International Association for Hospice & Palliative Care

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that death is not only a biological phenomenon it affects the entire family and community.

Earlier this year with funding provided by the Diana, Princess of Wales Memorial Fund, a multidisciplinary team of Health Care Professionals working in Pediatrics met and wrote 12 standards specific to the South African context.

Dr. Norval quoted Mahatma Gandhi " We must become the change we want to see."

During one of the workshops, a delegate from Mapumalanga, a province in South Africa, shared her own heartbreaking story of childhood loss, abandonment, abuse, poverty and the constant searching for an identity. She pleaded with the delegates present to never forget the need of children to belong and to know something about their family history.

A particularly good presentation on how to help children cope with loss was given by
Juliet Carter a social worker involved in Hospice Care. She spoke about the ongoing process of trying to meet the emotional, social, mental and spiritual needs of children. Psychosocial support is the foundation upon which Memory Work is based. Her input on Memory Work based on Life Story Work, facilitates preparation for death, loss and change. It creates a legacy for loved ones. Memories of loved ones, of times shared; family facts and traditions help the child to build a sense of identity. Poignant photos of little children decorating memory boxes were shown to the delegates. A story was told of a child as young as 5 years of age having to care for the sick and dying in their home while the only healthy adult went to work. 

Narrative Therapy forms part of Memory Work and is a way of re - authoring and recreating of life stories and  was shown to be of benefit to children especially as a terminal illness causes a disruption in the life story, resulting in loss of meaning and purpose. The right of a child to play and in so doing make sense of their world, was shown to have great benefits in healing and acceptance of their circumstances. Play helps children make sense of their world and is important in their development.

The conference showed the diversity of Palliative Care Training in this country and highlighted what was being done at the grass-root level. The importance of involving the communities in coping with their sick and dying, of training and supporting the carers, of developing, maintaining and monitoring set standards of care and maintaining and monitoring these, were all shown to be imperative. Many speakers mentioned the plight of the child in Africa.

The conference gave delegates the opportunity to meet other people involved in Palliative Care and to share experiences and ideas.

Winston Churchill said, "Everyone stumbles on the truth from time to time but most people pick themselves up and hurry off as though nothing ever happened."

The delegates and speakers at this conference do not fall into this category, on the contrary they are being proactive and each in their own way is making a difference to Palliative Care in South Africa. A topic discussed was" How to take care of the Carer " and certainly these people deserve care and support in their on going work of bringing relief to those living and dying of chronic diseases.

By the close of the conference all objectives had been met and a Palliative Care Focus Group was established to carry the work forward and to further develop Palliative Care Training standards at all levels.


On Thursday January 22nd, Island Hospice and Bereavement Service in Harare, Zimbabwe begins celebrating its 25 years of Hospice in Africa.

In 1979 Island Hospice and Bereavement Service
(Island) began operating as the first hospice in Africa. With Independence just around the corner, and the arrival of the AIDS pandemic in the wings, this small organization began its ground breaking work with a nurse, a part time medical director and receptionist (who happened to also be a social worker). The organization now employs 35 staff, with almost a quarter of these boasting 15 or more years of clinical service. Rona Martin a Social worker who is a Clinical Team Supervisor, and Steve Williams, the Medical Director, mark 21 years this year.

The event on the 22nd will also celebrate 2 other important occasions.

Firstly after 25 years of leasing, Island will finally be officially opening their own brand new home at 6 Natal Road, Belgravia, Harare.

Secondly, we will also be toasting the beginning of a significant partnership with Catholic Relief Services (CRS). Island and CRS have worked together on a smaller scale over the last few years. But, with both organizations committed to increasing the spread of Palliative and Bereavement Care skills in Zimbabwe, a major partnership has been formed, which indeed bodes well for those in need.

But this is not all. A 25th is an important occasion, so, despite all the difficulties facing us in Zimbabwe at present, we have decided that it deserves a conference. This will be in September, and we have our working party in place to organize an exciting event, worthy of 25 years of hospice in Africa!  Stay tuned to this channel.

You are all of course invited to start planning your holiday.sorry. working trip to Zimbabwe. September is a beautiful time of year. If you know of any sponsors who would just love to help in any way.point them in this direction.

