I first met Marie Carmel in July of 2016. She is 53 years old, the daughter of a dear friend who lives in the mountainous community of Basen Manyan. This is her story over the past six months. It is a long story but will give you a glimpse into one of the many struggles in Haiti. Facing a medical crisis anywhere in the world can be complicated and challenging but trying to navigate the medical system in Haiti can be overwhelming. To complicate matters further the situation is often exacerbated by a patient’s crippling fear and superstition of doctors and medical procedures.
On this July afternoon I walked up the mountain to visit my friend Mari and offer my condolences on the loss of her husband seven months before. They were a dear couple who were truly devoted to one another. Each time I visited them over the past several years I was given gifts; usually watermelon from their garden and one year a large, live turkey. After Mari and I spent time talking and reminiscing, shedding some tears and praying together I prepared to leave. It was then that Mari introduced me to Marie Carmel who was sitting on the ground off to the side. Mari asked her daughter to lift her arm.
Nothing could have prepared me for what I saw. In her right armpit was an external growth the size of an orange. I will spare you further descriptive details but will say that I was rendered speechless by the sight of this. When I composed myself I began to ask questions. I learned that the tumor had been growing for many months, that Marie Carmel had been to see a doctor and had been told that the growth could be removed. But she said she would not have surgery. She was too afraid. Too afraid to go to a hospital because she would die there. Too afraid to have anesthesia because she would never awaken. Too afraid of the unknown medical intervention that could save her life. I looked her straight in the eye and told her she was correct, that there was a chance she could die during the surgery. But I then stated firmly that she would more certainly die if she did not get the cancerous growth removed. She was not convinced. So we prayed and I asked God to provide her with wisdom, courage and strength.
I asked if I could take pictures to share with some medical people serving here in Haiti, mainly to offer her some professional opinions. I returned the next day with the news that several doctors and nurses also believed this was a life threatening cancerous mass. She agreed to my offer to assist her in seeking medical help, albeit somewhat reluctantly. She was willing to see a doctor but not yet ready to commit to surgery.
Within two weeks I was headed to Port-au-Prince with a nurse friend, along with Marie Carmel and several other women with cancer. Our four hour drive brought us to St. Luke Hospital for registration and consultation. The look on the physician’s face and on the faces of his two resident interns was not encouraging. Thankfully there is a beautiful chapel on the grounds where Marie Carmel and I took time to sit and pray after her consultation. The other women in our group began earnestly encouraging her to have surgery.
The following day we went to Bernard Mevs for scans, blood work, and a surgical consultation. Each of these were done in a different building, amidst throngs of people, long lines and confusion. The opinions of the doctors varied greatly, one saying he could do a biopsy, another saying the area was too vascular, another saying the entire growth could be removed. Follow up appointments were made and Marie Carmel agreed to return to have the tumor removed. Sadly not all of our patients that day received encouraging news yet still we prayed.
During Marie Carmel’s third appointment, while she was under anesthesia, the decision was made that the tumor should not be removed but that a biopsy be taken instead. After finally agreeing to the surgery this was discouraging for all of us, most especially Marie Carmel.
The biopsy was sent to a lab in Cap Haitian and only with repeated follow up did we finally get the results – after more that two and a half months. This delayed the onset of treatment which was discouraging and detrimental to Marie Carmel’s health. Several times I heard from friends in Basen that Marie Carmel was very sick and was getting weaker. My prayers continued.
Finally just two weeks ago, with the type of cancer identified, I was able to get medication for Marie Carmel. The hope was to begin oral treatment, reduce the size of the tumor before a team of surgeons arrive from the US in mid January. I headed to Basen with trepidation having heard of Marie Carmel’s weakening condition.
My walk from the rectory to Mari’s house was unlike any walk I have taken in Basen. It was the first time in seven years that I was not accompanied by a group of children. It became a time of private prayer and a beautiful feeling of peace filled my heart. I prayed for Marie Carmel and for my dear cousin who was lying in a hospital bed in Virginia, she herself fighting for her life after a three year battle with cancer. It was not lost on me that God provided this time for me to feel His loving presence.
When I walked up the hill through the corn field I asked God to give me strength and courage to meet this challenge. Mari was the first to spot me and quickly told me she thought I was too late, that her daughter was too weak to continue her fight. I walked into the tiny home and saw Marie Carmel lying on a mat on the floor. Her face and body were emaciated and her shallow breathing made it difficult for her to speak. My heart sank.
I spoke candidly with her and asked her if she thought she had the strength to make it down the mountain and endure the four hour drive to the hospital in Port-au-Prince. She did not think she could manage the trip. I told her I had medication to try to reduce the cancer in preparation of her upcoming surgery but still she said no, it was too late. I cried as I told her the biopsy should never have taken so long, that I was so sorry. Again we prayed. I asked if I could take another photo for my nurse friend. As I left Marie Carmel asked me to tell the nurse who had taken her to Port so often that she was grateful for her help and that she continued to pray for her.
I left the house, angrily threw my backpack to the ground and walked to the edge of the yard looking out at the beautiful mountains with tears streaming down my cheeks. Mari came over and placed her arm across my shoulders. The mom of a 53 year old daughter who is dying was comforting me.
I was alone again on my trip back to the rectory. I was sad for Mari and for Marie Carmel and wondered what God’s plan was for them. I contacted my nurse friend, sent her the new photos and explained Marie’s weakened condition. She agreed we were probably too late. Our spirits were crushed and the injustice of life for a Haitian hit us hard.
I did not sleep that night. I wasn’t sure of our decision. What if the Tamoxifen could help, what if the iron supplements and vitamins could increase Marie Carmel’s strength? The next morning we decided we needed to try. I prayed that Marie Carmel would feel the same way.
I headed back up the mountain with the medication. Once more I walked alone, comforted by the silence, praying for God’s guidance. As I reached the clearing at the top of the corn field and looked across the dirt yard I spotted Marie Carmel squatting on the ground wrapped in a blue towel (the picture on this post). It was breezy and cool. I held up the bag of medication and she smiled so beautifully. Her eyes were filled with hope. She was willing to try, to fight for her life.
Three weeks have passed. I have not been able to visit Basen so I don’t know if the medication has made a difference. But I will be there next week with the nurse because Marie Carmel is on the surgeon’s schedule for January 13th. I pray that she has regained her strength and we can get her down the mountain.
I know this was a long post. Writing for me is a way to process, understand and learn from what I encounter in Haiti. It is also a way to ask for your prayers for the Haitian people who suffer in so many ways. The grip of poverty, superstition and fear of the unknown can be paralyzing.