I would like to inform you that the new autoclave is now fully working since 3 days. The nurses are very happy and grateful. It saves us a lot of time. I wish you – a little bit late – happy easter days.

All the best and once more THANK YOU.

No, she said. She didn’t want to tell anyone outside her family about her breast cancer. “I only wanted my family to know: my husband, his mother and father and family; on my side: my mother, father, my brothers and sisters. Besides that, I didn’t want to tell anybody since in our culture, most people will go around mocking you. They will say, ‘Look at that woman, she is no longer normal. She is surviving with only one breast. She no longer has another breast.’”

Her words brought to mind people with AIDS I’d met during earlier visits to southern Africa who were affected by stigma. Some had isolated themselves in shame from friends and family; some were shunned by the community; one woman refused to go to the clinic for a chronic cough fearing that if she had TB, friends and family would say she had AIDS and reject her.

To stigmatize someone is to scorn or reject them because they possess some undesired trait. Stigma arises from fear, denial, myths and prejudices, and from a lack of knowledge about a disease. Stigma leads to alienation, rejection, ostracism and isolation of people with the disease, and, often, of their caregivers, family and children.

Sadly, a Zimbabwean doctor notes that still today stigma adds to the suffering of many people with AIDS…and for people with cancer, as the young woman indicates. 

Serious illness always brings suffering. It can include pain, disability, anxiety, economic need, and family disruption. The degree of suffering is still greater if adequate medical care is unavailable.

Stigma compounds this misery still further. It is particularly cruel because it is inflicted by the community and often by friends and family members—the very people who should want to aid the sick and support the caregiver.

Finding breast cancer early and getting surgical treatment (and chemotherapy, when possible) can prevent the disease from progressing to this advanced stage. "We see such cases again and again. The same goes for cancer of the cervix," says a doctor in Zimbabwe. Palliative care--pain control--in Zimbabwe is limited to mild analgesics, with morphine almost entirely unavailable.

Stigma affects the healthy, too. Upon seeing the painful effects of stigma, a previously healthy person may delay seeking medical care or deny that they—or a family member—are sick. Delaying treatment makes successful treatment more difficult, and it can help spread infectious diseases such as TB and HIV/AIDS. If a woman who suspects she has breast or cervical cancer delays seeing a doctor, her cancer will progress and worsen.

We can all act to end stigma and the unnecessary suffering it causes by practicing compassion.

Many people incorrectly believe that compassion means taking pity on someone. But, as Karen Armstrong points out in her book Twelve Steps to a Compassionate Life, compassion is derived from Latin and Greek words that mean “‘to suffer, undergo, or experience.’”

“‘Compassion’ means ‘to endure [something] with another person,’ to put ourselves in somebody else’s shoes, to feel her pain as though it were our own, and to enter generously into his point of view.”

Both the Golden Rule—Do unto others as you have others do unto you—and the Christian maxim to “Love your neighbor as you love yourself” are expressions of compassion. They tell us to use our feelings as a guide to our behavior toward others.

How do we do that in daily life? Armstrong suggests that every time we are tempted to say something unkind or vile about someone, we first ask ourselves, “‘How would I like this said about me and mine?’” and then refrain from making the unkind statement.

To encourage compassion globally, Armstrong initiated the Charter for Compassion. Practicing compassion can help political leaders, police and others in authority develop humane policies and practices. But it is imperative for doctors, nurses, aids, caregivers and community home-based care volunteers. Compassionate medical care encourages the sick in the community to seek help. Compassionate healthcare workers are more likely provide empathetic care and less likely to divulge private health information such as a patient’s diagnosis.

Armstrong also raises a less obvious aspect of compassion: compassion for ourselves. To “love our neighbor as we love ourselves” supposes that we do in fact love ourselves, but for many reasons we might not. We might instead castigate ourselves for shortcomings, feel self-hatred, or hold ourselves in contempt.

As the doctor’s email notes, this can happen in people with HIV/AIDS:

“Stigma is also a problem for parents with children with HIV, especially teenagers. Parents find it extremely difficult to tell their children about their status, how the kids got HIV through vertical transmission, and how their lives will be affected. In some cases parents with kids taking ARVs have lied to them and told them the medication is for congenital heart problems.”

Also:

“…once [HIV/AIDS patients] are physically affected or they test HIV positive, they move away from the family. They blame themselves and look down upon themselves.”

Who can know the anguish and depths of sorrow of these parents? Or of the self-hating person with AIDS? Compassion for oneself can be one step in easing such grief.

