Manan:  Big Liver. Even Bigger Heart.

Image for Manan:  Big Liver. Even Bigger Heart.

After spending half his life in hospitals fighting leukemia, Manan’s liver and pancreas failed, and our precious little friend died. (The Tirados wrote about Manan in the October 2023 issue.) Manan had wanted to become a teacher for Jesus, and he was sweet and smiling to the end.

Manan’s mom and dad, Srey Neang and Vanna, had made innumerable long trips into the city over the last five years and spent countless months sleeping under his bed in the crowded hospital. They had slowly lost everything to cover expenses.

A year ago, Manan was declared cancer-free and sent home with a follow-up appointment set for a year later. The doctors had said Manan was a rare success story and that the way his bones had started making blood cells again after the chemotherapy was better than one in a thousand cases. They had said Manan just needed physical therapy to regain control of his legs. Other patients whispered to them about a place with fancy techniques and equipment. Srey Neang took him there for therapy sessions costing forty dollars an hour, and the clinic guaranteed he would be walking again in a month or two. She borrowed money to cover the costs, as she had done many times over the years, but this time she did it out of false hope.

However, because of various health issues, his family frequently returned with Manan to the hospital for further treatment.
On one of his short stays at home between hospital visits, Srey Neang had let him ride his bicycle. A ten-year-old boy, Manan loved the freedom of riding around the neighborhood and enjoyed several days of biking. Unbeknownst to them, his brain was swelling, causing him to lose his motor skills, and he crashed. A few days later, he lost his ability to walk. His mom thought the brain swelling resulted from his crash and, therefore, her fault for letting him ride. (We now understand it was likely the other way around, with the brain swelling as a reaction to the chemo.)

Again, they returned to the hospital. Doctors told the family that Manan was fine and just needed to continue with physical therapy. Broke, exhausted and entirely in the dark about his true condition, Srey Neang brought him to us.

“If the doctors say he is fine, why are his headaches so bad, and why is his abdomen so painful?” she asked. “They do not share diagnoses or results from bloodwork, scans, or other tests with me. The picture of one of Manan’s x-rays that I sent you was possible only because I photographed it when the nurse was called away from her desk.”

So Carly Tirado evaluated him and consulted with her doctor friends. She could tell right away that his huge belly was not fat gain from his diet or from being unable to run and play for so long like other children. We sent him to the Christian-run Mercy Medical Center (MMC) in Phnom Penh. They told us his bloodwork showed that either the cancer had returned or he was in the final stage of liver and pancreatic failure. They referred him back to the same hospital, the only one in Cambodia that deals with these cases. The medical staff there were wide-eyed when they saw a referral letter from MMC, and they changed their tone. After running tests and discussing the results, they brought a Buddhist chaplain to the bedside and told Manan and his family to prepare for the end.

In total disbelief after previously receiving the cancer-free diagnosis, the family came to stay with us. We did hot and cold baths and fever treatments. We got his temperature up, wrapped him in blankets and put him straight to bed. It gave him some relief. We held an anointing service. We also played games with him, took him on cyclo* rides, and told him Bible stories, which he loved. He talked about them often.

Srey Neang said that her life caring for him for the last five years had been like a prison without walls. If she didn’t need to be at his side, she didn’t want to see anyone or eat anything. She only wanted to sleep for a whole month.

Because Manan seemed stable, Srey Neang and her husband decided to return home to earn money to pay the mounting bills and support themselves and their other children. At home, they continued the fever treatments in a big mortar-mixing tub we gave them.

Our family and the Tirados then left for the scheduled Southeast Asia retreat, hoping to soon be back for them. While we were gone, Manan revived a little and asked to send us a message. In his sweet little-boy voice, he thanked us for all our love, said he missed us and asked when we would be back. Manan tried to hold on until we returned but didn’t make it. He wanted us there surrounding him. We received voice messages from Srey Neang, barely audible because of tears, in one saying, “Of all the times you had to leave! Why weren’t you here for me when I needed you?”

After we arrived back in Cambodia, our family and the Tirados rushed to them. The dam of tears broke all around. We spent the late afternoon around the grave sharing memories. Manan’s parents told us he was not scared to die because God had prepared him with a beautiful dream. He even saw that there would be two friends buried next to him and stillborn twins buried beside him on the same day.

As I write this article, their grief is so raw they can’t think. They can’t breathe. They lost the precious boy who had been the focus of their lives. This, after a year of repeatedly being told Manan was cancer-free and had a clean bill of health, only to eventually receive the truth from the hospital after first going around them to another who gave a more accurate and honest answer.

The forty-day memorial takes place tomorrow, and we will not miss it. Srey Neang is hosting a meal called a jemu to thank everyone who comes to the three o’clock prayers for Manan at the mosque. Then they will have a few days to prepare their things before moving here for a little retreat. Srey Neang has some urgent health concerns long overlooked while Manan was sick; she couldn’t leave him. She is supposed to receive ongoing treatment for a cyst but has missed many appointments and run out of prescriptions many times.

Pray that we can use this time together to disciple Srey Neang into a soul winner with a vision to reach her people for Jesus. Pray that Vanna will take a stand for Christ. Pray that the testimony of what God has done for them will be too good not to share.

*A cyclo is an iconic Cambodian three-wheeled bicycle used as a taxi (

Be the first to leave a comment!

Please sign in to comment…