Palliative care trainees in Koudougou, Burkina Faso, and their trainer, Dr. Eric Some (center right, in the blue shirt). Photo used with permission.

It's a Start! Burkina Faso LEAD project trains 33 in basic palliative care

By Alison Ramsey
Pallinews Editor

Putting forth a proposal for the Leadership Development (LEAD) program tends to bring out the optimist in applicants. 

In keeping with IAHPC's mission, successful applicants often hail from countries with limited access to—or public knowledge of—palliative care, that lack essential palliative care medicines, and have few, if any, hospice services under way. This was the case in Burkina Faso and its application by the country's sole palliative care provider, Groupe de Recherche et d'Actions Sociales/Centre médical Clinique du Bon Sauveur, written by project coordinator Dr. Eric Some.

The four LEAD grantees are at the end of IAHPC's $2,500 USD, two-year commitment, and Some's initial optimism has been tempered by unexpected difficulties, government setbacks, and enthusiastic people who haven't the resources to devote their time to the cause, despite wanting to.

The spirit is willing

"Everyone is sensitive to the question, and they are immediately willing to do something," he says. "People react with emotion, then realize the challenges. They have to spend their time without earning anything in return, and they are not rich people." Financially, spending time volunteering just isn't feasible.

Bumps along the way

Further complicating factors have included:

• a revolving door of Ministers of Health, thwarting attempts to draw palliative care into the public system of primary care, or even to get a meeting with a current minister
• an influential regional chief who is supportive, but unwilling to proclaim it publicly; the good news is that he has promised to advocate behind the scenes, and agreed to help arrange a meeting with the Minister of Health
• public hospitals that have a supply of morphine, but cannot—or will not—share it; while another source of morphine is said to be available, it is never ready when contacted

A palliative care patient cared for at the Bon Sauveur clinic. Photo used with permission.

Many more than expected now trained

One big success has been the interest in palliative care training in the three municipalities targeted. The goal was training 15 in all: five for each city. Instead, the organization trained 33. Some made it as easy as possible by holding the training sessions in each of the communities, which are not geographically close. "They didn't have to pay for transportation, or a hotel," he says. "We asked anyone interested to join, then we will select five to work with." The training of additional people won't go to waste: those working in health care the skills will be useful on the job, and the new knowledge all acquired can make them effective local advocates.

The private sector is the new focus

Despite the project coming to an official end, "I have to continue," says Some. 

The focus now, he has decided, is to "preach by example and by proofs." Since the public sector is not ready to implement palliative care, it must begin in the private sector, he adds. Some is also talking about forming an official association, which will help pave the way to accepting donations and fostering local knowledge, support, and trust of palliative care.

Read more of this week's issue of Pallinews

October's Rich Harvest

Katherine Pettus' monthly advocacy roundup covers World Day, SECPAL's congress, a new network for young doctors, three WHO meetings & more.

In Practice

Member Stories & Insights

These are two sayings that we found helpful at our community palliative care intake office:

"She is at the crossroads and will declare herself in next day or so." It is used when the family is unsure if the end of life is happening, and is unsure how to proceed. They are usually in a realm of struggling to accept the decline in condition, and often wanting to push fluids, etc., when acute symptom management has been given and it is unclear if the person has responded.

“How about you let your mum guide our practice here." This was useful when a son was struggling with his mother's refusal of food and fluid. It worked magic in a gentle way.

—Bronwyn Lee, Eastern Palliative Care, Royal Melbourne Hospital, Australia

In Practice features anecdotes and advice from IAHPC members. Do you have something to share? Send it to the Pallinews editor at: [email protected]

Plus

Community & Home-Based Palliative Care This topic is the focus of the most recent issue of Barry Ashpole's Literature Search, divided geographically with sections on Africa, Asia, Australia, central Europe, India, Korea, North America, Scandinavia, and the UK.

Care Seminar Online Did you miss IAHPC's October seminar on the UN's International Day of Care and Support? Now you can view it online.

IAHPC resources

Always available to all

Pallipedia The free, online palliative care dictionary consulted by tens of thousands of users each month. The top five terms searched this year have been: percentile, evaluation, community health, overflow diarrhea (spurious diarrhea), and medical condition.

Always available to members

IAHPC's Comprehensive Basic Pain Assessment and Management Course, 9 modules including essential analgesics for pain management, opioid therapy, neuropathic and musculoskeletal pain, and the role of the pharmacist.