As we forgive friends for their mistakes, we can forgive ourselves. We can remind ourselves of past kindnesses we have shown to others, the good we have done in our lives and the good we can resolve do in the future. If we treat ourselves kindly, we are likely to treat others kindly, too.

Becoming a compassionate person is a lifelong project, Armstrong writes. “It is not achieved in an hour or a day. Nearly every day we will fail, but we cannot give up; we must pick ourselves up and start again.”

By practicing compassion, Armstrong writes, “Every man or woman in the street can become a force for good in the world.” Applying that good to the sick and the affected can end stigma and improve healthcare.

Be well, everyone. And compassionate…Darrell

Better Healthcare for Africa (BHA) is a secular, non-political, charitable organization dedicated to improving health outcomes in southern Africa by supporting health facilities and educational efforts that empower patients, caregivers and healthcare providers.

Our Vision

To alleviate suffering due to disease or injury by providing equipment, supplies and educational resources to medically underserved communities in southern Africa.

Our Objectives

• To obtain and deliver equipment and supplies for St. Albert’s Mission Hospital and other healthcare facilities in Zimbabwe and southern Africa.
• To support educational initiatives for healthcare providers and communities.
• To increase awareness in the United States of healthcare needs in southern Africa.
• To partner with other organizations to maximize the aid we can provide.
• To raise funds to support these efforts.

Better Healthcare for Africa, Inc., was founded in February 2009 to support St. Albert’s Mission Hospital in Zimbabwe. BHA now extends help to other hospitals in Zimbabwe and to Maipelo Trust, an HIV/AIDS clinic in Botswana. BHA initiatives include support for midwifery training and cervical-cancer screening and education. The BHA board of directors consists of six volunteers, so 95 percent of the dollars we raise go to the hospitals and activities we support.

For more information, email us at info@betterhealthcareforafrica.org

This doctor’s thoughtful reply is a reminder that stigma remains a cause of serious and unnecessary suffering for people and families coping with HIV and AIDS. We can end stigma and the unnecessary suffering it causes, and improve healthcare in the community, by practicing compassion. Compassion means putting ourselves into the shoes of another person, feeling that person’s pain, and then treating that person as we would want to be treated in that circumstance. Whereas stigma burns and hurts, compassion soothes and heals.

Darrell

Here is the Wikipedia article on typhoid fever.

Cervical cancer is the leading cause of cancer death for women in Zimbabwe. Nearly 1,300 Zimbabwean women died of cervical cancer in 2008, according to the latest estimates by the International Association for Cancer Research GLOBOCAN project.

Cervical cancer can be prevented if caught early through screening and treatment programs. Here are three important methods for detecting the presence of abnormal cells that are an early warning that a woman might soon develop cervical cancer: 

Papanicolaou (Pap) smear

The Pap test (also called cytology-based testing) has been used for decades by high-resource countries to detect precancerous cervical cells, and it has greatly reduced the number of cervical-cancer cases in these countries. Pap tests involve gently scraping cells from the cervix, staining the cells and examining them under a microscope to see if abnormal cells are present. Pap tests involve rather expensive supplies, skilled technicians, and infrastructure for processing and evaluating cell samples and following up with patients. Also, Pap tests detect cells that might or might not become cancerous, so women must be tested repeatedly over time. These requirements make Pap tests less practical for low-resource countries.

HPV DNA test

The leading risk factor for cervical cancer is infection with the human papilloma virus (HPV). Testing cells from the cervix for the presence of DNA that belongs to HPV is proving to be the most effective way to screen women at risk for cervical cancer. At present, however, HPV DNA testing is too expensive for low-resource countries.

Visual inspection with acetic acid (VIA)

This is the simplest and most economical way to detect the abnormal cells that warn of cervical cancer. In brief, very dilute acetic acid (3 to 5 percent, like vinegar) is applied to the cervix, and the solution turns abnormal cervical cells white. These white, precanerous cells can be seen by visually examining the cervix. According to the Alliance for Cervical Cancer Prevention (ACCP), “Until low-cost HPV DNA testing becomes more widely available for developing countries, visual inspection methods, especially VIA, provide reliable and effective means for reducing the burden of cervical cancer.”

Treatment – Cryotherapy

Cryotherapy is a technology that kills pre-cancerous cervical cells by freezing them. The ACCP has concluded that cryotherapy offers a safe, effective, and simple means of treating women with precancerous cervical cells. And it is affordable in low-resource settings.

