Grants in Action: Reports from Indonesia & Botswana

IAHPC sponsored 10 doctors from Indonesia and three healthcare workers from Botswana to attend conferences organized by their palliative care associations. This IAHPC Scholars program is one element of IAHPC's continuing commitment to improving country-wide access to, and knowledge about, palliative care.

Read some of what they learned and how it changed their practice from their reports, below.

The 1st National Congress of the Indonesian Palliative Physicians Association was held in Bandung in November. While Indonesia's nursing schools include palliative care as a mandatory subject, physician training is lacking and opioid availability is poor in all but urban areas, where the 2025 Atlas of Palliative Care in the Asia Pacific Regions describes it as "fair."

Steps Taken to Advance Awareness At All Levels

By Kevin Wietmond Rebo, MD
Prof. Dr. W.Z. Johannes Public Hospital Kupang, Indonesia

The Indonesian Ministry of Health passed a regulation in 2023 to establish palliative care services country-wide, which palliative care stakeholders are working to fulfill by creating the necessary infrastructure. I learned that palliative care is absolutely essential in treating chronic patients with catastrophic disease, to maintain quality of life for both the patient and family at any stage of the disease.

I attended a workshop that gave me more knowledge about how to perform subcutaneous hydration and therapy; I also attended a symposium on improving access to—and the rational use of—medicines such as opioids. I plan to strengthen communication among other palliative centers in Indonesia, as well as my own. Also, since the congress, I have met with a city official to discuss coordinating palliative services in Kupang City; provincially, my team and I spoke with the governor's spouse, who is very concerned about cancer treatment. I hope that leads to opening the door for speaking with the governor, with the goal of establishing an integrated palliative care service. 

I plan to research the number of cancer patient that have died with an "undiagnosed condition" (i.e., no biopsy, no palliative treatment, etc.). I believe that this data will help in advocating for palliative care services in our hospital and our country.

Other voices in Indonesia

Dita Prawita Sari. Photo used with permission.

"We have opioids in our hospital. But the use of opioids is still very low and often inappropriate. I plan to conduct in-house training on the proper use of opioids in palliative patients or those experiencing severe pain."

—Dita Prawita Sari, a physician at Rumah Sakit Baptis Batu in Kota Batu 

Janu Aji Patri. Photo used with permission.

"I learned that palliative care should start early, when the patient is declared to have a progressive or incurable disease. [And] opioids are the mainstay therapy for cancer pain."

—Janu Aji Patria, a resident of internal medicine at Moewardi General Hospital in Surakarta

Eriza Patih. Photo used with permission.

"A session on advocacy emphasized the importance of engaging government officials in efforts to integrate palliative care into national health policies. I plan to build and strengthen collaborative relationships with government officials by initiating regular communication through meetings and consultations, discussing existing gaps in palliative care services, and presenting evidence-based recommendations."

—Eriza Patih, part of the palliative care team at RS Mohammad Hoesin in Palembang

Reports from Scholars in Bostwana

Three IAHPC Scholars attended the 8th International African Palliative Care & Allied Services Conference held in Gaborone in September 2025. The four-day conference was geared to "spotlight the pivotal role of palliative care in achieving the United Nations' Sustainable Development Goals," which include: good health and well-being, reduced inequalities, and partnerships.

A Commitment to Action Can Solve Problems

Goitseone Abel Setlhake, registered nurse in Gabarone. Photo used with permission.

"I intend to involve palliative care professionals in training prescribers, nurses, and pharmacy personnel in the safe and rational use of palliative care medications. I also intend to improve a referral system that encourages nurses and doctors to refer and/or consult early with the palliative care team to ensure proper assessment and prescription of the right medications and dosages, reducing wastage with prescriptions that are not effective.

"One takeaway for me was that the many challenges of palliative care in Africa, including a lack of national policies in many countries, inadequate funding, and poor access to opioids, can be managed and improved by adopting strong policies, building capacity, and implementing community-led approaches."

—Goitseone Abel Setlhake, a registered nurse at Sidilega Private Hospital in Gabarone

Montebatsi Mautle with her poster. Photo used with permission.

"To strengthen relationships with government officials, I will align our messaging with national priorities like Universal Health Coverage and noncommunicable diseases. I aim to engage in regular dialogues with the Ministry of Health, particularly regarding the Integrated Community Home-Based Care Program and palliative care initiatives, sharing brief policy discussions and evidence summaries to support our objectives. I also aim to build connections with district health officials, social workers, and clinicians through joint activities like training sessions. 

"By sharing data and case studies from the conference, I hope to influence policy decisions effectively."

—Montebatsi Mautle, a nursing officer and community health nurse specialist at the Ministry of Health & Wellness, presented her poster: " Facilitating a Seamless Transition from Hospital to Home-Based Oxygen Therapy for Oxygen-Dependent Palliative Care Patients in Greater Gabarone District, Botswana."

Family physician Naledi Radikara. Photo used with permission.

"The launch of the African Palliative Care Research Centre of Excellence offers renewed hope for generating locally derived evidence that reflects our cultural, social, and healthcare realities. It marks a critical step toward strengthening context-specific research, ensuring that our policies and practices are grounded in the lived experiences and capacities of African communities."

—Naledi Radikara, a family physician at Deborah Retief Memorial Hospital in Gaborone, also delivered an oral presentation: "Evaluating the Outcomes of Cancer Patients Receiving Palliative Care in Botswana."