Why did Paul Howie place all his faith in a Dutch complementary medicine practitioner when he was dying of cancer? His widow tells Marese McDonagh
Paul Howie was dying that night but his wife Michelle was too terrified to ring an ambulance. But she rang the health therapist Mineke Kamper several times.
Alone in their end-of-terrace house in Ballinrobe, Co Mayo the couple must have been consumed by fear. Paul lay in bed too weak to move and at some stage Michelle put baby Alan in beside him for comfort. Father and son kissed goodnight for the last time. The 49-year-old Belfast-born picture framer was getting weaker, his voice hoarser and his breathing more and more difficult.
Kamper had told the couple that such shortness of breath meant Paul was having a panic attack. That night on the phone the one-time paediatric nurse told Michelle to give Paul a tablet. A State forensic scientist later analysed the tablets Kamper had given to Paul Howie and found that if they contained any active ingredient it was too low to detect.
"It was like giving a glucose tablet," local doctor Jerry Cowley TD remarked following this week's inquest. As midnight approached on April 21st, 2003 Michelle Howie knew something terrible was happening. She rang her sister and Paul's sister who pleaded with her to call an ambulance. Even then she baulked, reminding them Mineke had warned that Paul would die if he was taken to hospital.
"I was frightened that no matter what I did Paul would die," Michelle poignantly said in a statement to the inquest.
She did not know Paul had cancer, nor did she realise initially that evening as he struggled for breath that he was about to die. Paul had a cancerous tumour in his throat and had shrunk to eight stone but he didn't have a GP. When Michelle was eventually summoning medical help Paul stopped breathing and a nurse on the phone talked the terrified young woman through mouth-to-mouth resuscitation.
When the ambulance arrived Paul was dead.
At Monday's inquest the south Mayo coroner John O'Dwyer said it was clear Paul Howie would still be alive if he had received conventional medical treatment. The consultant pathologist who carried out the postmortem said the tumour was localised and could have been removed and treated with chemotherapy or radiotherapy to provide a longer and better quality of life.
Alan would have had his father for longer than five months, Michelle says.
There are several shocking aspects to this case.
Michelle knows it must seem "ridiculous and off the wall' that she and Paul were so under the influence of this elderly Dutch woman that they defied logic and the relentless pleadings of both their families and refused to see a doctor.
This seems even more incredible given that Kamper, who arrived in Ireland 25 years ago, had come under the spotlight 16 months before Paul's death and just a few months before he first visited her at her bungalow overlooking the sea near Mulranny, Co Mayo.
There has been outrage this week that Kamper ignored a summons to attend the inquest into Paul Howie's death and that the penalty for her non-attendance is a fine of just €6.35. But, more than three years ago Kamper failed to attend another inquest in Co Mayo which followed the death of Jacqueline Alderslade (55), who was secretary of Connacht Asthma Association, from Hollymount, Co Mayo.
Jacqueline, who died as she drove to Kamper's home for a second appointment, recorded in her diary that the health therapist had advised her to give up her medication apart from her Ventolin inhaler. Kamper denied this to the Garda but she refused to attend that inquest and the same coroner, O'Dwyer, made it clear he was less than happy with the law in this area.
In the aftermath of Jacqueline's death a deputation from the Coroners' Society of Ireland met the then minister for justice John O'Donoghue to plead for a change in the law regarding the compellability of witnesses.
This week O'Dwyer found himself in the same "unsatisfactory" position, making yet another plea when Mineke Kamper refused to give evidence once more. "If she had been put out of business the last time this [ the Howie case] would not have happened. It just cannot be allowed to continue," says Dr Cowley, the Mulranny GP who lives up the road from Kamper and who raised these two cases in the Dáil last December.
The public heard this week Michelle Howie's description of how Kamper intimidated her and her husband to such a degree that they were afraid to seek conventional medical help. When Paul collapsed at Kamper's home on his last visit there his wife pleaded with her, asking if Kamper would refer him to hospital when the need arose.
"She said 'oh you can take him to hospital but he will die. Do you want your husband's death on your hands?' " recalls Michelle. "She looked at Alan who was four months old at the time and said 'will you be able to look at him and tell him that you are responsible for his father's death'." On that day Michelle and Mineke had to link arms to help Paul into the house. He collapsed on the floor and Michelle recalls he crawled to the settee as she wept.
This was about two weeks before he died without having received any conventional medical help.
Kamper has refused all media requests for interviews since the controversy erupted this week but locals in Mulranny say she too has known sadness in her life. She arrived in the area 25 years ago with a Dutch female companion who was understood locally to have been a former consultant paediatrician.