The Need for Cervical Cancer Screening in Zimbabwe

Currently, cervical cancer early detection and treatment are largely unavailable to women in Zimbabwe. One Zimbabwean physician, who is not connected with St. Albert’s, described the situation this way:

It is of great importance to detect cervical cancer early to reduce the burden, but the main problem here is that most cases we see are [at the] end stage of the disease (stage 4 cervical cancer). We also don’t know much about cryotherapy nor VIA, and we have no capacity to test for HPV DNA.

Basically, apart from physical examination, a speculum exam is done and a punch biopsy is done to confirm the diagnosis. The results come in after about 10 days, and, if cancer is confirmed histologically, the patient is referred to Parirenyatwa Hospital for radiotherapy. But most of these patients are financially constrained; thus, they cannot travel to Parirenyatwa in Harare, the only centre with radiotherapy machines, though most of the time the machines are down (they are old machines), and the queue is long.

 Women with advanced cervical cancer who cannot travel to Parirenyatwa Hospital simply return home to die. Little palliative care is available, the doctor said. (Palliative care is designed to control pain and to comfort a dying person.)

 As for palliative care, we don’t have morphine for pain, and most of the patients cannot be followed-up because they come from far away areas. It is probable that most of these patients die at home from complications of cancer (anaemia, renal failure, fistulas of the bladder or rectum). At our hospital, we can transfuse anaemic patients if blood is available, though it is often in short supply and it is expensive. We can supply simple pain-killers.

As a first step in our cervical-cancer prevention efforts, BHA in mid-January provided St. Albert’s with funds to purchase nitrous oxide, which the hospital will use as a refrigerant for cryotherapy for treating women with precancerous cells in the cervix.

We will keep you informed here about the problem of cervical cancer in Zimbabwe and our efforts to ease the suffering it causes. Please note that you can become a part of this and our other efforts with a financial contribution to BHA.

Thanks…Darrell

As the year comes to a close we are excited to share the accomplishments of Better Healthcare for Africa with you. BHA had a very successful year in 2011, and we hope you will consider making a tax-deductible donation to enable us to continue our efforts. We often worked in partnership with other nonprofits in ways that were mutually beneficial and that enabled us to stretch our precious dollars. We look forward to continuing those relationships. Here is a brief recap of BHA’s main activities in 2011:

• BHA helped Brother’s Brother Foundation (BBF) and Hospital Sisters Mission Outreach supply and support a 40-foot container of donated medical supplies that BBF shipped to St. Albert’s Mission Hospital this summer.
•  BHA purchased a large refurbished autoclave for Muvonde Mission Hospital, which BBF shipped to Muvonde as part of another container shipment this autumn. Muvonde performs an impressive number of surgeries daily, including mastectomies and prostatectomies for cancer, and cataract and glaucoma surgery. They had been without a large autoclave since 1990.
•  Muvonde was one of five hospitals visited in early 2011. During this trip, BHA hand-carried medical supplies that were shared among these hospitals. The supplies were provided by Columbus area hospitals and by Brother’s Brother. Read about the overall visit here.
• Through BBF, BHA worked with International Orthodox Christian Charities to provide five pediatric wheelchairs for St. Albert’s and for Mutemwa Leprosy and Care Centre in Zimbabwe.
•  Global Links Suture Program provided hundreds of sutures that BHA shipped to St. Albert’s, which shared many of them with other mission hospitals.
•  Through the generosity of individual donors, BHA provided several teaching models for a new midwifery training program at St. Albert’s.
•  BHA began accepting donations on behalf of Maipelo Trust, a charity registered in Gaborone, Botswana, that provides medical care to Zimbabwean and other migrant and refugee families with AIDS in Botswana.

In 2012, we will work to improve cancer care at St Albert’s and other hospitals in Zimbabwe. Our focus will be cervical- and breast-cancer early detection, treatment and education. Donations to help support this effort are needed.

BHA is an all-volunteer organization with minimal expenses, so 98-99% of donations go toward improving healthcare and reducing suffering in southern Africa. Please make a donation using PayPal on our website or by mailing a check, payable to Better Healthcare for Africa, to our postal address:

Thank you, and all of us at Better Healthcare for Africa hope you have a New Year of peace, contentment and good health.

Sincerely…Darrell

Darrell E. Ward
President
Better Healthcare for Africa

Dear Friends,

Here is a bit of news from your St Albert’s Mission Hospital. Please, do not get frightened of my English. These days I tend to think, dream and write in Italian since it’s the language I am currently using.

The life at St Albert’s goes on as usual, but with a lot of challenges. The government is unable to assist us at all, but our friends the Chinese are carrying away the little that the country has towards the East. We are able to go ahead with our work of healing because there are angels like you who continue to help us. Thank you so much!

