What happened at the stadium

Where you live should not decide whether you live or whether you die.

So wrote a certain Irishman with a penchant for sunglasses (and occasional fits of self-aggrandizement). Unfortunately, he was wrong. It does.

Let me tell you a story.

Yesterday was screening day, the kick-off to this year's outreach, and a day we had all been looking forward to with excitement, with fear, and with a certain measure of trembling. As our caravan of white four-wheel-drives left the Africa Mercy, it transported four hundred souls bent on doing good. Watching this line of cars, emblazoned with the green-and-blue Mercy Ships logo, negotiate the pre-dawn darkness of Monrovia, and knowing that each one moved with a single, united purpose, was profoundly inspiring.

I think few of us were prepared for the intensity of what was to come. The line that met us outside the Samuel Kanyon Doe stadium snaked across the parking lot. I don't know the official numbers yet, but it looked like thousands. And, as the day wore on, it felt like thousands, too.

In the midst of those thousands, in the heat of the day, Michael showed up. He sat down at my table, having passed through multiple layers of pre-screening, a twenty-two-year-old man in the prime of his health. We shook hands, in good Liberian fashion (one day I'm going to write a post about the Liberian handshake. But not today), and he began to tell me about these annoying knots that had appeared on the left side of his neck. They'd been there for four months. They weren't really hurting him, but they were getting bigger. People were starting to talk. He hadn't lost any weight, hadn't noticed any fevers. He didn't smoke, didn't drink, didn't do drugs. Instead, he spent his time studying. We talked a bit about his studies, his family, and then we got down to examining.

Under my fingers, the knots in Michael's neck weren't shy. They weren't large, but they were palpably, inexorably there. A collection of lymph nodes, scattered. And under the pathologist's microscope, they became downright exhibitionistic. This young man had Hodgkin disease.

Now, here's the problem: In the US, this disease is eminently curable. In its early stages, it frankly flees under the ministrations of a four-drug chemotherapy regimen and some radiation. Nine out of ten times. And even for the most advanced stages, nearly two-thirds of patients are still alive at five years. This is one of those cancers you can scare off with a sidelong glance.

In Liberia, though, it's a death sentence.

There is no radiation therapy in the country. And the four drugs in the regimen (first described in the US thirty years ago) still aren't available here. The best chance you have is to get yourself to the one hospital in Ghana, 650 miles away, where, for something like $6000 of your own money, you have a chance (and only a chance) at treatment. For a full course of oncologic therapy, $6000 seems like a steal by North American standards. But for a country whose per capita GDP is $195 per year, that represents a whole lot of money. It's the equivalent of asking any one of us to pay $1.3 million.

Or die.

I hate to be melodramatic about this, but I've got to admit...this was hard news to break. This is injustice, pure and simple.

As I write, our palliative care team is pulling as many strings as they know to get him up to Accra, and in to treatment. The fact remains, though—if they can't, a young man will die from a tremendously curable disease. Simply because he was born in the wrong place. There, but for the grace...

I realize that I'm focusing on one patient, with a less-than-optimal story. There are many stories of hope, many patients we have been able to offer surgery to, many whose lives will—God willing—change because of the work of the ship here in the next ten months. Two friends have written eloquently about Abraham, one such boy.

But, it's the ones whom we had to turn away that have been leaning heavy.

As another has written:

Sometimes when I lose my grip

I wonder what to make of heaven;

All the times I thought to reach up

All the times I had to give.

Babies underneath their beds,

Hospitals that cannot treat

All the wounds that money causes,

All the comforts of cathedrals.

All the cries of thirsty children—

This is our inheritance.

All the rage of watching mothers—

This is our greatest offence.