ECU Field Journal: Africa

Marie's Blog from Lambaréné, Gabon<-- back

Disparity has taken on a whole new meaning for me here in Gabon….
August 16, 2008

Yes, you are indeed seeing a heart—a heart that took my breath away as I held the radiograph to the light. This heart belongs to a 22-year-old Gabonese woman with no documented past medical history. She becomes short of breath at the slightest activity, and is always tired and swollen with fluid. When I ask her if she has been sick before, or seen by a cardiologist, she only knows that she has been like this since childhood. She recalled episodes of palpitations and difficulty breathing if she played too hard.

This is not the only patient I have seen that has made me just want to drop my head in dismay. I keep saying to myself, “If only they were from where I am from.” And then that thought makes me angry. Why should where someone lives determine their ability to receive care? There are so many malnourished patients, and patients with diseases so far advanced that there is nothing that can really be done but wait for the inevitable. I cared for one young girl, 15 years old, in the advanced stages of AIDS. She has toxoplasmosis in her brain, and cries all day and night in painful agony. We give her pain and sedative medications to provide some relief, but there is not much else we can do.

Another woman, 40 years old, was suffering with an abdomen so large that it looked as if she was carrying septuplets! The ultrasound revealed a very large abdominal mass and gelatinous fluid filling the rest of her body cavity. From my experiences during my gynecology oncology rotation, I knew right away this was something grave—most likely metastatic ovarian cancer. The treatment she could receive in the states is not available here. To make matters worse, she was offered an exploratory laparotomy, but must first find family to give blood before they can proceed with the surgery. The hospital doesn’t have stores of her blood type.

Being confronted with such cold reality, I am learning so much about my own perspective on life, medicine, and what disparity truly means. I have so much already to reflect on during my short time here in Gabon. Where do I go from here?