Warm regards and here's hoping to see you in 2004.

Val Maasdorp
Acting Director
Island Hospice and Bereavement service

Eastern Europe

EAPC-East Newsletter
NR 18- January 2004
Reprinted here with permission.

Good wishes for 2004. We hope the start of this year was good and that life and work will prosper during the year.  For many countries in Eastern and Central Europe this year is going to bring a lot of changes, e.g., getting to be a country within the EU. We are full of expectations that this will be a positive push forward, also for palliative care. The Newsletters will continue to be sent and we are looking forward to have you share information with us. Information can be inspiring, don't you think?

New section to the website on The Pain and Studies Group

The Pain & Policy Studies Group would like to announce the addition of a new section to the website about the work by the WHO Collaborating Center with governments and colleagues in Eastern Europe.  The section contains opioid consumption statistics and trends for selected countries, as well as WHO Workshop reports, country reports, action plans, and detailed monographs.  All are available for printing or downloading at

This section will be updated periodically, and new sections will be added for other regions of the world. 

European Journal of Palliative Care - to be sent to you!
We have received volumes of the European Journal of Palliative Care to be sent to those interested in receiving them. Please let me know if you would like to have some issues sent to you. First come, first served!

ABC of palliative care - BMJ - British Medical Journal
This fourth article concerns Breathlessness, cough and other respiratory problems and is written by Carol L Davis. Please find the full text article to down load on

We have written a few times about the event Voices for Hospices in October 2003.
Here is a short example and description of  the event in Oradea, Romania.

Voices for Hospices is an international initiative and is the world's largest simultaneous singing event, the aim being promotion of the local hospice and fundraising.  On the 4th October, 2003  we held our second such concert here in Oradea (the first was in 2000).  This year we were one of 500 concerts happening worldwide in 40 different countries and apart from the date/time another unifying element of the concerts was the recitation of this poem.


When my life is finally measured in
Months, weeks, days, hours,
I want to live free of pain,
Free of indignity, free of loneliness,
Give me your hand,
Give me your understanding,
Give me your love,
Then let me go peacefully
And help my family to understand

From Children's Hospice in Minsk

About 400 people from the local community came to share this special evening with us. The music was performed by the mixed chamber choir of Emanuel University and included pieces by C. Porumbescu, F. Chopin, G. Dima, G Faure, D.B. Gyorgy, A. Vivaldi, F.M. Bartholdy, M.W. Posegate, J.S. Bach, J.Wyath, R.Thompson, S.Pautza. During the evening two families shared their experiences: a doctor whose mother died in the care of the hospice team and a grandmother whose 10 year old granddaughter died with a brain tumour.

A special moment during the concert was when a piano solo was played during a powerpoint presentation "In Memory", projecting the names of all the patients who have died in our care 2000-2003, this was a very emotional moment especially for the bereaved families who joined us for the concert. We praise and thank God for the way everything came together to make this a very special event for us and pray that we would be able to cultivate the local interest that this has caused.
Kirsteen Cowling, Hospice Emanuel, Oradea, Romania,
e-mail: [email protected]

Online Free curriculum in Psycho-Oncology and palliative care

On 15 December 2003, APOS - American Psychosocial Oncology Society unveiled two online training programs in Psychosocial Oncology.  The "Online Curriculum in Psycho-Oncology" comprises fifteen webcasts in six core curriculum tracks and "ICAN Distress Management Training for Oncology Nurses" includes four webcasts.  The webcasts are now available to the public on the APOS webcasts page ( and each has been approved for formal continuing education credit by the University of South Florida.  We extend many thanks to USF for its approval, and to the presenters for their contributions to these invaluable new resources.
This free program is designed to provide cancer care professionals with core knowledge in key areas of psychosocial oncology.  The program currently includes fifteen webcast lectures on oncology, symptom management, and psychosocial interventions.  There are lectures on "integrating psychosocial and palliative care into oncology practice - The Muffitt experience" and "Psychosocial and Palliative care program - Emphasis on Cancer related Fatigue".

Additional lectures on program administration, population-specific issues, and re

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