The Irish Catholic Autumn Legacy Supplement 2024
I am writing this from the Mater hospital. I went in last week with a sore throat and a week later I am just on the verge of getting out. I have always been healthy. I don’t think I have ever taken a sick-day in more than 25 years’ of work. Until this week.
Now, don’t get me wrong. I am fine now. But illness can put some perspective on life. I got an infection of the epiglottis which, if not taken seriously, can become fatal because it can close your airways. I didn’t get that far, but my wife was probably only a few hours from putting all she learned from Grey’s Anatomy into an emergency tracheostomy.
Lessons
What I learned was two-fold:
First, there is the care and compassion of healthcare workers, but nurses in particular. They looked after me when I came mildly distressed with reassurance and calm, but I also watched them look after all the other patients – in A&E, in the high-dependency unit and general ward. In each place, they didn’t just look after the health needs of their patients, but so much more. They made calls for the man who just had a laryngectomy; they cleaned his wounds, dressed him – and did it all with tenderness. Health systems everywhere get a hard time – put the people who are there, every-day providing what really are corporal works of mercy, should never.
If I was in Madagascar or Kenya, living in a rural area, getting the same sickness, can have a very, very different outcome”
The second thing I learned is how fortunate I am (we are) to be able to benefit from modern medicine. Being sick was not enjoyable at all but at least there was the benefit of pain relief when it was needed and the knowledge that antibiotics were probably going to resolve the issue eventually. I don’t know what the prognosis may have been without antibiotics but the likelihood of fatality is much, much higher. And I appreciate the relief that comes when the pain medication kicks in – and the pain when it runs out.
In the places where CBM Ireland works to end the cycle of poverty and disability, access to modern, effective medicine is not guaranteed. If I was in Madagascar or Kenya, living in a rural area, getting the same sickness, can have a very, very different outcome.
I wouldn’t have an A&E to go in the first place; I wouldn’t have access to antibiotics – or if there were some I would be paying a lot for them – if I could afford it; there may not even be a doctor that I could go to. I would have one choice really: just to see it through and hope for the best. Knowing what I know now about epiglottitis, that is not a prospect I would look forward to. It was hard enough with all the supports we have here in Ireland.
Reality
The realities of healthcare in the ‘Global South’ are stark for the majority of the people. The consequences of this are obvious: illness and death. But also there is acquired and avoidable disability. We don’t often think of disability as something that can be acquired – or avoided – but it is. The man across the ward from me that had a laryngectomy. He can no longer speak. He has acquired a disability. But he may find a new voice through an assistive device – an artificial larynx.
Disability can be overcome in many ways – through medical assistance but often through adaptations in society.
Another patient in my ward had to have an amputation due to complications from diabetes. Another acquired disability. Diabetes can be very tough and lead to different forms of disability – eyesight is particularly vulnerable. In Ireland, we can identify, treat and minimise the risk.
In places like Zimbabwe there are fewer options. The outcome is much, much more likely to be stark. Amputations due to poor healthcare and treatment, not just through diabetes, are commonplace. It often happens out of necessity to save lives. But once that is done, there are few options for the amputee to re-engage in society. It is hard to find work. It is hard to get prostheses and if you can, the technology to make them fit and to be comfortable is just not available.
CBM Ireland works with communities to try to put the necessary adaptations in place”
So, you may be wheelchair bound, in a village or a city where the roads are unpaved and the footpaths are just not there. You can’t get about.
CBM Ireland works with communities to try to put the necessary adaptations in place. But we also work with the hospitals to help them have the best equipment and care possible in place in the event of illness or accident. But our work can only do so much. It is full of difficult – either/or – choices – do we spend our money and resources helping someone who needs life-saving or life-changing surgery right now, or do we invest in the health-systems to be better in the longer term?
Answers
There is not really a right answer to this question. It depends on your outlook in life, your philosophy. Do good now, versus greater benefit deferred. A bird in the hand, two in the bush, as the adage goes.
When I arrived in A&E last week, I was triaged to determine if I was a priority for treatment. I was and someone else had to wait longer as a consequence. It is not so straightforward when talking about ending the cycle of poverty and disability. Getting the balance is much less scientific and more of a value-judgement.
Some organisations will prioritise the urgent, now, 100%. Others feel their best energies should go into working with the Ministry of Health to build more effective systems. At CBM Ireland, we try to find a balance between what we do and achieve today and what we hope we will be able to contribute to in the future.
For a child like Safiya who had cataracts, the wait for health-system change is just too long. At CBM, when we encounter a child in need of sight-restoring surgery, we have to be able to help. Children now shouldn’t have to compete with the children of the future.
Support
At the same time, we are starting a programme using new low-cost technology in Madagascar to train rural health workers to screen and identify children like Safiya when they are infants so they can receive the surgery they need as a baby.
The next generation of children in places like Madagascar will hopefully get to grow up with access to healthcare settings such as I benefitted from in the Mater Hospital. But the journey will not be easy. The Mater was founded by the Sisters of Mercy in 1852 “…to serve the greatest need in the city, somewhere the sick poor could go without having to know someone or pay money…” This reflects the value and principles of CBM Ireland, a Christian organisation committed to ending the cycle of poverty and disability, albeit in a much-changed world.
200 years ago Catherine McAuley dared to dream. The Mater Hospital started from humble beginnings. But it had to start somewhere to become what it is today. The same dreams exist in Madagascar, in Zimbabwe, In Kenya. With support from Ireland, those dreams can become reality.
If you would like to support CBM Ireland’s mission, whether through a donation now or a legacy gift in the future, please contact us by phone on 01 873 0300 or email us at info@cbm.ie.
Dualta Roughneen is the CEO of CBM Ireland, an international disability rights organisation, committed to improving the quality of life of people with disabilities and those at risk of disability, in low-income regions of the world.
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