Grantee details

Traveling Scholars Program Report

Clint Cupido, MD

Travel date: August 16, 2016

Name of Meeting/Event/Activity: 5th International African Palliative Care Conference

Origin: Cape Town, South Africa / Destination: Kampala, Uganda

How was this meeting/activity helpful to you?

This meeting was excellent in terms of learning and understanding the process of policy development at a Ministerial and government level. Day 1 the Ministerial Meeting was educational and I now understand that without policy at this level, there will be no government commitment and no part of the Budget for healthcare will be allocated to palliative care. Legislation around Morphine, is clearly governed at a number of levels of administration. Ensuring good control and access from international law allows access at a national level and then at a local level. I attended the research workshop and this was practical and encouraging. As I am an advocate for Palliative Care in Chronic disease and Non Communicable Disease through Abundant Life Palliative Care (Organ Failure PC) I was part of the team discussing Heart Failure. This was a fascinating process. Interacting in a team members with different backgrounds resulted in different approaches to the same questions. Being a clinician with no interaction with researchers I realized my limitations and their ability to analyze the clinical scenarios from such a different perspective. Clearly research is best done in a team approach. The conference was stimulating on all fronts. Meeting so many enthusiastic PC practitioners was inspiring. The presentations were of high academic quality and the research papers and posters presented seemed so relevant to my African situation. I was most impressed with the quantity of research coming out of countries I was probably not aware of (my ignorance) but now that I have been exposed it changed my perception. Having this opportunity to network with everyone in one place was probably immeasurable.

How will you new knowledge & acquired skills help in furthering your work in hospice and palliative care in your program/city/ or country?

Already this conference has resulted in: 1) Starting a Palliative Care Research Group in Cape Town September 2016, 2) Developing new areas of Research because of recognizing the power of research, 3) I am now appointed to a Task Force to develop Policy for PC in District Hospitals in SA, 4) One of my new contacts is Visiting Abundant Life PC from Mauritius in Feb 2017, 5) Gold Standard Framework from UK actually used my Abundant Life PC in their workshop and will be coming to visit me in 2017 as well. 6) The experience has confirmed my passion for PC is important and we as a PC movement are making changes to healthcare locally, nationally and internationally. This has just inspired me to continue the hard work. I have also been asked to Participate in a Debate on Euthanasia at the University of Cape Town Medicine Research Day. I will be “Against Euthanasia” and promoting good Palliative Care. 7) I attended the Media and community liaising workshop and from this met a South African who has booked me for a Radio interview on the 3rd October 2016. 8) I have turned our World Palliative Care Day on 8 October into our Victoria Hospital Open Day.

How IAHPC Traveling Scholars Program be improved in order to help other future traveling scholars?

I was extremely lucky that a colleague informed me about the scholarship and the organization. I am just grateful for the Scholarship and I found everything very efficient and professional. I also appreciated all the support during the event.

Narrative summary highlighting the needs and challanges you face

I have established one of the first Hospital Based and integrated Palliative Care Programs in South Africa. As a General Physician and HOD of Medicine at Victoria Hospital in Cape Town, I identified the most neglected group of patients for PC were the NON HIV and NON CANCER patients. Essentially this was 80% of my patients who were dying in the Medical Department. Abundant Life Palliative Care is thus unique in that it is fully integrated into the department of medicine. We started with only organ failure patients and this included Heart, Kidney, Lung, Liver and Brain Failure conditions. I am the PC trained but everyone is PC Conscious and all patients are considered for PC if needed. Today our team of Palliative Care is the Entire Hospital. The next step is proving that this service is not a luxury but a necessity. The ministerial meeting has put great emphasis on this and the Declaration of Kampala speaks to this. Integrated Palliative Care is the most cost effective and the way to increase access to PC for all those hospitalized patients. This model of PC has been called the “Infusion Model” by Hospice Palliative Care Association in SA’s Dr Liz Gwyther. There is no doubt as with all areas of medicine that the approach to delivering a service is that of the pyramid. Super-specialized at the pinnacle for a few patients, then the specialists involved in research and training and seeing more complexed cases, followed by the generalist who has a limited knowledge, but some practical experience in providing the bulk of the service to the bulk of the patients. To grow our service requires more research and more funding. This conference has helped in my understanding and given me ideas for research. This conference enabled and facilitated the reunion of Abundant Life Palliative Care with Gold Standard Framework. This has already led to improved collaboration and I am sure will further assist in development and training for the future.