TJ is a 38 year-old woman with 11 children. She is a Rwanda refugee who married a Ugandan man.  She was fine and going about her work when she noticed two lumps in her left breast two years ago; she did not mind as long as they were not painful. She got pregnant again as the lumps continued to grow. Someone in the village told her that she was bewitched and she started taking herbs. TJ had her child and continued to try to manage the increasing pain began spreading throughout her body. However, the lumps soon became so large and painful that she was unable to do her usual work as a mother. 

On her 3^rdday at the hospital, a nurse from Mobile Hospice Mbarara[i](MHM) came to the ward and saw TJ. She gave her oral liquid morphine for the painand also gave her and her family some food. That was the first night TJ rested in peace.  The next day the MHM nurse returned to check on TJ. Free from the intense pain, TJ was able to talk with the nurse and expressed that her dying wish was to go back home to see her children. 

The logistics of the return journey home was a nightmare. TJ was not able to sit up, yet the journey would require two long car rides and a final boda boda (motorbike ride). Plus, there was the issue of transport money – she had none.

Fellow patients were sympathetic, and were trying to put some coins into the basket but the journey was really long and costly and they did not know whether it was a normal matatu (community taxi van) they were collecting for or a special hire. The MHM team consulted the Chief Executive of Hospice Africa Uganda (HAU), who authorized a HAU vehicle for the transport. Although no easy journey, the long road home had become just a little easier for the small family.  

Time was of the essence in TJ’s case. Her advanced stage of cancer left her little time. The hospice team immediately brought the family of four to MHM where they were given dinner and a place to sleep on site so they could begin their arduous journey early the next morning.

Dedicated and committed to getting TJ and her family safely home, MHM’s driver and nurse arrived on site at 4:30am on Saturday morning. The family was awaken in the dark hours of dawn and provided hot cups of tea. After giving TJ a loading dose of morphine for the long journey ahead, the driver and nurse carried her to the van. “Every movement punctuated TJ’s pain,” the nurse recalled. Loaded and ready, the full van quietly drove away from Mobile Hospice Mbarara down the red dirt road.

The journey began with a horrible 30 minute patch from Hospice to Rwebikoona. Potholes. Potholes. Potholes.  The next section, from Rwebikoona to Ibanda, consisted of smooth roads and although it provided a little relief for TJ, the grandmother and young girl both got travel sickness because they were not used to travelling in a car.  “I was very scared that the old lady and the young girl were going to be sicker than the patient,” recalled the nurse,  “because they were having intractable vomiting.” The normal one hour stretch turned into two.

But Ugandan potholes are indelible to its landscape. From Ibanda to Kamwenge road, to Fort Portal and on to the Kampala-Mubende road, the nurse had to give TJ two further doses of morphine. The situation didn’t improve either for the two travel sick passengers.

After hours of brutal travel, they finally arrived at Mubende town. Unable to recognize the road to their home, they inquired from people at the petrol station who showed them the road to Kakumiro. “The road was really bad, dusty, bumpy with a lot of humps and potholes. The patient was once again in a lot of pain. Another break-through dose was given. We continued to inquire from passersby for the road to Kakumiro to make sure we were still on the right track.  But at last we came to Kakumiro town and that is when the young girl smiled with familiarity.  T.J. and her mother-in-law were able to direct us the rest of the way home.”

It was a great relief from everyone when they finally reached home after almost 12 hours on the road. All of TJ’s children ran out and greeted them as they drove up. They were incredibly happy to see the car which had brought home their Mummy. The happiness was short-lived, however, because Mummy did not come out of the car as they had anticipated but was carried on a mattress, looking very frail and weak.

They settled TJ into her home and provided all instructions on how to care for her.  Little Hospice Hoima was closer and they directed them to go there for more medication. TJ was very grateful to the entire team of hospice for their care, love and concern for her life. She said that she was not expecting to see her children again and was incredibly grateful. The mother-in-law was also full of praises and expressed deep gratitude.

The MHM team started their journey back home, reaching Mbarara late into the night.

“It was a long journey home but it was worth every trouble we went through to make it.This experience is a reminder to all of us that we can have a lasting impact on our patients and their families. We sometimes need to go a step beyond our normal duties and if we pull together, we can do extraordinary things.”

 This act of reuniting a dying mother with her family continues to be praised by not only the family but the whole community.

[i]Mobile Hospice Mbarara is a mobile branch of Hospice Africa Uganda.