A young woman whose sore throat became a life-threatening growth in her neck, leaving her struggling to breathe and facing suffocation, has had it removed for free by surgical volunteers from international charity Mercy Ships.
“When we first met her, we were incredibly worried about her life because her tumour was so large and constricting her airway,” explains Sarah Kwok-Page, a UK Consultant Anaesthetist volunteering with Mercy Ships. “We were worried that if she went home and waited for us to call her for surgery, she might not make it back to the ship!"
Harimalala from Mankara, on the east coast of Madagascar, was just 12 when her throat started to feel uncomfortable and began to swell.
“I took medicines, but it kept growing even more. I even went to a traditional healer, but it kept growing,” she said.
The large growth eventually became impossible to ignore. Ashamed of her appearance, Harimalala dropped out of school and wrapped a scarf around her neck to hide the mass. The swelling affected her physically, emotionally, and socially.
“I am unable to fetch water or carry heavy things. I can't bend down or run,” she shared before her surgery. Harimalala feared her condition was life-threatening but like 9 out of 10 people in sub-Saharan Africa, she was unable to access safe, affordable, and timely surgical care.
Still unable to find any help at 24 years old, she heard about Mercy Ships from a neighbour – a charity that sends floating hospitals crewed by volunteer medical professionals to provide free surgery. She held onto the hope that they would return to Madagascar.
In 2024, Harimalala heard the good news that the Africa Mercy had arrived in Toamasina. She travelled alone to the port where the volunteers first met her. The medical team quickly realised her condition was critical and she could not return home until she had surgery.
Dr AJ Collins, who has led Mercy Ships’ thyroid surgery programme for 17 years, performed the operation. He described her condition as, “A typical but massive multinodular goitre, which is the most common type of thyroid pathology worldwide.”
“It tends to compress the airway so breathing and talking and exercising become very difficult. It can make it hard to swallow your food. Those problems just become worse until they get to critical point, which I think for her, was close.”
Additionally, Harimalala faced bigger challenges. “I feel ashamed with people and don't dare go to church because people stare at me. People gossip, they talk – they say I have a big thing on my neck,” she said.
She also feared the condition would rob her of the chance to build a future.
“I can't imagine what that's like… seeing all the young people around you get on with their lives and do things like getting married and having families or other things,” said Dr Collins. “She had a deep feeling that wasn't going to happen for her.”
Her airway was so compromised that Mercy Ships staff raised concerns with Dr Collins before he arrived on the ship. Rather than send her home before the operation date was planned, Harimalala was asked to spend several months at the Mercy Ships HOPE (Hospital Out Patient Extension) Centre, receiving care to reduce the size of the goitre before surgery could take place.
After a complex four-hour procedure, Harimalala was finally freed from the 1.35-kilogram mass, which was almost two pounds in weight.
After successful surgery, Harimalala reflected on her future: “I really like necklaces, but I had a goitre so I couldn't wear it but now I can,” she said, smiling broadly. “I feel like I’ve entered a new life because the previous one, it was uncertain whether I would die or live.
“I can get married and have children now because the growth is gone,” she added.
For British volunteers like Sarah Kwok-Page, Harimalala’s transformation is why she gives her time to volunteer for Mercy Ships. “Harimalala showed incredible bravery and trust,” says Sarah. “When she first came to Mercy Ships she felt like there was no hope, no way forward. But now she has hope again.”
“Everyone goes into medicine with a dream to make a difference and this is why I love volunteering with Mercy Ships. You see lives transformed and people getting their futures back.”
Learn how you can partner with Mercy Ships to provide hope and healing to people like Harimalala. Visit mercyships.org.uk.
