Just $5,000 (33 million guaranies) paid all expenses for the 41 who attended, even compensating them for lost wages for the weeklong course.
All photos courtesy of the Santa Maria Education Fund; used with permission.

Accidental Advocacy: How a chat after church in England brought palliative care training to Paraguay

By Alison Ramsey
IAHPC Pallinews Editor

During coffee hour following a mass in London, two strangers fell into a conversation about England's proposed legislation on assisted dying working its way through Parliament.

The class took up a collection to give Dr. Leticia Viana a locally crafted pencil case.

Author Margaret Hebblethwaite told the person she was talking to that she had spoken with Cicely Saunders for an article, and learned that agony doesn't have to be part of dying. That wasn't news to the listener, IAHPC's Senior Director of Advocacy and Partnerships Katherine Pettus.

Answers to that common question—"So, what do you do?"—turned the conversation to Paraguay. It is Hebblethwaite's "second home," where she founded the Santa Maria Education Fund (SMEF), which had provided training scholarships for nurses and social workers. Pettus told her that the country lacked palliative care, and that training nurses and social workers could change lives. "I thought, 'That is something SMEF could do and that I would like us to do,'" said Hebblethwaite.

That conversation took place in 2024. It didn't take long for the idea to flourish and the funds were available, but it took many months to find a key person: someone willing to take on the responsibility—and had the enthusiasm—to construct the course content and find other experts to round out the teaching.

Finally, in October 2025, Hebblethwaite met for a coffee with Dr. Leticia Viana, head of palliative care at the country's National Cancer Institute, president of the Paraguay Palliative Care Association, and the person in charge of making the government's commitment to country-wide availability of palliative care a reality. 

They talked for two hours.

What $5,000 can accomplish

The result? In January 2026, 41 participants, mainly nurses, attended a full week of training. SMEF supplied or paid for the space, meals, housing, and all expenses, including money for attendees' lost wages, an astonishing result for $5,000 USD.

"The seminar had a big impact," reported SMEF's Alice Holden. A nurse participant, who also teaches, said, "It exceeded far more than just expectations: it generated a feeling of wanting to know more. I didn't think it would be so rewarding." Another nurse participant sent their thanks afterward, saying, "It taught me so much that I should have known, but didn't."

"It was money well spent," concluded Hebblethwaite. "We have this new contact now, and people are asking when we're going to do the next seminar."

Pettus describes that accidental meeting after the church service and its happy result as "Holy Spirit on the job!"

The happy, proud group after earning their certificates for the 40-hour course in palliative care. "We learned many things," said one participant, "including that cancer is not cured but, rather, treated and managed in order to live a better life to the end."