Kamper was a registered nurse but she allowed her registration in Ireland to lapse. When her friend became seriously ill with cancer she was treated by Dr Cowley, now one of Kamper's fiercest critics. Sadly, the woman died in 2001 and was buried locally.
Michelle Howie has been struggling for words this week as she is repeatedly asked how she could have been persuaded not to bring her husband to a doctor: a decision which drove a wedge between the couple and their respective families.
It had been a shared love of amateur musicals which brought the Mayo-born bank official and the Belfast man together. Paul had been living in Ballinrobe for 20 years and had immersed himself in community life through the local soccer club. He was involved in the Special Olympics and was stage manager in the Ballinrobe Musical Society. He met Michelle in 1994 when she was starring in the society's production of West Side Story and on their wedding day, October 5th, 1996 Paul remarked that this was their West Side Story.
Early in 2002 Paul complained of a sore shoulder and Michelle suggested he see Kamper who had been working for about 10 years in alternative medicine.
"I had heard of her through word of mouth and had gone to her with minor complaints like sore throats or backache and did believe she helped me," says Michelle.
When Paul developed a swelling on his neck, Michelle recalls, they were quite calm about it, especially when Kamper told them his body was now getting rid of the disease.
When the lump got bigger Kamper told the couple it was pre-cancerous and warned that if anyone interfered with it, it could turn into cancer. As it changed shape and bled Mineke said it was all part of the healing process.
In time both Paul and Michelle's families became perturbed, and frightened for Paul. "They begged us to go to a doctor but she [ Kamper] told us Paul would die if we did. I practically threw my own mother out of our house. I am not proud of that. I am ashamed," says Michelle. At the inquest she made an emotional address to both families, apologising to them and thanking them for being with her.
"We just pushed them away because she was manipulating us and when they tried to warn that Paul would die I just said 'oh, go away. Don't be so ridiculous'." While everyone else was excluded, the contact with Kamper was feverish. Records compiled by the Garda show that in the last two months of Paul's life the couple made 167 telephone calls to her. They rang her almost 400 times throughout his illness.
There has been no contact since he died, a silence which Michelle describes this week as "very telling". She says she can accept that Kamper may really have believed that Paul would die if he saw a doctor or went to hospital. She knows money was not the motive because the couple were charged as little as €2 for doses of tablets. "She should have contacted me since," says Michelle who is now undergoing counselling and says she will have to confront Kamper when she feels able to.
She was startled this week to see the face of Kamper staring out at her from the front page of a newspaper. "I haven't seen her for two years."
It emerged this week that the Garda prepared a file on the case for the Director of Public Prosecutions, but a decision was made not to file charges.
Asked whether she would consider taking a civil case, Michelle asks, "What would it achieve? I just want her stopped. I am begging anyone who is attending this woman to stop. Stop bringing children to her."
Local people say that while Kamper lives on an isolated road there has always been a steady stream of callers there.Some estimate that a dozen cars call each day and Dr Cowley says he believes she is still treating people.
"I would fear that there will be more cases and I believe this could be the tip of the iceberg because this is going on all over the country. I have no problem with complementary medicine if that is what it is, but I have a problem if it is regarded an an alternative to conventional medicine."
Calling for regulation, he points out that there has been a huge wave of interest in alternative/complementary medicine throughout the country, but proper controls are not in place. "When people are vulnerable they will naturally try anything, whether it is faith healers, bio energy or more traditional cures from, for example, the seventh son of a seventh son," he says.
His scepticism is underlined by a story he tells of an asthmatic who thought she had been cured by bio energy - then he got an SOS call from her when she got a bad attack.
Michelle is very clear about the lessons that must be learned from her husband's death. "I want people to stop going to Mineke and to stop bringing their children to her. I want the law changed so that people who are called to give evidence at an inquest have to do so."
She is unimpressed by proposals this week for a €2,000 fine for non-appearance at an inquest. "Liam Lawlor was jailed because he would not co-operate with a tribunal and surely somebody who doesn't co-operate with an inquest into a death should be jailed."
While refusing to condemn all alternative health practitioners, she is calling for regulation whereby practitioners would be licensed and operate to a code of ethics.
As the second anniversary of Paul's death approaches she wants to set the record straight. In her brief statement to the Garda, Kamper said Paul's condition deteriorated because the family could not cope. Michelle had had to cope with a new baby and "a demanding husband", Kamper added.
"Paul was gentle, loving, generous and never demanded anything. Sometimes I think things might have worked out differently if he had been a little bit more demanding," said Michelle.