Beati is the matriarch of a large Catholic family in Arusha, Tanzania, a city of more than a million people which serves as the jumping-off point for the many tourists who come to Tanzania to visit the country’s extraordinary game preserves. Beati’s family is involved in business, providing supplies and groceries to the local people who live in and around the city supporting the tourism industry. Although retail is not as lucrative as owning a safari company or Kilimanjaro outfitter, Beati’s family has enjoyed a level of financial stability that is uncommon in the country.
About three years ago, Beati was diagnosed with breast cancer. As a successful businesswoman, Beati had the financial means to seek out the very best treatment available in Tanzania and went to Arusha Lutheran Medical Centre (ALMC) to see the American doctor, Mark Jacobson.
Dr. Jacobson is leading a health care revolution in the region and frequently receives the very toughest cases that the country has to offer. In addition to offering some of the best diagnostic, surgical, and supportive care in the region, he’s built a neonatal intensive care, an orthopedic clinic, and an extraordinary practice that serves children with challenges including club foot, cleft palate, and extensive burns.
Beati had a successful mastectomy at ALMC after her first diagnosis. In the U.S. her surgery would have been followed by a course of radiation therapy and chemotherapy, and her five-year survival rate would have been better than 80%. However in Tanzania these treatments are unavailable, so when she was discharged after surgery, she knew that it was only a matter of time before her cancer recurred and metastasized.
In the United States these treatments would have also been extremely expensive, with patients frequently running up medical bills into the hundreds-of-thousands of dollars. However, due to efficiencies in the health care system of Tanzania, Dr. Jacobson and his team at FCCT believe the same treatments could be made available in Tanzania for about 1% of the cost in the U.S.
After Beati was readmitted to the hospital, her granddaughter, Betty, became her primary caregiver. Every morning, Betty would get up early to fix her hair and make-up and select one of her best dresses for her visit. She would then begin an hour-long walk through the city to reach the hospital, where she would sit with her grandmother until she fell asleep each night. I could never tell who was more pleased with the arrangement, Beati or Betty, but both women obviously enjoyed the company of the other. They would chat and read magazines, tell jokes about the orderlies and watch soap operas on television.
Over a period of several weeks the cancer continued to spread and a catheter was installed in Beati’s lung. The conversations and jokes began to fall away as the doses of morphine upon which Beati was increasingly relying became greater.
In the week before Beati died, the two women sat silently staring into the distance, holding hands and remembering a brighter time.