The Samoa Cancer Society has highlighted the value of nonclinical palliative care of its registered terminally-ill cancer patients.

As part of its preparations to commemorate World Cancer Day 2020, which was celebrated in Samoa on Sunday but is marked globally on February 4, the Society says nonclinical palliative care of its registered terminally-ill cancer patients continues to be one of the key services offered to ensure the best possible quality of life care.

And while nonclinical palliative care cannot cure the cancer at later stages, a patient can endure the battle until the final stage of death with love, hope and dignity amongst family and loved ones.

Over the years the Society has been witness to the bravery of some of their patients, who had the courage to share their stories, despite the personal challenges of the illness that they are facing. 

The Society continues, however, to respect the privacy of those who wish to share their story with the society when they are in search of comfort and support. They could just be on the lookout for a willing ear to their plight, and to be encouraged once more to face another day and the next.

In its search for cancer patient stories to share this World Cancer Day, the Society reached out to Lumepa Hald, sister of the late Manamea Apelu Schwalger, a former Miss Samoa and Miss South Pacific. 

It will be two years next month since Manamea lost her battle with breast cancer. Yet the strength of her conviction, to advocate for breast cancer awareness and education in the community, lives on long after her passing. 

However, there is a special part of the journey in the care that she had received by her sister and loved ones that is so poignant, yet it portrays the reality that many who are now suffering from cancer can relate to.

My sister Mana’s courage remains in me: Love is bigger than Cancer by Lumepa Hald.

Mana’s not one to be reintroduced on a day like this in Samoa. She similarly is the “sun” of it because of her journey with cancer. But I can’t help but think of her thoughts of life in general, when I sit down to write for you. I write to share a bit more of my private life with my sister, whom many Samoans have come to admire.

Mana’s cancer started a whirlwind of emotions for her family. We were all at war with it. And I am certain now that most of her close friends joined that war. Cancer, as many of you know, leaves us all wounded. Though Mana is gone, and after a warrior like fight, we will never be the same as a family. She left a void in us that nobody or anything can replace. Yes, our miss our beloved Mana a lot. Hence the writing of this short rag, takes much of me for the wholesomeness of it.

Mana’s journey was merely accelerated by the empathy she felt for the poorer people in Samoa. She of course, loved her country. A patriot, well, her Miss Samoa and South Pacific title were tools for her to show her pride in her motherland. She was modest to let me know that she did not want people to think that her being Miss Samoa meant that she would get special attention. But she realized later that she could use those titles to enhance her role as a spokesperson for people who could not voice their fears and frustrations about cancer treatments, and yes, cancer as a long suffering illness.

When Mana received her mastectomy in Motootua, she was in a ward with five other patients. An elderly man was groaning with pain next to her. We were told by his daughter that he was just told that he had cancer. And that it took several visits to the hospital to be told this fact. The daughter continued to say that he was drinking milk and eating a bowl of noodles because those were the things that would calm the pain. But he was at a stage where the doctors were giving him the option of having an operation on his stomach or there was nothing else. We heard him tell his children, that it was best they go home. The daughter had told us that they had to pay the neighbor to bring them from the village in his truck. And for them it was expensive.

Mana asked me to give them all her fruits from her visitors, juices and her spare sheets. I did so. Then we had a bit of a laugh at the nurse who refused our new sheets. She replaced it with a bloody sheet from the hospital supply. Not realizing this, she turned to us, and left without a word.

I do not write this to criticize the hospital staff. But I write it anyway, because it is part of the unvoiced things we see every day. And it is what Mana would have said out loud also pointing to the fatigue-ness of the nurses and doctors.

What followed after this incident was Mana’s change of energy and focus. While she still suffered with cancer, she felt a sense of purpose. She wanted to create awareness, write to the Prime Minister, advocate for the early detection of cancer, support her beloved Samoa Cancer Society, talk to students of medicine. It was a waterfall of determination. She said to me that even if she gets tired, it is what was bringing her back to life. She wanted people like the old man in the hospital, to be more hopeful, to have more help, and to be noticed.

While she was able to pay for a ticket to New Zealand and was blessed to have been on the list of people who got some financial aid for her care in New Zealand, she felt the long silence of help from the government was loud. It was telling her more about the need to be there for those who were really in need. Her family was strained, especially her husband and our parents, but they tried their best to provide for her care in New Zealand. It was the only place close to Samoa, where we could as locals go to get conventional treatments for cancer. Our sister Via was able to house her at her home in Manurewa.

This to say that Mana also felt that as a child of Samoan and Tuvaluan heritage, she was blessed with loving families both on her side and that of her dear husband Alan. And for that reason she was a believer that palliative care starts at home and should be supported by our medical funds and programs.

Mana was outspoken on the subject. She would call for her kind friends in the media to come ask her questions so she could answer in the best way possible on how it happens, and what could be done about it. She wanted to emanate the hopefulness that a family care unit for cancer patients entailed. She believed that Samoans being a collective society would do well in palliative care. She proved correct, when she was able to return home to pass away peacefully in the clinging embrace of her families and friends. That is how she wanted it. And that, she believes is how Samoans in general would prefer to go.

