IAHPC Traveling Fellow’s Report - Guatemala
A report by Barbara Lynn Kobierski, MD (Canada)
Guatemala is a country of exquisite beauty but cloaked in a myriad of difficulties found in many third world countries. There is a youthful expansion of the population that is still steeped in the ancient cultures of the Maya and the Spanish which clashes with the realities of palliative and end of life care. Poverty inhibits 95% of the people from getting needed end of life care while the remaining 5% have all they wished for to provide pain and symptom relief to the dying and support for their family. This is exceedingly frustrating yet humbling. One sees leaders and pioneers toiling quietly yet effectively against the biases of the societal culture and even while dealing with a culture of “unknowing” within the broader medical community.
Although the challenges of inadequate access to opioids in third world countries continues and although poverty limits the treatment modalities available to patients, the greatest difficulty for many of us who work in these counties is the lack of knowledge about what constitutes good palliative care and the modalities to accomplish this among our colleagues.
This urgent need to educate was highlighted by the challenge presented in May 2012 by Dr Eva Duarte (Director of Palliative Medicine at the Instituto de Cancerologia, Guatemala) and Dr Jose Maria Gramajo (Professor of Medicine, University of San Carlos, Guatemala). It was a privilege to be asked to lead a course along with pediatric palliative care physicians and nurses, and palliative physicians in the public health care system. The educational event was presented according to the format of EPEC (Education in Palliative and End-of-life Care) using material from EPEC and EPEC-O (Education in Palliative and End-of-life Care – Oncology).
We employed the “Train the Trainer” courses, during which six physicians, two nurses, a social worker and a pharmacist honed their skills so that they were more prepared to turn to the huge task of educating other physicians and nurses within the Guatemalan health system. The courses were conducted over six days, in Spanish and English. We learned, practiced, discussed, debated, laughed and finally finished. Many parts of the EPEC base had to be adapted to the reality of Guatemala, however the skills of good patient centered palliative care was foremost. The techniques of teaching this subject to others were mastered by those attending.
Was this successful? Yes! These leaders within the palliative care community accomplished much in a short time. Building on their expertise coupled with an intimate knowledge of their own culture and country, these health care professionals continue to turn outward -- teaching, educating, leading, guiding and directing. Those of us who visit cannot comprehend the nuances that will be required in a particular setting, but if we can assist in teaching the teachers, then gradually, one doctor or nurse at a time, will benefit one patient at a time and improve end of life care.
I am grateful to IAHPC for supporting my travel and enabling me to conduct this educational activity.
B Lynn Kobierski, MD
Clinical Assistant Professor
Department of Family Practice, Faculty of Medicine
University of British Columbia
Vancouver, Canada
IAHPC Traveling Scholar's Report - Kenya
A report by Robai Gakunga (Kenya)
I am delighted to report about my experience at the 3rd Kenya Hospices and Palliative Care Association (KEHPCA) conference.
Attending this conference helped me to visualize the entire picture of palliative care in Kenya and the region. I was able to get a sense of the areas that could benefit from an evidence based improvement or change -- hence research.
It was also an opportunity for me to meet and network with many palliative care stakeholders and to learn about their work.
Palliative care has grown tremendously in Kenya. I attended the 1st, 2nd and now the 3rd conferences. The attendance has grown exponentially in geographical distribution from across Kenya, the region and internationally. The increase in service provision and integration of palliative care services into the public health system in Kenya did not come easy and every presenter who spoke about their journey started from very humble beginnings with many hurdles that has resulted in a splendid outcome of happy patients and caregivers.
As palliative care grows, we are all encouraged as stakeholders to embrace research so that we can build our own local evidence base. I believe that this can happen: several participants at the conference were willing to carry out this research, although they acknowledged that they require additional education and support to carry on. I was happy to meet other participants and make acquaintances for possible future research collaborations.
I was sponsored by the International Association for Hospices and Palliative Care (IAHPC) through the (KEHPCA) to attend the conference.
Thank you very much for making this possible.
Robai Gakunga, MD
P.O. Box 2185-00202 Nairobi
Nairobi, Kenya
Email: [email protected]
IAHPC Traveling Scholar's Report - Montreal
A report by Sandhya Puthur Muthumana, MD (India)
The opportunity to present my work at the 19th International Palliative Care Conference held in Montreal, Canada, hosted by the McGill University in October 2012, was one of the most important events in my professional career.
My presentation on the success of “The Kerala model” which uses local self-governments in advancing the objectives of palliative care in the communities of Kerala was very well received. I had enlightening discussions and conversations regarding our model with world-renowned leaders in palliative care. The ability to interact face-to-face with pioneers in palliative care from other countries helped me to evaluate the significance of our work and identify areas for improvement.
The conference agenda included very high-quality presentations, workshops and poster exhibits. The plenary sessions were informative especially the session on coping, dignity and holistic palliative care.
Pediatric palliative care sessions on communication regarding prognosis, effectiveness of home care and challenges faced by kids with Duchene’s muscular dystrophy were very educational.
A documentary concerning community trauma and the strategies that were used to get through difficult stages of coping was very touching. Ms. Downing and her team’s persistent effort to improve the palliative care system in Uganda set an example for all.
The experiences and knowledge I gained strengthened my resolve to contribute more towards creating awareness and improving the quality of palliative care services.
I would like to extend my sincere thanks to International Association for Hospice and Palliative Care for enabling me to present my work at the International Palliative Care Conference. I sincerely doubt I would have been able to attend this international conference without the support of IAHPC. I wholeheartedly think that your organization is doing a phenomenal job. Your organization is helping professionals, such as me, who need financial and logistic support to further their careers and to reach an international audience. Such an exposure is even more critical in a field such as palliative care where lessons can be learnt from surprising and unconventional avenues. At times ingenious ideas for community capacity building, creating care networks and extending the palliative care message originate from developing and underdeveloped nations. Hence, it becomes critical to provide support to professionals working in such impoverished areas to share their work and experience in an international arena.
Thank you.
Dr. Sandhya Puthur Muthumana
Kerala, India
Previous Page News Index Next Page
This newsletter, including (but not limited to) all written material, images, photos are protected under international copyright laws and are property of the IAHPC. You may share the IAHPC newsletter preserving the original design, the IAHPC logo, and the link to the IAHPC website, but you are not allowed to reproduce, modify, or republish any material without prior written permission from the IAHPC.