I saw a lot of pretty horific cases, but a few stuck out for me specifically that I don't think I will ever forget!
1. Anal Carcinoma
This case was one of the first I saw and I only saw it once - after this the patient was too ill to attend.
So in the UK anal cancer is assosicated with the older population (along with most others), however, the population in Tanzania is obviously a lot younger than ours so cancers develop at earlier ages. But I did not expect to see that this man was just 25 when I looked through his notes. He was so frail he did not have the energy or life to lift himself out of his wheelchair, let alone get on to the bed! His father had to lift him up onto the bed. It was so sad having to watch his father care for his ill son knowing that he hadn't got long left.
2. Brain Tumour
This case was pretty similar to above in the respect that this young boys father had to do everything for him as he had no life left in him - he couldn't open his eyes and had to be carried everywhere. This young boy was about 6 and had to be transferred from another hospital everyday to have his treatment. I'm not sure what type of tumour he had as it wasn't recorded in his notes, but his treatment was not nessercary as it was not helping the little boys condition at all - in the UK he wouldn't have been started on treatment.
3. Pituitary Tumour
I watched this lady from the beginning of her treatment to near enough the end as she started when I started my placement.
At the beginning she was so chatty and trying to teach me Swahili and always laughing, but she deteriated a lot and quickly! By the end of three weeks she could hardly put one foot infront of the other, let alone walk in a straight line! Her eyes were hardly open and speech slurred. What struck me was how little care she was given still in this condition! She could hardly get herself on the bed, yet the staff all just left her to it.
I was asked what we would do in the UK, when I said that the technique would be completely different to start with they didn't understand that using right and left laterals was treating too much brain and meaning that the side effects she was having were horrific! I said that if she was in this state, we would have stopped her treatment as we were doing more harm than good to her obviously.
After this day, she didn't return for treatment whilst I was there as she was too ill.
4. Xeroderma Pigmentosum
This was something I had never heard of before I saw this patient. It a genetic disorder than basically means that you're allergic to sun and any exposure to UV leads to skin cancer.
This little girl was just 7 and had skin lesions all over. In her notes it read how she had had lesions on her back when she was younger and a few on her chest. But from that point, she had progressed into a state that was beyond repair and her treatment was very palliative. She had deep lesions all over her scalp that were pusey and scabby, her nose was none exsistant and had been consumed by cancer along with her right eye which she could no longer see through. Her mouth and lips were filled with ulcerative lesions which made eating a struggle. And this little girl was terrified!
On the first day she was too scared to get on the bed and was crying her eyes out! The radiographers had little sympathy with her and it just sounded like they were shouting at her. I felt so sad for her. The next day she hid behind her mum up against the wall, then she saw me and came over and held my hand and then walked with me over to the bed (I don't think she'd ever seen a white person before). On her third day I took some stickers in with me to give to her and when her mum gave them to her, she was extatic! She was smiling with all her might and wouldn't stop playing with them!
The even sadder thing was that her mum still held out hope that she was going to be completely cured soon, but her case was so that even the radiotherapy she was having wouldn't have made too big an impact on her situation.
It's hard to convey just how sad these cases were, without being there I think. But I've done my best for you guys!
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