Grantee details

Traveling Scholars Program Report

Agnes Chipo Terai, DR

Travel date: June 5, 2016

Name of Meeting/Event/Activity: Post-graduate diploma in Palliative Medicine second contact week

Origin: Harare, Zimbabwe / Destination: Cape Town, South Africa

How was this meeting/activity helpful to you?

The contact week was beneficial in providing me with the relevant knowledge from the lecturers for the diploma in palliative medicine. We received input from several specialists covering different areas of PC eg on euthanasia, pain management, terminal sedation, palliative care in ICU. I managed to have a practical session on using a syringe driver and providing terminal sedation by continuous subcutaneous infusion at St Lukes hospice.

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

I am working at an Oncology centre in Harare and also do voluntary visits at our local hospice once a week. I hope the knowledge I gained will help in the way I manage the symptoms of the terminally ill patients I see at work or visit in their homes. I am also going to mentor the team I work with in Palliative care and especially try to empower the care givers on how to manage a terminally ill patient at home.

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

I am grateful that this opportunity is there to aid scholars like me, of cause if the scholarship would cover the accommodation it will go a long way, however considering the limited funds I am happy even if it remains the way it is.

Narrative summary highlighting the needs and challanges you face

WHO report in 2010 showed that Zimbabwe had 3 hospices and 6 Home based care centers, figures which have gone down by 4 from a total of 13 reported in 2001. Palliative care in Zimbabwe has a long history since 1979 with Island hospice in Harare and main focus then was cancer, however with the advent of HIV/AIDS and increase in other chronic illnesses the services increased dramatically with establishment of home based care facilities in almost every district. However due to a variety of reasons the established systems are currently greatly reduced in numbers and some continue to offer services with limited resources. Medical students are getting lectures on palliative care, which I believe is a good start in empowering the future clinicians and hence importance of including PC in the medical school curriculum. There are few medical doctors who have trained in palliative medicine at diploma or masters level; hence the gap is still very big if we need all Zimbabweans to have access to palliative care. I think that ignorance of what palliative care is really, is the source of resistance from some health care providers hence the need of empowering as many clinicians as possible, something which I noticed Cape Town is way ahead, I hope I can slowly be influential to my colleagues and advocate for those interested in taking up the palliative medicine diploma to do so. There are also a number of nurses who have trained in Palliative care at diploma and some at masters level and most of them are doing a great job of being part of the palliative care team at our hospice in Harare and I am privileged to join them at least once a week. Island hospice in Harare is involved in a number of activities through the support of various well wishers. The activities include training community care givers, training of home carers, visiting palliative care patients at their local clinics or homes. The main challenges in my country include accessibility of opioid drugs e.g morphine for pain management in the clinics and remote areas, need for more doctors with training in palliative care and cost. Cost is a challenge as the patients have to buy the medications e.g. one month supply of morphine goes for $15 and not many people can afford this. I hope that as the palliative care team in Zimbabwe we can find ways to lobby through our ministry of health for more accessibility of palliative care drugs at affordable prices and to allow palliative care nurses to prescribe them.