2018; Volume 19, No 6, June
IAHPC Grants in Action
Last month, we brought you the first reports from some of the 20 Traveling Scholar recipients who attended the the IX Congreso Latinoamericano de Cuidados Paliativos in Santiago, Chile, held in April. This month, we present a roundup from the rest of our Traveling Scholars’ reports from Chile.
International Networking Helps Local Negotiations
Enric Benito (left) with Traveling Scholar Daniel Neves Forte of Brazil, who reports that, ‘Our biggest challenge now in Brazil is to have our Palliative Care National Policy approved. We are facing challenging negotiations, and the international networking, as well the learned experiences of other countries, are helping us a lot.’
All of Us Have Something to Teach, and Something to Learn
Linda Marisol Bustamante Tüchez, Guatemala
At the pre-Congress day, I met many pediatric specialists and talked with others who want to work in pediatric care. Education and advocacy that results from new skills and knowledge can be the strongest drivers to enact change. This experience gave me the impetus and desire to be more active in politics and education regarding palliative care in my hospital but also in my country.
When you bring together a person who wants to work, but does not have the resources, and a person who wants to help, you can see a miracle. All of us have something to teach, and something to learn, and there are many right ways to give comfort to patients.
Techniques and Tool Already Hard at Work
Rebeca Marielos Salandra Cañas, El Salvador
The palliative care service in El Salvador is barely starting to flourish. Even though we have a hospital that provides this service, we are short on knowledge. More than half of residents are not familiar with palliative care, and we have no palliative care training programs. At the Congress I learned practical techniques and started using them, as well as a spiritual evaluation tool, at the hospital where I work.
Listening to how other countries, such as Colombia, are starting to implement ‘compassionate communities’ gave me hope that if we join with our new health foundation and work on awareness we could start spreading palliative care services. I am totally convinced that palliative care is and could be for everyone.
Poster/oral presented: ‘Bienestar spiritual y emocional en pacientes con enfermedad oncologica en cuidados paliativos.’ [Trans. Spiritual and emotional well-being in patients with oncological disease in palliative care.]
Traveling Scholar Maria Luisa Rebolledo Garcia
Self-Care Amid Suffering
Maria Luisa Rebolledo Garcia, Costa Rica
Pre-Congress speaker: ‘El autocuidado de los que trabajamos con el sufrimiento.’ [Trans. The self-care of those of us who work with suffering.]
We must become aware of the need for self-care, due to the constant exposure to the suffering of our patients and their families. We must transmit the importance of self-care to all health personnel of palliative care, to obtain tools and strategies to face the occupational stressors to which we are exposed in our work area, and be able to detect in a timely manner the bio-psychosocial indicators that put us at risk of burnout and compassion fatigue.
Well-Structured Presentations, Good Contacts, Innovative Techniques
Ruth Stefany Yanes Bengoa, El Salvador
The presentations were innovative and interesting — they presented justified information with recent research, especially for the management of symptoms. In addition, the oral presentations of the research papers were very well structured and I had the opportunity to make very good contacts that could help me to develop my abilities. I learned many innovative techniques that are being carried out worldwide for symptoms that are difficult to manage. I also learned new terms that are being used in palliative care, and that identifying them helps to give an integral management of the patient.
Electronic poster presented: ‘Evaluation of the use of lidocaine in intravenous infusion as an adjuvant of opioids for the management of non-controlled oncological pain with a neuropathic component in palliative care.’
The Board of Directors of the Asociación Latinoamericana de Cuidados Paliativos.
Constructing a Roadmap for a National Policy
Anne Marie Liere De Godoy, Guatemala
As co-author of a proposed national policy for palliative care, presented in 2014, it is important to emphasize that policies are the starting point to adopt and apply a national strategy and public health action plan. This is required to face the changing needs of patients.
The needs, gaps, and barriers in Guatemala should be identified so that actions to improve quality of life and dignity during the advancement of cancer and other chronic diseases can be taken. Several studies have been done, and several recommendations — a road map for Guatemala — have emerged.
A Great Opportunity to Introduce ECHO Project
Bernardo Villa Cornejo, Mexico
Bernardo Villa Cornejo, 2nd from right
I was especially interested in a workshop on the Learning Style Inventory [based on a theory of a model of learning developed by David Kolb in 1984] that will be very important in the area of training programs in palliative care. In addition, the conference on spirituality in health professionals was especially important, as Mexico has a strong field in this area. The conference on the Lancet Commission Report will serve as a guide to work in areas of extreme poverty, and the implementation of palliative care services in the first level of care. Furthermore, it was a great opportunity to present my ECHO Project, a tool to improve training.
Poster presented: ‘Cooperación Uruguay-México a través de Proyecto ECHO: Democratizando el conocimiento de cuidados paliativos en Latinoamérica.’ [Trans. Uruguay-Mexico cooperation through the ECHO Project: Democratizing the knowledge of palliative care in Latin America.]
Traveling Scholar Carlos Alfonso Chavarro Dominguez of Colombia presented his poster: ‘Implementation of a Methodology of Excellence in a Program of Palliative Care in Colombia. Description of the Process and its Results.’ He also took the opportunity to join the Education Commission of the Latin American Association of Palliative Care.
‘I Feel Better Equipped to Face Our Obstacles’
Dr. Diane Dykeman Sabado attended with her husband, Rev. Dr. Francisco Sabado.
