The lady of the shed

Cindy Hatchett | 10/30/2015

She will never be forgotten!

I am a nurse practitioner. For two years, I worked for a nongovernmental organization (NGO) in Southern Africa. With referrals from hospitals, clinics, private doctors, lay care workers [carers], and other individuals, we visited people in their homes when they were ill. Every day was a challenge, because I never knew what I would have to deal with. The goal of our team was to provide palliative, holistic care to everyone we visited, which meant we tried to relieve suffering, whether psychosocial, environmental, physical, or spiritual.

Many of the people I visited did not have the wherewithal to write their own stories, so I will be their voice. These people and their families deeply touched me and remain etched in my mind. As a candle-lit Turkish lantern illuminated an uncertain pathway for Florence Nightingale, I offer these narratives to help light the way for others who have also chosen the noble profession of nursing.

Hatchett_Cindy_ID_embed_SFWAn image that has burned itself into the very depths of my psyche is that of a lady we were fortunate to find.
On the far boundaries of the Bitou area, carers, who work in the area they live in, had heard talk of someone who needed my assistance. They had tracked down a relative of the woman and determined where she was located.
To get there, we navigated a long dirt road filled with potholes. It was tricky driving, indeed, and I felt for a moment I was on one of those TV auto-rally shows where drivers compete in the back of beyond. The family member had come with us to show us the way. After what seemed an eternity, we turned off the road into a farm.
I thought the relative was going to lead us to the farmhouse, but he kept walking. All the way, we were followed by a pack of large dogs. Eventually, we came upon a shed, standing alone in the middle of the veld. The relative unlocked and pushed open the door, which was attached to the shed with large bolts. He then opened another door to the left and stood back for us to enter. Upon entry, I put my medical bag down on the floor, and the young man closed the other door to keep the dogs out.
The room was quiet and dark, and I was immediately struck by a rancid smell. There was no electricity for a lamp and, with very little light entering the room, my eyes took awhile to adjust. Once I could see better, I moved further in, where I was able to make out a small bundle near the far wall. I realised with horror and shock that the “bundle” was a human being, a tiny, middle-aged woman lying very still in a fetal position on a gray blanket spread out on the concrete floor.
We found a small window and pulled back the makeshift curtains. The woman’s head rested on a pillow, which also cushioned a few small pieces of cooked chicken, a small pile of rice, and a heap of shriveled vegetables. Flies were everywhere, and they were enjoying the feast.
Upon closer examination, I determined that, other than her head, this tiny lady was unable to move any part of her body. She was facing the door, and when she saw us her eyes filled with anxiety and wariness. Thoughts shrieked through my mind: Was she locked in this room to prevent the dogs from gaining access to her? Who would leave a human being like this? Not even animals are treated so! A mattress and a wire bed stood against the wall, unused because she was incontinent. The food on her pillow, her meal for the day, had been strategically placed so she could reach it with her head if she was hungry. But how could she chew? She had no teeth!
After we spoke to her and explained that we were there to help her, she smiled. A stroke had robbed her arms and legs of movement. Untreated with physiotherapy, they were frozen in fixed contractures. Although she tried to speak, we could not understand what she was saying. Her body was covered in sores, and the adult nappy that she wore was soaking wet, as was the blanket.
Both the community carers and I were so moved and horrified by the situation that we worked in silence most of the time, speaking only in hushed tones so as not to frighten her. After making the woman as comfortable as we could, we informed social workers, questioned the person who had been looking after her, and sent the woman to the hospital.
The last glimpse I had of this lady was a gummy smile, which conveyed more than words could have described.
A sad and blatant fact is that she was receiving a disability grant from the government so she could survive, be cared for, and have sufficient food. The people who had been caring for her had been abusing this provision. They had taken on responsibility for her care but were spending the money on other things.
This tiny lady died not long after we found her. If only we had been able to intervene sooner. She will never be forgotten! 
Cindy Hatchett, MSc, RN, RM, was born in Liverpool, England, and has also lived in Australia, Borneo, and South Africa. She has been a member of the Honor Society of Nursing, Sigma Theta Tau International since 2007.
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