International Association for Hospice & Palliative Care

International Association for Hospice & Palliative Care

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Promoting Hospice & Palliative Care Worldwide


2006; Volume 7, No 5, May



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Liliana De Lima, MHA

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Litein, Kenya

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Litein, Kenya

by Susan Breiddal
Victoria, Canada

Thanks to a Traveling Fellowship grant from the International Association for Hospice and Palliative Care (IAHPC), I was able to travel to Africa as part of a training team working with palliative care physicians, nurses and health care workers.

I am a transpersonal psychologist with a background in child protection social work. As a counselor in private practice over the past 25 years, I have been witness to many people’s painful stories, as well as to the healing and transformation of that pain. In 2005, I joined Hold Me Africa, ( ), a team based out of Agape Hospital in Calgary.



Hold Me Africa consists of volunteers from Agape Hospice in Calgary , Canada . This wonderful group of people came together to create awareness, community and financial support for hospice work and education in Litein , Kenya .

Hold Me Africa plans to accomplish this by working with local people to address the needs of people suffering terminal illness, their family and their community. The specific agenda includes:

  • Developing a hospice program reflective of and appropriate to the Litein community
  • Building awareness for the project locally, nationally and internationally
  • Donating and shipping medical equipment and supplies, medicine and computer equipment (and other items as requested)
  • Engaging in volunteer exchange



In September of 2004, AIC Litein Hospital proposed to have a comprehensive Palliative Care Program with support from “Hold Me Africa” partners in Canada.

In November 2004, members of the Hold Me Africa team visited Litein Hospital and met with the staff and Board to continue to explore collaboration between the two groups. In this meeting, Litein Hospital Staff and Board expressed a desire to build a separate hospice building in order that the terminally ill could be cared for as inpatients with quality palliative care.

During the first volunteer hospice training, Litein hospital trained approximately 30 volunteers. The plan was to use these volunteers for a proposed outreach program with coordination from the hospital. Their key role would be to identify issues and concerns, bring them to the attention of the nurses, doctors and counselors at the hospital. Hold Me Africa then proposed to bring a group of volunteers to work with the existing group in Litein.

The Hold Me Africa team met with the African Palliative Care Association

(APCA) in October 2005. Hold Me Africa decided to collaborate with APCA to provide an introductory training session for hospital staff in Litein.

An assessment of need in Litein indicated the prevalence of terminal cancer and AIDS in the community of Litein, and the need for a comprehensive palliative care program. The most common symptoms experienced by patients with terminal illnesses were severe, uncontrollable pain, and spiritual, psychological and financial distress.

The survey resulted in a recommendation of a well-established inter-sectoral collaboration on health education and home based care that includes support and care programs. For this reason, the partners decided to provide a joint training program by Hold Me Africa and APCA for hospital staff and surrounding community health providers.

- waiting at the gate of the Litein Hospital



Hospital staff in Litein, APCA, Nairobi Hospice and Hold me Africa hosted a joint training program. I was one of the facilitators on a team that included a multidisciplinary team from Nairobi , Litein, Calgary and APCA. APCA prepared the materials and provided electronic equipment for power point presentations, and participant training manuals. These were the stated objectives of the training:

  • To introduce and ensure an understanding of the concept of Hospice and holistic Palliative Care as it applies to the Litein region.
  • To empower/strengthen Health Professionals with basic knowledge and skills of developing and implementing appropriate Palliative Care services in Litein that are based on existing experiences within Kenya and elsewhere in Africa.
  • To integrate key components of Palliative Care into existing hospital and home-based care programs in Litein.
  • To empower and encourage participants to advocate locally for Palliative Care and to especially promote morphine availability and use in Litein.
  • To facilitate collaboration and networking between Litein palliative care program and other existing palliative care programs in Kenya .
  • To make recommendations for key plans and the way forward to the development of a comprehensive Palliative Care program in Litein.

The course was very thorough and I was delighted to see that the content was so current and accurate and very much in line with my understanding of good palliative care. Facilitators from APCA were organized, dynamic and capable teachers as well as being humorous and charming people. Working with them was very satisfying and definitely a highlight of my trip. Being a colleague is an honour. In general, the Kenyan and Uganda people were welcoming, open and eager to share their knowledge, and were very keen to learn. They were the most hospitable people that I have ever met.

 - Calgary stampede breakfast

While we were in Litein the HOLD ME Africa team continued their support and interest in the Orphanage that is located beside the hospital. Our team included a sound and film crew of three people. (See Matt Palmer’s wonderful website to read about the whole story.

These three team members were building a relationship between Fred Seymour Elementary School in Calgary and the Children’s home in Litein. They were recording the children’s voices for a CD and they were making a documentary of our trip. Every night after our Palliative Care training sessions we went to the children’s home to play games, dance, do art, and listen and record the children’s beautiful voices.



Three of our team members, myself included, traveled with the Uganda facilitators to Kampala . We stayed at Hospice Uganda . We met the dedicated staff there and joined them for morning prayers and attended their day care center for palliative patients. We also, visited the main hospital and went on home visits with a physician, nurse and volunteer. After meeting with Dr. Merriman, I was able to volunteer to work on one of their publications. I can do this from my office in Victoria . How exciting! I look forward to this partnership.

Dr. Zipporah Merdin Ali gave us a tour of Hospice Nairobi. This was an excellent connection because when we were in Nakuru we met a group of very keen community members who were determined to begin a hospice volunteer program. We were able to connect them, through Dr. Zippy, to training that has started in their area, and to provide them with a spontaneous information session. We left them some basic materials and contacts and an action plan.

I am so grateful to the IAHPC for providing me with support for this trip. I also want to acknowledge how much Dr. Henry Dunge and Fatia Kiyange added to our trip. They shared so much with us and accommodated our every wish. Thank you too to Hospice Uganda for being such welcoming hosts while we were in Kampala . In addition, of course, thanks are due to the people in Litein who made a home for us while we were there and did such a great job of organizing the training session. I am so grateful to have been involved with my beautiful, supportive friends at Hold Me Africa.

Although the trip was very emotional and tiring at times, it was very worthwhile. The cultural differences seemed less important than I had imagined and I found more similarities to bind us than differences to separate us. My African colleagues truly inspired me with their dedication to palliative care. It gave me a renewed sense of the importance of our work and made me want to apply myself and to work harder to do everything that I can to promote Palliative Care worldwide.

Susan Breiddal
Nurse, Educator and Counselor
Victoria Hospice Victoria, Canada

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