Hospice Without Borders Blog ..... Updates from our international work and Amahoro House

Rwanda:  Mothers Day Tribute to an African Mama


To be loved by an African Mama is to really know deep love.  It was on my first trip to Rwanda that I understood this.  I began to notice the children.  Happy, smiling, laughing and full of wonder and love. It’s unusual to hear a child crying in Rwanda.  You simply do not hear it. Despite deep poverty, wearing tattered clothing and playing with a ball constructed of torn up knotted t-shirts, the children know and radiate love.  That’s when I noticed the moms.  Always working and keeping a watchful eye on the children.  Making a meal to serve 6 or more out of a handful of rice, beans and sorghum.  Tending fires, washing laundry and carrying water many miles each day.  The majority of moms carry out these daily tasks with their smallest infant on their back.  Despite long days filled with work, there is always laughter and smiling.  The moms I observed were finding joy in their days, despite conditions of poverty. 


I remember meeting Charlotte.  She is my favorite African mom, a woman I have deep affection for.   Charlotte and her daughter Kevan lived in 8 foot x 10 foot room constructed of mud walls, a dirt floor and corrugated metal roof. They shared a small mat on the floor in the back of the room.  A table and two rickety wooden benches were in the front of the room, and a cook pot was outside the door.  We were visiting Charlotte, a palliative care patient diagnosed with metastatic cervical cancer, to evaluate her symptoms and medications.     Kevan, curious about my white skin, sat close to me and watched me intently.  I began to hear more of their story.  Charlotte lost her husband and sons to HIV some years before.   Both Charlotte and Kevan are HIV positive. During the story Charlottes eyes rarely left Kevan.  Charlotte shared her worry about Kevan, and conversations with God late at night at night when Kevan is sleeping next to her on the mat.  She pleaded with God to take Kevan first so Kevan will not know being an orphan, and later pleads with God to take her first, and spare Kevan so she may know a long life.  She finishes the story by saying “we’re all each other has,” and sharing their morning ritual with me. They have made a promise to one another to carry out each morning in which they.  Whichever of the two wakens will awaken the other, so they may celebrate making it through the night.


Since that trip much has happened to Charlotte.  The palliative team helped to move Charlotte and Kevan to a larger home. Kevan’s health began to deteriorate; she developed heart failure and was hospitalized many times. Each visit we would find her more and more frail.  Kevan died in 2014.  Charlotte joined our first grief and bereavement workshop later that same year, where we called her “mama Kevan” for the two week workshop and she cried and shared her journey with Kevan, and what it meant to be Kevan’s mom.   Charlotte has moved into a home supported by a Catholic church, her own health is failing.  She continues to be followed by the palliative care team.


Although this Mother’s Day story has a sad thread running through it, it captures something important and essential.  It’s an invitation to stop in our day and honor those who have lost their mom, and those moms who have lost a child.   I pause today to honor Charlotte a true African mama.  Despite serious illness, poverty and an uncertain future, Kevan knew joy every day.  She laughed, and sang, and played when she felt good.  She felt loved and radiated love.



Amahoro House:  Honoring our Nurses May 6


In an essay titled “The Power to Make a Difference” Jimmy Carter writes about nurses.  Nurses are a constant reminder of who we are at our best; caring for others, even those who are different from ourselves. He writes, “Guided by the belief that everyone deserves care and compassion, nurses fight against discrimination and stigmatization.  They reach across the widening chasm between the rich and poor.  They break down the other walls that too often separate people – religion, nationality, race, and gender – to affirm the essence of humanity that joins us.  They understand the incredible power one person can have to make a difference in the lives of others.”    


The Amahoro House volunteer nurses embody this sentiment in every way.  From completing hours of wound care, and medical assessments with shelter guests, to sitting in the ICU deep in the night, supporting the shelter staff as one of the shelter guests life slips away. Each of the Amahoro House volunteer nurses have brought richness to those we serve.


May 6 is National Nurses Day, and it is with gratitude that we honor our nursing volunteers at Amahoro House.  Thank you Linda, Madison, Rainie, Trish, Tish, Terry and our nursing assistants Andrew , Lee and Erin – you help us to embrace the most vulnerable people in our community, and thus remind us that we are all interconnected.