Diane A. Dykeman-Sabado, Dominican Republic
Practicing palliative care in the Dominican Republic has been challenging, but I left the conference with a new perspective and ready to combat some of these challenges head on. We have created a network of individuals and professionals working in the realm of palliative care. We have decided to meet on a regular basis in different areas around the country to get more familiar with each other’s work, share challenges and build a support system.
Although all the plenaries were excellent, I especially was moved by the pediatric component. I learned so much about pediatric palliative care, and I feel that I am now better prepared to address the specific needs of younger patients and to creatively deal with their parents and caregivers.
After hearing how others have overcome the challenges of lack of education and awareness on palliative care, I feel better equipped to face these obstacles. Up to now, there has been no formal hospice program recognized, and we are excited to begin actively working toward opening a multidisciplinary approach to an organized program for hospice care.
‘We Feel Paralyzed’: International help is important
Ismariel Espin Gonzalez, Venezuela
The main needs we face in our country for palliative care activity is the lack of opioids, the government's resistance to the evidence that palliative care has great sanitary importance, and the blocking of medical updates. We currently do not have government support; we are paralyzed. And it is only the palliative care doctors who provide medical treatment in terms of physical, emotional, spiritual, and social symptoms; and who participate in courses, conferences, and everything related to acquiring knowledge about palliative care for patients. Any international help is of great importance and benefit to our patients, and is invaluable for our doctors. We feel blocked and displaced, and are grateful for help in keeping up to date and bringing a better quality of life to our patients.
Victor Samayoa Morales, MD (far left)
Information Will Aid in Upcoming Ministry Meetings
Victor Rolando Samayoa Morales, Institute of Cancer of Guatemala, Unit of Palliative Care, Guatemala
Education is the key to initiating the changes in our health systems to improve palliative care. The needs of the patients and their families must be comprehensively understood in order to provide support and accompaniment.
Knowledge and tools gained at the Congress will help me to promote the use of opioids and palliative care in upcoming meetings with the narcotics office of the Ministry of Health. In the Institute of Cancer, we seek to improve psychosocial support and address spiritual needs, and will develop to a psychological guide for patients and families. Finally, we are starting an online course in palliative care to help respond to the needs of palliative care in rural areas in Guatemala. We have many challenges! Thank you for your support!
A Spiritual and Biopsychosocial Perspective
Juliana Suárez Cardona with her poster.
Juliana Suárez Cardona, Colombia
From the theoretical and practical knowledge that was made known from the different Latin American countries that participated in the event, our teamwork will be reinforced through highlighting the biopsychosocial and spiritual perspective. It is becoming more common to observe this in patients and their families, which is being emphasized at the investigative level. At the same time, there is a need to carry out more research on palliative care from non-medical professionals (psychologists, social workers, and nurses) to update these approaches.
Poster presented: ‘Evaluación del impacto de un programa de sensibilización y capacitación en cuidados compasivos en un grupo de cuidadores formales e informales de un centro geriatric.’ [Trans. Evaluation of the impact of a program of sensitization and training in compassionate care in a group of formal and informal caregivers of a geriatric center.]
A Thousand Thanks for This Opportunity
Patricia Bonilla, Ecuador
I participated as a moderator in the workshop of researchers and at the symposia of palliative care in vulnerable populations and the importance of primary care in palliative care. In addition to learning from the experience of so many Latin American professionals, the Congress allowed me to strengthen ties with different groups and to know not only different forms of work, but also charming groups and people. It was an enriching experience and will allow us to continue strengthening palliative care in Ecuador. A thousand thanks for this wonderful opportunity!
The Next Steps in Palliative Care Integration: Sustainability and reach
Clarisse Musanabaganwa, Rwanda
As Rwanda has already made tremendous steps in the integration of palliative care in the health system, the conference has opened my mind to think about palliative care program sustainability. Moreover, the skills and knowledge that I gained from the conference have oriented me to give more attention to the quality of palliative care services in Africa and also to think about how vulnerable groups, such as children, can be considered with special care while delivering palliative care services. In addition, the skills and networks gained during the meeting have helped me to think about advocacy of prioritizing enhancement of public health perspectives in Rwanda as one of the strategies to tackle the challenges of palliative care delivery, such as limited financial and human resource capacity.
Poster presented: ‘Evaluation de la prévalence des maladies limitatives et des besoins institutionnels pour le programme des soins palliatifs au Rwanda, 2017.’ [Trans. Assessment of the prevalence of limiting diseases and institutional needs for the palliative care program in Rwanda, 2017.]
Congress Has Improved Hospital Management
Erika Hernández Guevara
Erika Hernández Guevara, Mexico
I work in a hospital for people who have many educational, social, and economic shortcomings, with late diagnosis of their illness, many times in terminal preventable stages. The need for optimal palliative care is imminent and yet is a labor of very few trained people. Meetings such as this Congress let us know how other professionals have solved situations similar to ours.
The hospital that recently hired me had a Clinic of Pain and Palliative Care, but integral attention was not given to the terminal patients. The Congress taught me how to better manage better the clinic, how to clarify objectives, and address specific needs. My formal education did not include pediatric palliative care; the Congress had a whole amazing section about palliative care for children.
Poster presented: ‘Conocimiento de los conceptos “voluntad anticipada” y “cuidados paliativos” entre los familiares de los pacientes ingresados a una unidad de cuidados intensivos.’ [Trans. Knowledge of the concepts ‘anticipated will’ and ‘palliative care’ among the relatives of patients admitted to an ICU.]To find out more about IAHPC’s Program Support Grants, and our Traveling Scholarships and Traveling Fellowships, 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 to the Traveling Scholarships Campaign in the Global Giving website.