2016; Volume 17, No 10, October
IAHPC Traveling Scholars’ Reflections – 5th African Palliative Care Conference
In August 2016, IAHPC members from Africa and South America received grants to travel to Kampala to attend the 5th African Palliative Care Conference hosted by the African Palliative Care Association and the Worldwide Hospice Palliative Care Alliance.
As a requirement of the scholarship, grantees deliver an oral presentation and/or a poster and are asked to give a glimpse of palliative care in their countries and how they hope to adapt some of the knowledge and experiences gained at the congress to their own settings. To complement the report on the previous page, we publish a selection of comments from other traveling scholars from Benin, Ghana, Guyana, Nigeria, South Africa, Sudan, Tanzania and Zimbabwe.
Three great lessons
Dr. Anita Eseenam Agbeko, Department of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana
The palliative care team in Komfo Anokye Teaching Hospital has been in existence for about three years. It is a challenge to meet the demand for palliative care in the hospital because the team is small and members have to perform other clinical duties as well as palliative care. Also, the team’s proficiency in providing spiritual, psychosocial and other specialized care is limited. But in spite of these challenges, the team has persevered and maintained its presence in the hospital. Workshops to raise awareness of palliative care have resulted in a gradual increase in referrals to the team, and a weekly outpatient clinic now sees on average three to four patients a week.
Dr. Agbeko gave an oral presentation at the conference: ‘Palliative care training as a process not an event’
Anita describes the important learning points she gained from the conference.
“The conference was a good experience that offered some insights into how the palliative care service in my hospital could be improved. I learned three great lessons.
- However small the team, we have a great potential to cause change. Meticulous documentation of all our work could be a powerful tool and the data we generate is evidence to convince our hospital management to invest more in the service. Moreover, publishing it (however small the platform) could draw potential collaborators who would support our development agenda. Although we are few, we could still train other people (even one person at a time) and mentor them to provide palliative care through our daily interaction at work.
- Advocacy is an indispensable part of any palliative care service. Concentrating on clinical care alone is not enough for team growth. Advocacy has to go beyond medical circles to include the communities our hospital serves.
- National and regional collaboration provides the avenue to share best practices and provides a stronger platform for advocacy and initiating change.
The conference was a good opportunity to explore and initiate potential partnerships for the future... growth cannot occur in isolation. Coming from a small team into the company of experts can feel intimidating. But I have learned that people are happy to celebrate one’s ‘little’ successes, and are also willing to see how they can help you grow better.”
Research is best done in a team approach
Dr. Clint Cupido, Victoria Hospital, Cape Town, South Africa
Clint Cupido (left) beside his poster, ‘IMPAQT study, incorporation of palliative care through audit and quality training’, with Prof. Keri Thomas, Founder and National Clinical Lead of the Gold Standard Framework.
Clint has established the Abundant Life Palliative Care program in Cape Town, which he describes as one of the first hospital-based and integrated palliative care programs in South Africa. He identified that the most neglected group of patients for palliative care were the non-HIV and non-cancer patients and started with organ failure patients including those with heart, kidney, lung, liver and brain failure conditions.
“I attended the research workshop and this was practical and encouraging. As an advocate for palliative care in chronic disease and non-communicable disease through Abundant Life (organ failure palliative care), I was part of the team discussing heart failure. This was a fascinating process. Interacting in a team with members from different backgrounds resulted in different approaches to the same questions. Being a clinician with no interaction with researchers I realized my limitations and their [the researchers’] ability to analyze the clinical scenarios from such different perspectives. Clearly research is best done in a team approach.
Having the opportunity to network with everyone in one place was probably immeasurable.”
Patients are the greatest beneficiaries of new skills
Dr. Andrew Amata, Guyana
Andrew explains that Guyana is a low-resource country and the only English-speaking country in South America. A combination of the vast landscape with poor transport and communication, and very limited medical and social services, makes provision of palliative care a challenge. He is pictured below delivering his presentation at the conference: ‘Implementation of an integrative comprehensive palliative care service in a community oncology centre in a developing country’.
“My patients are the greatest beneficiaries of my newly acquired knowledge and skills. I have started integrating into my practice some of the new, effective and innovative therapies and techniques I learnt. I am now a better advocate for palliative care especially to administrators and policy makers.
