Special Report #1

Volume 23, Number 10: October 2022

Rash Decision Reaps Rewards: The empowerment of being an IAHPC delegate

By Alison Ramsey
IAHPC Newsletter Editor

Dr. Victoria Hewitt. Photo used with permission.
Two small words = One big win

Despite Victoria Hewitt’s ease speaking to groups of students, the WHO meeting was a bit of a trial by fire. The text of a European framework of action to achieve the highest attainable standard of health for people with disabilities 2022-2030 didn’t include palliative care, and she knew she had to take action. Katherine, “who has been a fantastic mentor throughout,” penned a “very strongly worded statement” for Victoria to present.

“It become evident to me that I was stepping into that uncomfortable place where change happens. Though I like to do that with my students, every part of me wanted to step back, and remain comfortable. But I knew Katherine would not allow that to happen.”

While it became clear, with consultation, that the statement needed to be softened slightly, the revised statement prompted the addition of two key words—palliative care—to the framework of action: it was a big win. “You have to get noticed to get your point across,” Victoria learned. That win provoked her to speak up during a later session on healthy aging. Here is the official, final wording of the European framework of action:

Objective 1. Ensure that all persons with disabilities receive quality health services on an equal basis with others

6. WHO/Europe is committed to achieving universal health coverage and ensuring that people of all ages across the Region have access to health care, as outlined in the EPW. Universal health coverage includes the full spectrum of essential, quality health services from health promotion to disease prevention, treatment, rehabilitation and palliative care across the life course. The accomplishment of this objective will ensure that persons with disabilities have access to and can use affordable, timely, relevant and good-quality general and specialist health services in primary, secondary and tertiary care, including community and at-home service delivery.

Dr. Victoria Hewitt replied instantly to Katherine Pettus’s call for delegates to the World Health Organization’s regional meeting for Europe. “It connected with something deep in me,” she says. “I was ready to move into some format of advocacy.”

Katherine prepped her before the WHO meeting, saying, “This is your chance: you can’t miss it. The session is very short, the audience is very diverse; you have to take the opportunity” to speak up.

Victoria returned exhausted but exhilarated and, after a bit of rest and reflection, was ready to talk about lessons she learned on the fly.

Lesson #1: Learning how to make official written responses.

“It’s a skill that I will take into many aspects of my life. We can all say, ‘I’m not happy about this!’ I see a lot of that. But writing an official statement that is endorsed [by interested parties] brought it to a different level.” After the WHO meeting, she applied the lesson over a minor contractual issue at her hospital trust that coworkers were grumbling about. Victoria suggested that a statement be written that those in favor could sign, then stood up in the proper forum and read it. “We got want we wanted! It showed we are serious about the issue. That’s very empowering.”

Lesson #2: Connecting to the audience.

Victoria gave a seven-minute “lightning talk” during a lunch break at the WHO meeting. Her topic: the consensus definition of palliative care, and “how the concept of serious health-related suffering fits in to the wider narrative of providing treatment. Those who really seemed to engage with it were medical and pharmacy students. They are early in their careers, and see things very globally. Katherine is mentoring me to connect with them, tap into their motivations. What’s in it for them? From them, I got a sense that things could be done differently and done better.”

Lesson #3: The sheer breadth of palliative care.

“As a session for regional directors in both prevention and primary care, it dawned on me that palliative care is essential to both of these tracks in a different way, but in essence the same. If you look at the core principles of palliative care, it applies equally to someone dying of COVID as to someone living with cancer. Only the context is different.” Few specialties can say the same.

Bonus lesson: Be bold.

When asked what she’ll do differently at the next meeting she attends as an IAHPC delegate, Victoria’s answer was swift. “I will be much braver, and much more assertive to take the floor. Next time, I’ll put my hand up, wave my arm—do whatever I have to do to take the floor.”

A lesson she learned as a participant, not a delegate, was put to use at once. “The day after my return I was back on the wards, reviewing a palliative care patient who had fled the war in Ukraine. Discussions at the event made me aware of the complexity of the needs of persons displaced by the war. I explained this to the clinical team and we changed the plan of care to more closely involve appropriate social, spiritual, and psychological care.”

Dr. Victoria Hewitt is a palliative care physician, advocate, and teacher specializing in online clinical education. She is a Senior Fellow, Higher Education Academy, and associate lecturer at Newcastle University.

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