But we cannot talk about Mana and not mention her thoughts about health and the health system. She had a lot to say about it. She realized through her cancer the pressing need to re-educate Samoans on healthy living. Her diet was usually plant based. She turned to meat sometimes, and tested that too. It seemed that her inquisitive mind went as far as dissecting the very use of each plant, fruit, and meat she ate. It brought her satisfaction to see her own children and families were beginning to agree with what she was saying about the foods and their importance.

It seems today, this is a dialogue that Mana would continue with us if she was here. She would be outspoken about the need to eat healthy and to protect our immune systems. She was always an outdoors person. Her belief in gardening as a healing activity became more realized when she would spend her mornings, and evenings in her gardens with her young daughters. She felt that there was a spiritual upliftment in that.

During the measles epidemic I thought a lot about Mana. In fact I cried missing her. She would have reminded me of the insufficient ways of which the hospital handles the sick. But she would have said that it takes a shift of concern for the right things to make a difference. From the first hello to a patient, to the last goodbye, she was skeptic of how patients were being received in a short staffed entity. But she warmed up to the busy staff at one point and she directly told them how she felt as a patient, and that she was appreciative of their work. It seems, as the months passed, and with her regular visits to the hospital for check-ups, she found the hospital system for her care had become more efficient. That was a big change from the many uncertainties she faced when she first visited the hospital for a check-up before she was recommended to go to NZ for treatment.

It was during these unsure times at the hospital in Moto’otua that she talked to the Samoa Cancer Society about the lack of awareness for patients of cancer. Nobody seemed to know where to go and who to ask. In light of that fact, Mana felt that this is where there seemed to be a lack of empathy from the medical system. People seemed to be categorized as numbers. Mana wanted the care for cancer to be humanized. By humanizing cancer, Mana felt the hope given to patients itself, would make a tremendous difference not only to the patients but to their families as well.

If anything, I think Mana dressed her arguments elegantly by bringing in the Miss Samoa Alumni to promote the cause for cancer awareness. These ladies, in her mind, were powerful, in terms of women advocacy for cancer and for healthy living in families. She saw the potential of these beautiful women, and found courage from them, as they tried to promote Cancer in her lingo, so to speak. More also, she saw that people of Samoan heritage would be proud to carry a pink ribbon with them, wear a pink puletasi, or a pink tee shirt in favor of the Pinktober month for breast cancer awareness because the Miss Samoa Alumni with her support was dynamically inspiring. That said, when we went to the shops to buy groceries or supplies for home, she would always be touched by the staff of various businesses recognizing her, and saying hello with their pink outfits.

Online awareness cannot be left untold. Facebook was Mana’s source of comfort in her late nights whence she would converse with strangers from afar, sending her love and words of courage. I would find her crying over a story about someone who suffered from cancer. She made several friends whom she has not met via the Facebook medium. Hence when the Prime Minister wanted face-book to be taken down, Mana went on television and begged him from her heart, not to do so. She saw that many people with cancer were using this medium to reach out to each other from various countries in the world. Samoans. They danced in videos and wore pink outfits, as well as their children to show their love for country, and well, for Mana. Mana told me to always remember them in our prayers. I have her phone. She kept all the photos of the people who sent her their photos and their loving messages. We are grateful she had you to talk to when she was not able to sleep. It felt as if the whole world was looking after her too. Facebook made her smile a lot.

In the end, Mana’s fight to survive cancer succeeded beyond the 18months she was originally told she would only last till. She stayed alive for another five years. It was at a stage 4, that she battled cancer from the beginning. She managed to fight it for as long as possible. But in that time, she did not ever say that she wanted to give up. She saw there was light in her suffering.

She had a reason to live. She lived for others, not just her family, but for her countrymen. She hoped that with whatever she could do, whether it be painting the clock pink, or walking on the roads of Apia wearing a pink Tee shirt with “ Love is bigger than Cancer” on it, or talking to an aspiring student of the medical profession, Mana was filled with enthusiasm for life. She spoke profusely for the leaders and anyone to hear her plea, to better the care of cancer patients in Samoa. She said it is expensive, but if we could reach out to our richer partners to fund a cancer care clinic for Samoans, that would be a break in the ice for all better beginnings. She was not one to say no to. She felt that anything can be done with God as our guide. And she did so, in her weakening body, show us how it could be done.

I often think of her these days. We had a knack for philosophical talks which I long for.

She would update me on the coroner virus. Something I do not like to think about because I am often lost in my emotions with tragedies. But she is one to head straight into them, with her eyes open. I know she would say that this virus simply tells of the greed of humanity and the need to take things in moderation.

I leave you now with warm wishes from her families. I am left inspired by my sister to work for others, still. She is sorely missed. Her laughter still lingers when I am driving by myself to the village. Dear Samoa, Mana is right, “ Love is bigger than Cancer. “ And it seems that for the troubles we are facing in the world today, we should also say with her, “ Love is bigger than life.”