“My trainees and colleagues are also being better informed and educated because of my greater knowledge and skills.”
Finding the strength to get more involved in palliative care
Dr. Kouessi Anthelme Agbodande, Benin
Dr. Kouessi Anthelme Agbodande visits the IAHPC booth
Dr. Agbodande presented ‘Benin’s experience on introduction of palliative care in national health facilities’. He explained the struggle to integrate and develop palliative care in a country where there is a lack of funding, a lack of staff dedicated to palliative care and limited access to oral morphine and other medicines.
“This meeting allowed me to share with others the experience of Benin in the palliative care field as well as disseminate what we do. This conference was an opportunity for us to learn from the experience of other countries in order to improve our practice.
“The recognition of our efforts by others, gives us the strength to get more involved in palliative care. We will improve our method to seek funding for palliative care and work to integrate palliative care as part of the health system in Benin.”
New ideas and inspiration
Eunice Garanganga, Zimbabwe
Eunice commented on the further advocacy skills that she had acquired at the conference:
“Being able to engage donors by actually using their own language . . . The strategies of using beneficiaries of palliative care as change agents is key as they bring credibility into the issues relating to palliative care. I will use the skills to involve everyone, taking into account some of the language that hinders palliative care conversation.”
“A wonderful conference with lots of new ideas for the betterment of palliative care . . . inspiration from what others are doing and achieving in palliative care service delivery which pushes one to follow suit.”
Eunice added that IAHPC is doing a wonderful job in supporting people to attend activities that add value to palliative care.
Bringing important ideas and solutions
Shaimaa Siddig Alfki Ali, Khartoum, Sudan
For Shaimaa (pictured below on the right), a highlight of the conference was the chance for discussion with Dr. Anne Merriman during the launch of the Anne Merriman Foundation.
“The conference was characterized by really interesting sessions and discussions that were inspiring, bringing important ideas and solutions to many of the challenges that face palliative care and hospice at the local, regional, and international level.”
Palliative care – not a privilege for a few, but a human right for all
Elvis Joseph Miti, Uzima Project Ndanda, Tanzania
For Elvis this was his first time at an international palliative care conference, where he presented a poster on blended community-based palliative care in rural Tanzania and an oral presentation on the effectiveness of memory work therapy for HIV-positive orphaned children.
“I had the opportunity to meet a large number of scholars, researchers, beneficiaries and others who are working hard to find the best way we can improve palliative care in Africa.
“I have this growing feeling that I am, in fact, doing the right thing at the right time and at the right place. I had the time to appreciate the different efforts of different individuals and organizations to ensure that the World Health Organization gives weight to the different efforts of palliative care services, and it was nice to see different governments making efforts to confirm that palliative care is not only a privilege for a few people but a human right for all.”
Inspiring the need for advocacy, sensitization and education
Abiola (left) discusses her poster, ‘Home-Based Palliative Care at The University of Ilorin Teaching Hospital Nigeria: Experience and Challenges’.
Abiola Omowumi Durojaiye, Department of Nursing Science, University of Ilorin, Nigeria
“As a clinical palliative nurse/lecturer from a limited resource country, l observed that palliative care services have not been fully rooted in my country. The few hospitals that are practicing palliative care are limited to hospital-based care with very few offering home-based care. This is not adequate for a country with a population of more than 170 million and millions of people living with HIV/AIDS and non-communicable diseases that require palliative care.
“My new knowledge and skills acquired at this conference will help me to form a team that will find a means of connecting the influential ‘Big Boys’ in the country that can link us to the policy makers and the Minister for Health, hence allowing advocacy, sensitization and education on the need to strengthen palliative care services in Nigeria.”
Congratulations to the African Palliative Care Association and the Worldwide Hospice Palliative Care Alliance on a most successful conference and our thanks to the Traveling Scholars who contributed to this article. For reasons of space, comments have been edited and are limited to one per country represented.
To find out more about IAHPC’s Traveling Scholarships and other opportunities, please visit our website. Through these programs we support projects and individuals around the world, especially in developing countries in Africa, Eastern Europe, Asia and Latin America.
You can contribute to this program and help palliative care workers attend and participate in congresses and courses by donating the TS Campaign in the Global Giving website.