International Association for Hospice & Palliative Care News On-line

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.