In 2015, Dr Gerard Corcoran, a palliative medicine physician and lecturer at the Marie Curie Palliative Care Institute Liverpool, UK, traveled to the Caribbean island of Grenada as an IAHPC Traveling Fellow. Here, Dr. Corcoran gives highlights from his report.
I am very grateful for the support I received from IAHPC which enabled me to complete a palliative care project in Grenada, in collaboration with the Windward Islands Research and Education Foundation (WINDREF). The main aim of the project was to develop recommendations that would lead to improvements in the management of severe pain and in the provision of palliative care in Grenada.
With the excellent cooperation of the Chief Medical Officer and other key personnel within the Ministry of Health, I was able to interview and meet over 35 health professionals to seek their views on aspects of palliative care provision. Wider consultation took place during three lectures/seminars that I delivered to the Grenada Medical Association, hospital-based nurses and community pharmacists.
All health professionals acknowledged that severe pain is under-treated in many people with progressive life-limiting illnesses. The clinicians have received very little training in palliative care and there was a great enthusiasm for an educational program to be developed. Nursing support for terminally ill persons at home is limited, and care is predominantly given by family members.
Preparations of Immediate Release Morphine were not regularly available on the island and were rarely used for pain control. The absence of a pharmaceutical policy or guidelines for pain management seemed to be the main reason for lack of availability of essential medicines.
In March 2015, a project report ‘Promoting a Public Health Model for Palliative Care’ was submitted to the Ministry of Health in Grenada and the recommendations were accepted in full. The Chief Medical Officer obtained funding from PAHO (Pan American Health Organization) for education and training and I returned to Grenada in October 2015, along with nurse colleagues (Dr. John Unsworth and Guy Tucker, University of Northumbria, UK) to deliver four two-day workshops to a total of 130 doctors, nurses and pharmacists.
The Palliative Care Association of Grenada (PCAG) has now been established to advocate for excellence in the provision of end-of-life care and to help develop and promote national standards of practice for the support of palliative care in Grenada.
There has been recent progress in formalizing a national pharmaceutical policy including a policy for the use of opioids and hospital clinicians have reported the increased use of immediate release morphine. We are now exploring ways of obtaining further funding for follow-up training and for developing the community nursing service.
Dr. Corcoran’s tip to other Traveling Fellows:
“Ensure that your host organization has agreed to introduce you and facilitate meeting key personnel within the Ministry of Health, e.g. Chief Medical Officer, Chief Nursing Officer. This ensures a prompt start to the time-limited project.”
Gerard Corcoran, MS, FRCS (London) – Palliative Medicine – qualified in 1975 at The London Hospital Medical College, University of London. He worked in Grenada (1979-1980); served as Macmillan Consultant in Palliative Medicine at Aintree University Hospitals and Woodlands Hospice in Liverpool (1993-2012); Medical Director, Merseyside and Cheshire Cancer Network (2000-2011) and is now part-time lecturer at Marie Curie Palliative Care Institute Liverpool.
To find out more about IAHPC’s Traveling Scholarships and Traveling Fellowships, please visit our website. Through these programs we support projects and individuals around the world, especially in developing countries in Africa, Eastern Europe, Asia and Latin America.
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