Noeline: Our Brave Little Girl

By Tusabe Innocent, Kathy Chang, and Stephanie Van Dyke

We are sad to inform our Engeye family that Noeline, a brave young girl, passed away on March, 29th 2013, at the age of nine. After battling cancer for approximately two and a half years, we came to know Noeline well; she was dear to all of us who had the chance to fight alongside her.

A quiet girl with a bright smile and gentle nature, Noeline and her mother first visited Engeye Health Clinic in July of 2011. At that time, she was very weak with an abnormal growth and discharge from her vaginal wall, later found to be a rare cancer called rhabdomyosarcoma. Noeline’s father had given up hope, but her mother was determined to seek care to give Noeline the chance she deserved; with little money and waning hope, her mother was desperate. She could not afford the necessary transport to Kampala, where the Uganda Cancer Institute is located at Mulago Hospital, let alone pay for Noeline’s treatment.

As a clinic in rural Uganda with few nearby medical resources, out of necessity, Engeye Health Clinic typically focuses its efforts on strategies that will have the most impact. From vaccinations to malaria diagnosis and treatment, most of our initiatives embrace an underlying public health strategy. At the root of most decisions lies the question, what is the least expensive method to bring about the most benefit to the population? So when individuals present to the clinic, like Noeline, who require more intensive care, the decision to intervene is not easy. But in Noeline’s case, given the potentially curable nature of her cancer, we opted to try.

Thanks to your generous donations, which were collected as a special fundraising effort separate from general clinic funds, Noeline started treatment in October of 2011 at the Uganda Cancer Institute. With her transport, food, and treatment made possible thanks to your kindness and support, she was given hope. While accompanying Noeline and her mother to many of her treatments, we learned that she loved Orange Fanta and liked to dance. She even went on safari with a visiting medical team – the chance of a lifetime for most village children. Staring wide-eyed at the elephants and hippopotami, she laughed and giggled in excitement.

Noeline endured countless rounds of chemotherapy, underwent a successful surgery to debulk her tumor at CoRSU Hospital, was given a second tumor diagnosis that projected a better prognosis, and ended with radiotherapy. There were many times throughout her care that we thought we had her cancer beat. Full of energy and apparently tumor-free, she worked, played and laughed like other children in the village. For the first time, we saw her come to life.

However, earlier this February, Noeline’s tumor returned and did not respond to the remaining treatment options. With few other realistic choices available in Uganda, her doctors reluctantly transitioned her to palliative care, with the goal to keep her comfortable during her final days. As hard as it was, the Engeye Health Clinic staff fought back the tears, stayed strong, and visited Noeline at her home as life slowly left her tired body.  One week prior to passing, Biz, the 2012 Union Fellow, and John, clinic manager, visited Noeline and her mother at home. Reduced to bones and in pain, Noeline was still able to gently laugh at Biz’ jokes, showing her beautiful smile and strong spirit.

We thank you for your encouragement and financial support. You eased Noeline’s pain, provided her with hope, and allowed her soul to dance as her fight came to its end.

(Click on photos to enlarge.)