Throughout the year, IAHPC board members contribute a range of opinion pieces and other thought-provoking articles to our newsletter. This month, it is the turn of our board member Dr. Mhoira Leng.
Mhoira is a specialist palliative care physician currently holding three roles as Head of Palliative Care in Makerere University, Uganda, Medical Director of Cairdeas International Palliative Care Trust, Scotland, and an honorary position in the Global Health Academy, University of Edinburgh. Mhoira has a particular interest in international palliative care and works alongside partners in the developing world to build capacity, offer mentorship, support curriculum development and models of health systems integration.
A perennial question I am asked as I travel and work in different parts of the world, often in low- and middle-income settings, is ‘How do we develop the clinical and academic leaders of tomorrow?’ Palliative care has benefited from amazing pioneers, creative, innovative and inspirational. How does this inspiration translate into an integrated, health-strengthening approach, and how do we transition to next generation leaders who are credible, visible, committed and well positioned?
First, it takes time – perhaps five years – to take inspired young colleagues and nurture their development into excellent, compassionate clinicians able to manage complex palliative care problems and take up senior positions. Next, we must ensure our young colleagues are credible and visible with appropriate qualifications for their context . . . we can sometimes train great clinicians but they are not appointable in their academic or clinical settings.
Crucial to this is ongoing mentorship and clinical modeling, not just knowledge-based training, that allows mistakes, provides opportunities for learning, encourages high standards with the support to meet and exceed expectations whilst ensuring personal, relational support. We encourage rich opportunities to develop academically and work collaboratively with mutual learning across settings and resources. We foster a culture of curiosity and research to strive for excellence and quality alongside compassion and patient-centered care where our communities and patients are our best teachers. Arriving in Makerere University in 2008, with the privilege of starting an academic and clinical palliative care unit, I asked the Dean for one of her best postgraduates to train and that person is now an excellent senior clinician with a PhD in palliative care. We have seen more than 100 presented abstracts, eight academic qualifications and more than 200 trained in research skills with strong collaborations particularly with the University of Edinburgh. Our next step will be to offer a formal Fellowship Program in Palliative Care.
The Leadership Fellowship program for nurses in Uganda received the joint European Palliative Care Academy (EUPCA) Leadership Award at the EAPC World Congress in Madrid.
A government conference, where my young colleague presented well on my behalf, elicited a fascinating remark from the chairman: “Dr Mhoira, thanks for bringing your hair.” (He meant 'heir'). “We don't let our heirs come in case they are better than us.” The greatest compliment for existing leaders is nurturing and supporting the next generation – and if they do better than we have done then let’s celebrate.
Let me highlight the excellent IAHPC scholarship programs. Young, middle and experienced colleagues come together, building networks, supporting attendance at international conferences or other training opportunities and then giving a voice to that narrative. I was interviewing my young colleague, clinically excellent, academically curious and forging a research career, committed and compassionate and articulate – part of the future for palliative care. He identified his first attendance at the 13th World Congress of the European Association for Palliative Care (EAPC) in 2013, when he was supported by an IAHPC grant, as a key moment that inspired him to choose palliative care as a career.
Lastly, let us consciously train and support leadership skills investing in cohorts rather than one champion who then has to shoulder impossible burdens.
A recent Leadership Fellowship program for nurses in Uganda not only allowed us to support personal development but also to build networks of practice, engage expert mentorship from within Uganda and the UK and engage in national level research . . . a huge achievement for all those involved and a model to be replicated. Thanks to European Palliative Care Academy (EUPCA) for recognizing and jointly awarding a prize at the EAPC World Congress in Madrid.
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