Featured Story

Volume 23, Number 3: March 2022
Without strong community support, CUDECA would not exist. All photos in this story supplied by CUDECA. Used with permission.

CUDECA's Lofty Goals for Palliative Care Training throughout
Latin America Are No Bigger Than Its Founder's Realized Dreams

By Alison Ramsey
IAHPC Newsletter Editor

It is no surprise that Spain's Fundación CUDECA is expanding into palliative care education in a major way, inviting the entire Latin American community to participate. The big surprise is that the veteran palliative care provider exists at all, because—honestly—even CUDECA's medical director, Dr. Marisa Martín-Roselló, was skeptical at first.

Dr. Marisa Martín-Roselló

Dr. Martín-Roselló was working in Malaga's only, newly opened palliative care unit when Joan Hunt, a British expatriate living on the Costa del Sol, transferred her terminally ill husband there from a large university hospital. Joan marveled at "the dramatic difference" in the care received by both of them at the small unit. It fuelled her vision of building a hospice, to offset the lack of palliative care locally.

Impossible, Dr. Martín-Roselló told her, as public health authorities were in charge of palliative care in Spain. "There were good public health strategies and policies for palliative care," she says, "but they were not accompanied by good resources.”

Joan was undeterred. A fledgling home care service in 1992 cared for eight patients, but Joan's vision was much, much bigger: multiple home care teams serving the whole region, plus a day centre and an inpatient unit, complemented by palliative care training and research programs.

Why not us? Why not here?

"Joan was determined; she didn't see why it couldn't happen. If it happened in the UK, she told me, it could happen here. I asked, 'Where will we get the money?' 'Well, that's easy,' said Joan. 'We'll get it from the community. We have to get people to trust us, trust our project, and make it their own.'”

And they did. Joan's enthusiasm was infectious: she talked about the project to every British expat she met—and everyone she knew—and asked for their help. The British community launched CUDECA, but the Spanish community has sustained its ambitious growth.

British tactics, transplanted

Charity shops, common in the UK, were a fundraising tactic Joan wanted to replicate. But Dr. Martin-Roselló was unsure. "I told her that in Spain people don't like to buy second-hand," she said. Today, more than 1,000 volunteers staff CUDECA's 26 charity shops, the main source of funds for its seven home care teams as well as its hospice (1998), outpatient clinic (2001), rehabilitation/day centre (2003), and nine-bed inpatient unit (2005).

You can see how CUDECA has grown tremendously from a small home care service in 1991. In April, the training and research center pictured below will open.

A persistent fundraiser, CUDECA organized 220 events the year before COVID-19 hit, including a walkathon involving children from 12 schools and hundreds of others.

Last year, CUDECA (short for cuidados del cancer, or cancer care) served a region of one million people, caring for 1,780 patients. Fundraising and support from Andalusian Public Health means that all care is free of charge.

A renewed focus: education

In 2021, its operating budget was €4.2 million. "We have to look for money everywhere: donations, charity shops, grants, events, legacies, etc.,” says Dr. Martin-Roselló. Successful fundraising has enabled CUDECA to fulfil an ever-expanding mission: palliative care education.

It has created The CUDECA Experience, a month-long program for health care team members, including social workers and administrators, that uses classroom training and hands-on learning with its home care and hospice teams to share their methods and successful practices. There is also a one-year interdisciplinary master's degree in palliative care (including an online option), and a shorter, online postgraduate course has recently been added, Expert in Palliative Care. These degrees from the University of Malaga and the Cudeca Foundation, comprise hours of classroom work and practical instruction. Registration begins in June.

A new training & research center

Soon, all educational programs will be housed in the new Yusuf Hamied Training and Research Centre, to be completed this April.

"One of our main objectives is to promote our educational programs among the Latin American community," says Ángel Bataller, head of the new CUDECA Institute for Studies and Research.

"We are very excited about the centre and what it means," says Dr. Martín-Roselló. "To be able to share what we have learned in 30 years, and to learn from colleagues who come here to train, is a gift. We also hope it will bring the funds to grow and get to the 10 home care teams we need, and to support CUDECA's mission."

Participants of the first Cudeca Experience with Joan Hunt (front row, center): sharing and learning between Colombia and Spain. Not all medical degrees in Spain include palliative care training. "We get a lot of enthusiastic young people taking our courses," says Dr. Martin-Roselló. "But it is essential to spread the philosophy and knowledge of palliative care widely to ensure that everyone has a dignified end of life with as little suffering as possible.

To learn more about CUDECA, visit IAHPC Global Directory of Palliative Care Institutions and Organizations.

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