are probably going to die soon from their illness, or they are patients that we don't treat on the ship.

Our first stop was at a man's house who has a tumor behind his eye. He was going to travel back to the bush country and she was dropping off pain medication that he could take with him. She asked me to assess him because he was having pain on the upper jaw area and she didn't know if it was from the tumor or something else. I think it could be from the tumor, however when I looked in his mouth he had a tooth with an exposed root. We refered him to the Mercy Ships dental clinic so that he could get that pulled before leaving in case that was the root of his pain. The son was familiar with the clinic because he said his father had two other teeth pulled there last year.

Next we went to St. Joseph's Catholic Hospital to visit two kids with Burkitt's. I am not familiar with it, but it is a type of cancer--a lymphoma that is very fast growing, but treatable with chemotherapy. There is not one oncologist in the whole country. Can you imagine that!! Apparantely there is an oncologist that is going to come for three months to Liberia so maybe he will assess the situation here and see there is a need. Anyways, these two children had come to the ship for help, but since the ship is primarily for surgical patients, they have a deal with this catholic hospital to treat these kids. Mercy ships ordered the chemotherapy drugs needed, and they bring the chemo, and supplies to the hospital. Mercy Ships pays for half the care, and I am unclear who pays the other half (either the government or the hospital). At any rate, the treatment is free for the patient. June even left money for one of the mothers so she could get food for herself while she stayed with her child. So the hospital gives the chemo.

I then worked my evening shift. Rita, the 9 year old girl with the casts is doing so much better. I didn't have her as a patient but I was on the same ward. One of the nurses who was off of work took her outside for a while and read to her and I think it did wonders for her. One of the other patients, a 14 year old boy (Borkai) that I had taken care of last week, found out that the tumor on his left arm that they removed was cancerous. They now have to remove part of his hand and two of his fingers. He has the greatest smile, and I felt sooo bad for him when he found out because his uncle and mother were trying to comfort him and he just looked off in the other direction. His adopt a patient crew member came later and spent some quality time with him, and he also played cards with some other boys on the ward, so hopefully his mind wasn't on it all the time. Pray for him as he will probably have the surgery soon.