We received four containers full of all goodies (medical supplies, equipment both medical and building, exercise books, clothes for the poor, food etc).  Three were from Rock No War and Luisa Guidotti Missionary Group and one from America—Brother’s Brother Fountation, Better Healthcare for Africa and Hospital Sisters Mission Outreach.

The Waiting Mothers Home under construction is 80 percent complete funded by Radio Deejay and CESVI. At least the poor mothers can be welcome in a dignified home and be worthy to be called precious mothers. It is a huge complex with 12 more rooms. Medicines for the sick regularly arrive from Luisa Guidotti Missionary Group, the only entity that is assisting us with some running costs of the Hospital.

The orphans are still going to school, thanks to the tireless parents at long distance that are sacrificing for these children who are the future of our country. We used to cry tears of blood for the lack of water for the Hospital and the community around the Mission, now the water purifying plant has been completed. Hats off to our Ferrara friends who have committed themselves to maintain the running of the plant. The School of Nursing is ongoing. We do not forget many other friends who in times of crisis chip in with their support.

Your close friends of the International Medical Association on the frontline in Italy, India and Zimbabwe continue to work hard carrying out the mission activities also on your behalf. Without your support it would be impossible for us to carry out meaningful service to the needy. One of our workforce on the frontline, is not too well, she is fighting the cancer that has invaded the bones, and is currently being treated in Italy. Continue praying hard so that Elizabeth can be restored back to health so that can continue the battle in the field against disease, suffering and pain of others.

The Zimbabwe Catholic Bishops’ Conference Health Commission has embarked on a three year program of helping other Mission Hospitals that are in need. Five ambulances have been purchased and other 5 are in the pipe line, drugs and various medical supplies were purchased. Trainings of the Hospital managers were done.

We thank God who takes care of all, at St Albert’s there are three doctors working full time.

What shall we do with the crisis all over the world that is striking more and more on the generous group of people who have been helping the other poor in under developed countries? We better leave these worries in the hands of God!

We greet you with affection and love.

St Albert’s Hospital Staff [Elizabeth and Co.]

Christmas Card 2011

Refurbished autoclave of the type purchased by BHA for Muvonde Hospital.

The refurbished, $7,500 autoclave measures 24” x 36” x 60”. It was rebuilt by and purchased from CHOSEN Mission Project and included in a container of donated medical supplies assembled for Muvonde Hospital and Nyadire Hospital by Brother’s Brother Foundation (BBF). BBF shipped the container to Zimbabwe Oct. 17.

Muvonde Hospital has 190 beds and a School of Nursing. It has been without a large autoclave since 1990, says administrator Mr. Musvolen Zhou. “We have been relying on two small [autoclaves], which have to work almost the whole day due to the number of items which need to be autoclaved,” he said by email. “The new autoclave will mean saving electrical power, saving manpower [because workers must] attend the autoclave everyday and the whole day, and it will prompt provision of sterile material to user departments.”

Muvonde was one of five hospitals visited by BHA in March 2011. The hospital performs a high number of surgeries (528 major and 469 minor surgeries in 2009), including prostatectomies, mastectomies and emergencies, three or more per day. Two days a week are reserved for eye surgeries for cataracts and glaucoma.

The crated autoclave in the Brother's Brother warehouse ready for loading into the container and shipment to Muvonde Mission Hospital.

Please send a donation to BHA today to help improve healthcare access, treatment and education for underserved people in southern Africa. Your contribution will support care and education programs at St Albert’s Mission Hospital,  targeted equipment purchases such as a large autoclave for Muvonde Mission Hospital, and treatment programs such as Maipelo Trust.

By Darrell E. Ward

View Tracking the St. Albert’s Container in a larger map

2010

BBF begins planning to ship donated medical supplies to three African countries, Zimbabwe, Malawi and Liberia. Luke Hingson, president of BBF, contacted BHA for help in reaching Dr Elizabeth Tarira, director of the Zimbabwe Catholic Health Commission, which oversees Zimbabwe’s network of Catholic mission hospitals. BBF then works with Dr. Tarira, who also directs St. Albert’s Mission Hospital, to identify the Catholic mission hospitals in Zimbabwe most in need of aid.  

December: BBF Medical Director Dr. Chip Lambert makes a reconnaissance trip to visit the hospitals identified for possible shipments. The list for Zimbabwe list includes Catholic and Methodist hospitals, and a Salvation Army hospital.  

