Grantee details

Traveling Scholars Program Report

Valarie Maasdorp, MD

Travel date: August 16, 2016

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

Origin: Harare, Zimbabwe / Destination: Kampala, Uganda

How was this meeting/activity helpful to you?

Zimbabwe faces many challenges on many fronts. At times therefore we can feel somewhat isolated and a conference of this type in Africa enables one to network with those also engaged in the field sharing both technical expertise and experiences. One of my research findings relevant to my presentation at this conference was that one of the ways Resilience is boosted, is by networking with colleagues in the field, and ongoing education to increase both competence and confidence. This conference fully met my expectations with so many diverse yet connected specialists in the field of palliative care. Many who attended my presentation came to talk to me afterwards about how meaningful the content was to them and had many many questions and queries.

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

Many of the presentations offered the prospect of contemplating a dynamic and creative way to mold their learnings to our specific situation. Whilst we are diverse countries each with our own unique cultures/ challenges and contexts…there is the thread running through that where we can identify possibilities for uptake in our own programmes. Also the networking was excellent where one meets and discusses and chews over challenges and differences in situations, often with the “outside eyes” having some clarity or observation that we are able to adopt. We have planned meetings already to disseminate so many of the interesting learnings. These will no doubt be utilized in our ongoing strategic decisions and also in our many and diverse training programmes both in and out of country.

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

It was a wonderful scholarship thank you! Whilst the amount did not cover all expenses it covered the major part of the budget and I am extremely grateful to your organization. Keep up your great work

Narrative summary highlighting the needs and challanges you face

Zimbabwe has a population of 14 million with 40% below the age of 15 years. The Zimbabwe Agenda for Sustainable Socio-Economic Transformation (Zim-Asset) which guides the economic development of Zimbabwe until 2018 is difficult to implement given the macroeconomic environment in Zimbabwe remains weak. This is a result of inadequate external inflows, low commodity prices that keep liquidity conditions tight, an appreciating U.S. dollar, growth that has slowed, and rising unemployment. The economic situation in Zimbabwe is fragile. There are cash shortages, import bans and debt that continues to build up. Compounding this, across Zimbabwe more than 2.8 million families are struggling to cope with food insecurity, lack of water and disease. 2 years of erratic rain fall and drought is wreaking havoc on the lives, livelihoods and health of many vulnerable families. In Zimbabwe, the right to health care is enshrined in its constitution. The public health system in Zimbabwe operates at primary, secondary, tertiary and quaternary levels. Once lauded as excellent, the system has become seriously constrained over the years as a result of economic and funding constraints, new and evolving disease and health patterns as well population distribution and settlement patterns. The country cannot attract and retain health professionals especially as public health spend is low – only 6.57% of the total budget has been allocated to health in 2015. Prior to 2000, the government financed the majority of healthcare expenditure. Although donors have supported the sector since its deterioration, Zimbabwean households have had to assume a larger share of the sectors financial burden. In particular, user fees have a negative bearing on access to health service especially among poor and vulnerable groups. A prevalence rate of 15% makes Zimbabwe one of the hardest hit countries by HIV/AIDS globally. There are more than 35 000 children in need of Anti Retroviral Therapy (ART) with only 17 000 accessing the life prolonging drugs. Every fourth Zimbabwean child is orphaned, the second highest orphan rate in the world. The maternal mortality rate (an indicator of a nation’s health) is 614 deaths per 100,000 live births versus an MDG target of 174 per 100, 000 live births. The under-five mortality rate is at 70.7 deaths versus a target of 43 per 1000 live births. Zimbabwe has urgent need for palliative care services. The WHO global palliative care study identified 1 in 60 Zimbabweans in need of palliative care and the recent UNICEF/ICPCN study identified a significant need for palliative care among children in all 10 provinces of Zimbabwe. Island was founded in 1979 as Africa’s first Hospice. It pioneered the development of expert palliative care services including bereavement services for families of deceased hospice patients and for the general community suffering loss due to any cause. Island has played a major role in scaling up palliative care in Zimbabwe and regionally. The organisation’s philosophy encompasses a skilled and sensitive way of caring for those suffering life threatening illness and their families whether in hospital, at the roadside or home. The care of patients is provided within a multi-disciplinary approach that focuses on the prevention and relief of suffering by means of early identification, impeccable assessment, treatment of pain and other problems such as physical, psychosocial, cultural and spiritual. Island through multi-sectorial partnerships such as with Ministry of Health practitioners, plans to continue to teach, capacity build, implement and strengthen palliative care knowledge and practice throughout Zimbabwe; to continue to develop palliative care services with collaborating agencies to address the needs of special population groups, including orphaned and vulnerable children, women survivors of gender-based violence, the disabled, prisoners, traditional leaders, gays and lesbians, displaced persons, and others. This conference was an excellent opportunity to network with those in the same field facing similar challenges, to investigate initiatives that may work in our context, to share our innovative practices and our resilience in the face of such ongoing consistent concurrent challenges and difficulties for staff and patients alike; to initiate new partnerships and opportunities for research and funding to enable Island to provide the needed palliative care services in the severely resource constrained landscape in which we operate .