Amahoro House: An opportunity for deep connection in each moment.


I saw her in the shelter a few days before the following conversation took place.  She had a flower in her hair and I remember thinking how much she really was like a flower.  When she allowed herself to smile, to really smile, it was as if a tight bud was bursting into bloom.  We exchanged a hug that night and I went about what I was doing.


The conversation took place a few days later while meeting with the shelter director. We were meeting to go over our presentation at this year’s National Healthcare for the Homeless symposium.  I had been aware that this shelter guest had been hospitalized twice since that brief hug early in the week.  Hospitalized, on life support briefly, then discharged and re-hospitalized on life support again, finally discharged a second time.  It hadn’t sounded optimal. 


She started the conversation by sharing her time at the woman’s bedside just before her second hospital discharge. A nurse had come into the room and engaged the woman; chastising her in a way that might only be described as “shame based care.”  It was a salient example of the very reason we were approaching this national audience.   


Our presentation   would focus on “helpful being.”  Illustrating ways to care for someone; who suffers from serious illness and chronically homelessness, which are driven out of deep compassion and awareness of our interconnectedness.  In Africa we know this as “Ubuntu-I am because we are.”  Our goal was to illuminate the possibilities in every encounter, to shine a light on the bud that can burst into a bloom with the right nourishment.


As the conversation dissolved into the room an image floated through my mind of the importance of each encounter.  Each encounter we enter into holds the potential for a type of reciprocity and deep connection.  I imagined the partnership that emerges between a bee and flower bloom.   The flower radiates the light of beauty and life.  The bee, a marvelous being, pollinating flower blooms, equally holds the power to sting. 


I wondered how many more people would encounter this young woman and choose to nourish her instead of stinging her.  I vowed to hug her the next time I saw her, nourishing her beauty and light. And I was grateful we would have a chance to take the podium and offer healthcare providers a new awareness of the opportunities each encounter holds.


Hospice Without Borders in partnership with Interfaith Works Emergency Overnight Shelter will be speaking at this year’s National Healthcare for the Homeless symposium.  For a detailed summary of our presentation follow the link below:





Save the Date: June 25th, 2016

Hospice Without Borders is having it's first ever Gala event this June. Join us for a great evening of food and community, with a fun Live and Silent auction! Help support the work of this all volunteer organization!


Tickets will be $65 per person, and will be held at beautiful Annie Wright School in Tacoma, WA.


Ticket purchasing will be available soon. Please contact us at victrinia@hospicewithoutborders.com with any questions.


We hope to see you there!


Amahoro House: Medical Respite.... a rest in the midst of things

".......I walked by the bathroom and was surprised to see her boots in the middle of the floor.  I recalled seeing them hidden under her pillow at the homeless shelter.  It must feel safe here....."


Sally came to Amahoro House for medical respite in February.  The community emergency room had treated her for bronchitis and a near catastrophic thyroid level, and discharged her to the street.  She was not resting at the shelter and thus unable to meet with housing advocate volunteers, and maintain discharge medication plan.  The morning the Amahoro House volunteer encountered her boots in the bathroom marked day three of her medical respite stay.  On this morning she was sleeping in one of two designated respite beds, and would later meet with her housing advocate volunteer.


During her short stay at Amahoro House Sally would recover from her illness and make progress towards housing, open a bank account, and begin the long process of moving her medical home to a local provider in Olympia, Washington.  With access to food, rest, and structured day she would  complete her antibiotics and steroid to assist her recovery. 


Amahoro House is one of only a handful of medical respite efforts in Washington state, and the only effort in the South Puget Sound.


Medical respite is defined by the National Health Care for the Homeless Council as " short term residential care that allows homeless individuals the opportunity to rest in a safe environment while accessing medical support and other supportive services."


The team at Amahoro House creates an intentional nurturing and safe environment to aid in guests recovery.  For Sally this meant plenty of mint ice cream, long naps and an afternoon spent with volunteer Pam online looking for her father whom she hadn't seen in over 50 years.