The Florence Nightingale of Mazabuka

Fr Jason Murphy had a few moving encounters on his recent trip to Zambia. He tells us about them in his most recent column Let the Busy World Be Hushed...

We sat in her darkened office, painted a gloss lime green, lined with shelves from floor to ceiling of cardboard boxes filled with donated children’s clothes, sanitary towels, bandages anything she could lay her hands on that might be of use to her on her rounds through the sprawling compounds that surrounded the town of Mazabuka. Compounds like her office - cluttered, with mud walled huts in which thousands of people live cheek by jowl, whole families of eight, nine, 10 people of varying ages and several generations living in single-roomed dwellings in the most appalling of conditions that you’d get it hard, at home, to put the dog into.

Hundreds of people sharing a hole in the ground that serves as a communal lavatory, flies swarming, around which a grass fence is renewed every so often to give the semblance of privacy. Rubbish and dirt meet you at every hands turn, plastics embedded in the earth walls of the dried up drains that become like rivers in the rainy season.

Just a few hundred yards beyond the myriad of alleyways and hovels she welcomes us into her office at rear of this district hospital, conditions in which are indescribable, reminiscent of what might have been in the workhouses of long ago, little equipment or medicine as relatives sit outside by open fires cooking for their loved ones within.

We are invited to sit on plastic garden chairs around a wooden table, the curtains pulled to keep out the direct rays of the sun, as she tells of the work she does day in day out, as one of the only palliative care nurses in the Southern Province of Zambia if not the whole country, some eleven times the size of Ireland.

Rose is her name, a beautiful looking woman in her late fifties who began her life as the child of the Rwandan Ambassador in Cairo, a privileged upbringing, spending periods of her childhood and adolescence in countries all across Europe, Asia and Africa, training in Belgium as a specialised nurse who could have had the opportunity of further training and an illustrious career in a top hospital there but, because of her deep-rooted faith, she returned to serve the people of her native Rwanda only for her life and that of her family to be turned upside down as the savage Rwandan civil war of the early 1990s erupted between ruling Hutu government and the Tutsi rebels.

Her father, being a member of the established government, was savagely slaughtered at the outset and she fled on foot into Tanzania with her newly-wed husband, to escape the horror, pregnant with twins, walking and at times running with the caravan of people to escape their pursuers, all through the Congo, giving birth in the wilderness, sleeping in the wild under the stars, week on week, month on month, for all of two years, packing up the little they had each morning to walk on until they finally reached Lusaka the capital of Zambia where they found asylum.

Here after many years selling tomatoes on the streets to make a living and cleaning for those who once would have been her equal in the higher echelons of society, Rose gained employment as a nurse first in Lusaka and thereafter some many miles to the south in the town of Mazabuka where she was to settle with her family in a rented house. Her life wasn’t to be all plain sailing as her husband deserted the family leaving her with five children to bring up on her own but, as she says herself, by the Grace of God, she provided.

As a nurse in the hospital she witnessed the plight of the dying, in the midst of the AIDs epidemic and in more recent years with the ever increasing cases of cancers sky rocketing out of all proportions, coming to know that her call was to the care of the dying.

Palliative care is not at all valued or prized in Zambia as it is here in Ireland, it is a very poor cousin when it comes to medical provision; the widely held attitude being that if someone is going to die, they are going to die, so why waste valuable resources, medicines and pain relief on them. But for Rose, who witnessed much suffering and pain, she has a different outlook. She herself took the initiative to train in Palliative Care in the only course available run by Irish Sisters in Lusaka, some hundreds of miles away, and having qualified, she began to work quietly in the midst of her nursing doing the little she could to relieve the suffering of those nearing the end of their lives.

Day after day Rose finds people through word of mouth in the community, who are suffering, never having presented for any form of treatment, sometimes in the most excruciating pain in the compounds and in remote villages she cannot access for she is without transport and has little money to pay for taxis to reach them - people who have never known the offer of chemotherapy or radiation and who, without such treatments and compromised immune systems, can manifest the most appalling of symptoms, which I witnessed at first hand. Morphine is non existent and, often times, she only has Paracetamol to rely on to relieve the pain and suffering of her patients.

As I sat listening, I held my head nearly between my knees, my eyes welling up as I tried to take in all that she talks on before she takes us, just a stone’s throw outside the hospital fence, to the compound of hundreds of these aforementioned mud-wall homes to visit a number of the patients in her Palliative Care programme.

The first patient we meet with is an emaciated woman, deserted by her family, dying with AIDS; her husband, having being unfaithful to her, contracted HIV and is already dead. She has to beg a little food from her neighbours each evening as they cook their maize so she can eat; she is a pitiful state, so much so, I find it hard to think back on her. I give her the few hundred kwacha (twenty euro) I had that will feed her for a month and more, part of the donations given to me by friends at home and the joy that her face exudes is embarrassing in the little I have given. With this little money she does not have to beg for the days and weeks to come but she will not see the years end.

And so it is for the afternoon, one case after the other, people, in fact mostly women dying in hovels, a mother surrounded by little children who call on her for their every need dying of breast cancer, wondering who will feed her children after she is gone and so it goes on and on, too much to think of, too much to bear.

Rose is a Florence Nightingale in the midst of much darkness and pain, she brings light and hope to the great suffering she meets with. Her work goes unacknowledged, financially unsupported and unrecognised and yet she continues, begging and borrowing from here, there and everywhere to fund what she does and the few thousand euro I give her, collected by the people of Redhills at Christmas masses, makes her fall to her knees in sheer and utter appreciation, knowing that she can provide basic pain relief and medicines for the remainder of this year and on into the next.

That night as I lay on my bed beneath the mosquito net, the sound of crickets like white noise in the darkness which surrounded me, I thought on my life and the superficiality I am caught up in, day after day, week after week, and I wonder to myself what in God’s name am I at; living in the midst of a society that prizes greed and the accumulation of wealth, rewarding the pursuit of power and control and I am party to it. Trump and Starmer cutting their third world aid to fund ammunition to kill the innocent people of Gaza, whilst on the other side of the world a single woman, willing to go beyond, with the little she has makes the world of a difference to the lives of so many suffering people amongst the poorest of the poor.