2011

Feb. – March: Luke, a representative of HSMO, and I spend a week visiting Zimbabwe mission hospitals targeted to receive container shipments. The visits enable us to understand each hospital’s needs and to explain to the staff how the supplies are requested and shipments are carried out. Our trip together concludes with a morning-long meeting with Zimbabwe Association of Church-related Hospitals (ZACH), an organization formed to work with customs officials and faciliate the importation of donated medical supplies for member hospitals. I then spend another week visiting St. Albert’s, and Luke spent several days visiting Nyadire Mission Hospital, affiliated with the Methodist Church.  

March – May: St. Albert’s director Dr Elizabeth Tarira works with the St. Albert’s executive board and staff to identify the hospital’s needs. She then begins selecting supplies and equipment from HSMO’s online inventory. Along with basic medical supplies, St. Albert’s requests beds, mattresses, 25 wheelchairs, including one for a child with cerebral palsy, suction equipment, and a treadmill for the rehabilitation department (interestingly, most of the hospitals we visited requested treadmills for rehabilitation).  

During this process, BBF, HSMO and Elizabeth (who can communicate only when she is in Harare) discuss whether equipment manuals and surge protectors/ power converters are available for the requested equipment, and whether the reagents and other consumable supplies required required for the equipment are available in Zimbabwe. These questions affect which equipment is ultimately sent. A biomedical engineer who helped BBF with mission hospitals in Liberia helps answer these questions.  

April: BHA acquires a used treadmill from Ohio State University for St. Albert’s. HSMO sends a truck to pick up the treatmill, along with medical supplies donated by other organizations in Columbus, OH.  

Treadmill donated to Better Healthcare for Africa by Ohio State University and destined for St. Albert’s is picked up by Hospital Sisters Mission Outreach.

Late May: HSMO begins assembling the supplies requested by St. Albert’s, then ships them by truck to Brother’s Brother Foundation, Pittsburgh, PA.  

Items from Better Healthcare for Africa included in the shipment: Several models for the St. Albert’s midwife program (purchased using contributions from individual donations to BHA) and the treadmill donated by Ohio State University. BHA also provides $5,200 toward the cost of shipping the container.

June 9: The shipment arrives at BBF. BBF loads the goods into a 40-foot container, filling the remaining space with manually operated hospital beds, mattresses and other items. Here is the packing list of HSMO items and of packing list of BBF items.

Walkers and stands for intravenous fluids (IV stands) in the BBF warehouse prior to loading into the St Albert's container.

The full container is shipped by truck to Seagirt Terminal, Baltimore, MD.  Luke notifies Elizabeth by email of the container’s progress. She replies:  

“Thanks for the good news about the container. The dream has become a reality. Our project has taken off! I really thank God and ask him in prayers to bless and reward each and every one who has worked so hard for such a good cause. Friends, thank you so much for being there for us. Together we will make a difference for our needy brothers.”   

Her email also points to the ongoing conditions that hospitals in Zimbabwe cope with when she also notes: “This morning I received a mail from Dr Thistle [at Howard Hospital, a Salvation Army mission hospital], asking if St. Albert’s can spare some IV fluids because they are in a crisis. I am sure that the Team at St Albert’s will assist.”   

June 21: The container arrives at Seagirt Terminal C324, Baltimore, MD. 

June 30: The container is loaded on board the cargo ship Maersk Visby.  

Early July: The Maersk Visby departs the Port of Baltimore.  

July 8: The Maersk Visby is located east of Anguilla, Virgin Islands, traveling south southeast at 17.7 knots.  

Aug. 1: After stopping briefly at Port Elizabeth, South Africa, the Maersk Visby arrives at the Port of Durban, South Africa, where the St. Albert’s container is off loaded.  

Mid- to Late August: The container is loaded onto the vessel Ridge, which departs the Durban Container Terminal for the Port of Beira, Mozambique.  

Aug. 26: The Ridge arrives at the Port of Beira, where the container is off loaded.  

Late Aug., early Sept.: The container is trucked from the Port of Beira to Harare, Zimbabwe’s capital. ZACH works with government officials to clear the container through customs.  

Sept. 10: Elizabeth sends the following email saying that the container arrived at St. Albert’s on this day.
“Dearest friends, Brothers Brothers, Better Healthcare for Africa, Hospital Sisters Mission Outreach,   

This is just a short note to let you know that the treasure container for St Albert’s Mission Hospital has reached its destination safely. The container was delivered to the Hospital yesterday and I am still in Harare. I made haste to write before even I see the goods so that we can share this joy all of us. We beneficiaries especially and you also for having accomplished a good gesture in the name of the Lord. On behalf of all the beneficiaries I would like to extend our sincere gratitude and thanks. Thanks again. We have made it. The dream we had this February has become a reality. 
Your friend, Elizabeth”