Nurses find hope amid Africa's dying

The Catskill Hospice nurse found out in a thatched-roof mud hut in Tanzania, where a woman lay crying out in agony as she died of breast cancer.

"I was with Masai nurses, and they had nothing to give her," he said helplessly. "In Catskill, I call the doctor, they deliver the medication to the home, and the patient feels better in a couple of hours. Knowing there was zero I could do was disturbing."

Singing amid death

The nurses sang in Swahili, and the combination of song and medicine soothed the dying woman for 10 minutes before the pain overwhelmed her again.

Mr. Perrella had been thinking during the trip about the theory that "without drops, oceans can't exist." When he was able to help a woman in agony feel better for just 10 minutes, he realized why he was in Africa: "That was my `drop.'"

Hospice visits

The other nurse, Karen Frishkoff, called it an honor to be a part of the group.

"I feel privileged to have been given this experience and have been able to make contact with these people living in very different circumstances," she stated. "I hope to build on it, not let it be a one-time experience."

Sharing skills

"The South Coast Hospice was set up by a white woman, a nurse, nearly 20 years ago," she explained. "When the AIDS epidemic was running rampant, she started training native Africans as healthcare providers to go into where AIDS had taken hold."

Today, the nurse said, the African hospice has good facilities and employees who are working toward becoming licensed nurses. However, the AIDS epidemic in sub-Saharan Africa is still staggering: 70 percent of the population is infected with the HIV virus.

"People live in great poverty," Ms. Frishkoff said. "The people do not have electricity or running water. The houses have dirt floors, and walls made of mud and dried dung, and corrugated tin roofs."

Signs of death

At one small hut, Ms. Frishkoff and her group found a woman in her 40s, close to death from AIDS. Some women from a Wesleyan Methodist church were keeping her company, singing and praying.

"I asked whether they were praying for her life to be spared," Ms. Frishkoff told The Evangelist. "The nurses said [they were praying] that she be taken soon."

The next day, Ms. Frishkoff held death in her arms. A 21-year-old woman was found so emaciated and weak that she could barely nod her head. The woman's family had no idea how to help her. Ms. Frishkoff cradled the woman in the backseat of a jeep as they drove her to the Hospice, where she died the next day.

Without a common language, "I just gave the kind of touching and reassuring anyone might give a young person who's dying," the nurse remembered, adding wryly: "My professional expertise wouldn't be very relevant."

Making do

With such limited resources, Mr. Perrella noted that the African healthcare workers concentrated more on comforting patients emotionally than medicating them. The patients themselves, he said, showed a typically African response to their condition: tolerance.

"They just tolerate it: 'This is what it is,'" he said. "Even though they were in pain, suffering, they managed it African-style."

Both nurses found it difficult to reconcile the beauty of the African landscape with the suffering of its people. Coming out of huts where patients struggled to survive, Mr. Perrella was constantly awed by the vistas around him. He hoped the dying took some comfort in nature, as well.

AIDS education

Later, Ms. Frishkoff learned that the woman had come to the car because she didn't want her neighbors to see nurses coming to her house and realizing she had AIDS.

"Chances are, she's still engaging in unsafe [sexual] practices," Ms. Frishkoff noted. "There is a stigma about having AIDS. It's disheartening to realize what a steep, uphill struggle they have -- and that's just in South Africa, which is probably the most advanced country in sub-Saharan Africa."

In Tanzania, she explained, Western influences are less pronounced, and tribal traditions like polygamy are common. The Masai, for example, believe in "widow inheritance": If a woman's husband dies, she is taken in as a wife by his closest male relative. If her first husband died of AIDS, that means the disease is passed on to the next.

Female circumcision is also done "by anybody, with any instrument," said Ms. Frishkoff. Since the instruments aren't sterilized, AIDS can be transmitted when several women are circumcised at once.

Prognosis

"We can't make them Americans," Mr. Perrella said. "We expect results the way Americans expect results, and that's not going to happen. There are Africans in the bush that can't fathom [HIV]."

He believes AIDS will be cured, but that millions more will die first. Still, the trip left both nurses not helpless, but committed to helping with the American-African Hospice partnership in any way possible.

The visit "was a very spiritual event," Mr. Perrella stated. "We are our brothers' keepers, whether we like it or not. It was incredible how easy it was to fall in love with them."

(Send donations to The Community Hospice African Fund, 295 Valley View Blvd., Rensselaer, NY 12144.)

(06-21-01) [[In-content Ad]]