IAHPC Traveling Scholars’ Reports
From Argentina
Visit to the Palliative Care Department at MD Anderson Cancer Center and the Houston Hospice
Thanks to a grant from IAHPC, I was able to travel to Houston this past November and spend some time visiting and learning at the Palliative Care Department at MD Anderson Cancer Center and the Houston Hospice.
My visit to the different palliative care settings in Houston can be summarized as a journey through unique programs in which good palliative care has been achieved. Both, the Palliative Care Department at M.D. Anderson and the Houston Hospice visits were rewarding experiences for me. It was impressive to observe how smooth the transition is from a palliative care unit, where patients with complex symptoms are initially admitted and treated, to the hospice setting where, in a peaceful environment, patients are able to say goodbye. I had the opportunity to visit patients’ homes where a multidisciplinary hospice team cares for American as well as a large community of Latino patients who live in Houston.
I want to emphasize the great program developed at M.D. Anderson by Dr. Eduardo Bruera and his colleagues. I was able to experience the benefits of excellent clinical assessment and symptom management. I spent a number of hours talking with Dr. Bruera, mainly about research, but also about diverse palliative care issues. This was most useful, since I usually meet him in crowded Forums where in depth conversations are difficult. Furthermore, and also very important to my research objectives, I had an opportunity to discuss a number of research protocols with principal investigators. The culture of clinical research at the department is amazing, but what is most remarkable is the way they look at complex research questions through the lens of simplicity.
During the visit to the Houston Hospice, the staff under the leadership of Dr. Sue Krauter, made me feel at home. I was able to attend a wonderful team meeting where communication between doctors, psychosocial professionals, priests and volunteers was met with respectful attention. I made some home visits, visited the in-patient hospice and had interesting conversations with Dr. Krauter about service organizations and quality assurance.
Finally, I do not want to end these comments without the mention of having spent a full Sunday at Liliana De Lima’s home where we passed the hours working on issues related to the Latin American palliative care movement, its connections with the rest of the world and how to obtain support that IAHPC provides to our region.
The experiences accumulated during my visit to Houston will help me in several ways. Having been involved in palliative care research for several years, and appreciating how good research can improve clinical practice, I left Houston with a feeling of responsibility to continue spreading the culture of research at the national and regional level in Latin America. Additionally, I came home with a suitcase full of projects based on collaborative work between regional teams and more developed centers. The commitment of Eduardo Bruera to Latin America is not new, and the perspective of collaborative work will surely benefit palliative care for all of us living to the South. On the other hand, being at the hospice and observing how important palliative care assistance is to cancer, and non-cancer patients, made me reflect on how I might reinforce, with my regional colleagues, the various initiatives necessary to make palliative care available for all those in need, irrespective of their diagnosis - something that has not yet happened in our region.
I am very grateful for the support I received from IAHPC which made this experience possible. The Traveling Scholarship program has enabled other palliative care practitioners from developing countries, like me, to gain experiences which will benefit many patients and families living in resource poor countries. I hope that many more organizations across the world will follow the example of IAHPC and its Traveling Scholarship Program.
Jorge Eisenchlas, MD
Coordinator Palliative Care Program, Hospital B.l Udaondo
Director, Research Task Force - Latin American Association for Palliative Care
Buenos Aires, Argentina
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From Zimbabwe
Thanks to a grant received from Help the Hospices in the UK and a Traveling Scholarship from IAHPC, I was able to participate in a course called Tutorials in Research (Master’s Program) and the HPCA Conference “The Winds of Change, August 2006, in Cape Town and Port Elizabeth, South Africa.
The training provided a unified understanding of research in palliative care and clarified crucial aspects such as ethical issues especially in dealing with vulnerable groups such as children. Having identified gaps in palliative care for children, I have developed a research proposal on “Palliative Care Needs of Stage 3-4 AIDS Children in Zimbabwe ” which is ready for submission to the Research Committee at Cape Peninsula University of Technology. I will conduct research in 2007 once the proposal is approved. The aim is to inform the Zimbabwe Public Health Sector of palliative care health needs of children with AIDS (stages 3-4). It is anticipated that as a result of the research findings, strategies will be put in place to promote the availability of palliative care for all in need, including orphans and vulnerable children. The course helped me to build a foundation on which practice is based on reliable evidence and information that is consistent with health science research. I will encourage and mentor other palliative care providers to apply evidence based practice in the following areas:
--Focus on developing knowledge of the care of people in health and illness, and in particular palliative care
--Emphasise the development of a fund of knowledge, policies and systems to deliver effective and efficient palliative care and
--Develop ethical guidelines to deliver services that can fulfill the profession’s current and future mandate.
--At the HPCA Conference “The Winds of Change” held at Port Elizabeth, in August 2006, effective sharing of information, particularly on palliative care for children, was the theme of the Advocacy Workshop and helped me to strengthen my ability to advocate for children’s issues.
Palliative care is a new area in many developing countries which means that qualified palliative care workers are few in number and require assistance with training. I am very grateful with HtH and IAHPC for their support.
Eunice Garanganga
Hospice Association of Zimbabwe (HOSPAZ)
Harare, Zimbabwe
January 7, 2007
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