Thursday, March 26, 2009

They are all No Codes!

As an oncology(cancer)nurse in the states, if a patient or family agreed that they didn't want to be resuscitated, they signed a paper saying that they were "no code" status. Which means that if they stop breathing and their heart stops, no CPR, or resuscitation measures would be taken.

Most patients in the states want all measures taken to resuscitate them. When a patient that is not a "no code" stops breathing, and/or their heart stops; a code is called. A team of nurses and doctors rush to the scene and do everything possible to bring this person back.

I was on the ward today at the Government Hospital, visiting a couple of our breast cancer patients. One of them had a mastectomy a couple of weeks ago, the other one was getting ready to go to (theater)surgery, to have her mastectomy today.

While we were visiting, I heard a lady crying out "MaMa!","MaMa!". I thought that it was someone having a nightmare or talking out of their head! Then I saw a woman standing by the bedside of an older woman. She was shaking the woman and crying out for her to wake up. The older woman was limp and not breathing. She had a large bandage on her neck. I realized that the older woman had just passed away and her daughter was calling for her in a panic! Finally, the nurses made their way, casually, not hurriedly, to the patient and pulled her daughter away. They layed
the patient down flat and covered her head with the sheet, and closed the curtain around her bed.

"I thought, is that all, is that it, you are not going to do anything else?" I wanted to run and get the crash cart, call a code, and try to save her. I looked around the room full of patients. The wards here just have bed after bed, no individual rooms. None of the other patients were reacting at all. Their faces were blank, no emotion! I was amazed! It was as if nothing was happening!

I asked the nurse that was visiting the patients with me if they ever try to resuscitate patients when they stop breathing, intubate them,or try to do CPR? She said, no usually they can't even get a doctor to come and they don't have the proper equipment to intubate them.

This was a HUGE REALITY CHECK as to where I am working! I realized that they are all No Codes here! How very sad! I also realized that they see death so much that it doesn't affect them unless it is their own family. I was able to go back to the ward later and I saw the daughter sitting in the hall on the floor. I told her I was so sorry for her loss and asked her if I could pray with her. She said yes and I prayed and gave her a big hug! I asked her if she knows Jesus and she said yes.

Sunday, March 22, 2009


Zodwa Hlope is a 45 year old woman who had a cervical biopsy in March of 2008. She only received the report from the biopsy in February 2009. The Central Laboratory in Manzini had difficulty finding her report. She now has stage IIIB cervical cancer, which is an advanced stage, after waiting so long for a diagnosis. She is having severe pain all around her waist, difficulty urinating, bleeding from her vagina, and is feeling very weak. This lady is a single mom with 4 children at home, 2 in primary school, and 2 in secondary school. The oldest is 16 years of age. Zodwa is no longer a candidate for a hysterectomy since the cancer is so advanced and is now growing outside of her cervix. She has great difficulty sitting and walking because of the pressure of the tumour. She needs to go to South Africa for chemotherapy and radiation to shrink the tumour before anything else can be done.
While I was visiting her in the hospital, her 14 year old daughter came to visit. The girl had been beaten by an older male relative, who thought that since Zodwa was being sent to South Africa for treatment for cancer (and would surely die), he could kick the kids out of the house and take over the house. She also received a letter from her son’s school that she must pay E2, 500 in order for him to stay in school. She is asking for assistance with school fees for her son. This is just one more issue for this sick mother to worry about while going to South Africa for treatment.
She received word from the SMO’s office that she should be going to South Africa this week, if can get all medical visa issues completed. Her children will be left alone, except for her sister and mother who live nearby and check in on them from time to time.
It was such a blessing to be able to visit Zodwa in the hospital. I was able to minister to her and pray with her about her needs . She was so grateful every time that I was able to go by and see her. I gave her a devotional book that has scriptures for circumstances that we go through in life. When I came to see her the next time, she was so glad that she had the book to encourage her in the Lord. Her family was supposed to bring her Bible to her from home, but they forgot, so she was thankful that she had the devotional book.
In the picture is her mother, her sister, and a friend. A friend of mine and I were able to pray with all of them as well! She has started her treatments in South Africa by now. I will give a follow up as soon as I hear from her again! Please keep this precious sister and her family in your prayers. Let’s pray especially for the protection of her children and that her treatments go well with good response!