Nahla Gafer, a member of the IAHPC Board of Directors, is a clinical oncologist at Khartoum Oncology Hospital, Sudan.
By Dr. Nahla Gafer
In any country with limited resources and a dysfunctional health system, the effects of practicing palliative care are great. At a small palliative care unit at Khartoum Oncology Hospital, where palliative care first sprouted in Sudan, we realized that training doctors and nurses in palliative care dramatically changed their practices and their attitudes, and even improved their morale. Here are the words of three health professionals (translated from Arabic) on how training in palliative care affected the way they treat patients and caregivers, how it changed their priorities, and — most importantly —the positive outcome for patients.
Mohja Marhoom, Palliative care trainer and Register of Family Medicine, Sudan Ministry of Health, Khartoum
I discovered palliative care at the start of my career as a doctor. Practicing it allows me to help patients effectively, and gives me great personal satisfaction that eclipsed other career considerations, like salary, effort exerted, and work environment.
Palliative care training has made me both more capable and more skilled in assessing patients’ problems. In addition to their disease status, I consider the whole patient: their psychological, spiritual, and social problems in addition to their physical ones.
Training in palliative care increased my understanding of the effects of each person’s life situation on themselves and their carer, which showed the importance of giving some of my time, care, and support to carers. At times, for instance, it is essential to provide them with training on how to care for the patient. It is also important to communicate effectively, in order to reduce their worry and tension.
Most of the time, the effects of providing palliative care to patients are instantaneous, especially when treating pain and other symptoms. At other times, results and feedback from patients and family members are later in the disease trajectory. Sometimes, the result of palliative care comes as comments received even after the patient dies.
I recommend that all who deal with patients, whatever their specialty, be trained in palliative care. I dream of a world with palliative care services available to all who need it.
Mohamed Mahoub, Palliative care trainer and Oncology Registrar, Khartoum Oncology Hospital
Palliative care training has caused me to deal holistically with patients’ needs, even when managing those without a life-limiting disease. It affected the way I treat caregivers because I discovered that their needs are huge, as the care of the patient falls upon their shoulders and they sometimes take on full responsibility for the patient.
Training in palliative care also affected the way I deal with colleagues and superiors: I became more communicative to their humane side.
Palliative care not only provides patients with a better quality of life, but their carers become more accepting and accommodating to the disease. I feel that palliative care is not just a specialization — it is a holy mission.
Alfaki Adam, Palliative care trainer and Community Nurse, Soba University Hospital, Khartoum
When I deal with patients I consider all aspects; I deal with the patient in a holistic way. Training in palliative care made me more skilled at conducting good and effective communication with the patient and their carer. It also changed how I deal with patients: pain management became a priority. Providing palliative care to patients improved all aspects of their situation. It makes patients more accepting of their disease, and more capable of living with it peacefully. I realize that we still need to talk more about death and dying.
These three interviews reflect how training in palliative care can really change the aims of care, the way that care is provided, and the outcome for both patients and caregivers.