Volume 24, Number 4: April 2023

Recognition Award Winners Answer A Few Personal Questions

In March, IAHPC announced the winners of its 2023 IAHPC Individual Recognition Awards, which celebrate individuals dedicated to developing and providing palliative care to improve the quality of life of patients with serious health-related suffering.

Three winners—two in low-middle-income countries, one in a high-middle-income country—were each awarded a $1,000 US cash prize, a certificate, and a one-year IAHPC membership. Candidates for the award, available to both members and non-members, are nominated by others; winners are selected by a committee created for that purpose. Meet this year’s winners:

Dr. Mawuli Kotope Gyakobo, Cape Coast, Ghana

Dr. Gyakobo, “a humble and empathic man with deep concern for the vulnerable patients who require end-of-life care,” tied in the low-middle-income country category. He is a university professor, researcher, and mentor, who “advocated for—and initiated the development of—palliative care in Ghana,” says Dr. Barbara Naadjadjamah Adu, who nominated him.

For more than half his medical practice, Dr. Gyakobo was a general practitioner. He is now National Coordinator of the Pain Free Hospital Initiative Programme and supervises training health care staff in pain management, a program being scaled up across the country.

1. Was there a particular event (or person) that drew you to palliative care?

“I began my career by working at St. Dominic’s Hospital, a very busy Catholic Mission hospital in rural Ghana with a wide variety of medical and surgical patients at various stages of presentation, some quite terminal. As a young doctor, I believed that medicine was science and I approached it as such until I met Monsignor Alex Bobby Benson, a Catholic priest from Florida posted to the hospital. In 1998, he introduced me to hospice care and that was the beginning of my journey.”

2. How do you stay motivated?

“Motivation is intrinsic to my nature: I am not necessarily motivated by financial gain or social recognition. The outcome of my interventions—especially if they improve the quality of life of my patients and family—motivates me greatly. Palliative care is a budding area of medicine in Ghana with very few practitioners, and this in itself motivates me to fill a gap.”

3. What form of relaxation or self-care do you enjoy?

“I am a naturalist and relax by taking hikes in quiet areas of town, like reservation parks, or sitting by the sea at sparsely populated beaches. I derive strength from being alone in quiet places.”

4. What advice do you have for those who follow in your footsteps as a palliative care practitioner?

“I encourage you to be self-motivating and not focus principally on financial gains, which follow naturally with a lot of blessings. You must build resilience, since palliative care can feel like a lonely practice that can lead to morbid thoughts, with risk of depression and burnout.”

Dr. Wah Wah Myint Zu, Yangon, Myanmar

“She encourages the medical personnel she works with, including myself, to practice palliative care in our daily patient care services.” Dr. Shoon Mya Aye said when nominating Dr. Zu, who tied in the low-middle-income country category. “I am amazed by her relentless contributions to palliative care advocacy and educational processes, and her continued commitment to inspire and motivate all of us. She even spends her free time volunteering to support palliative care and hospice development!”

1. Was there a particular event (or person) that drew you to palliative care?

 “Taking care of cancer patients’ suffering, when lacking resources, accessibility and availability of opioids, and palliative care, was a devastating experience when I was a postgraduate student and young oncologist. When beginning to fulfill my desire to learn palliative care, it was difficult to search the literature and find textbooks, and technological access was poor. In 2013, Asia Pacific Hospice Palliative Care Network’s training-on-trainers program and Professor Cynthia Goh led me to the palliative care world.” 

2. How do you stay motivated?

“I stay motivated with hard work, keep my mind positive, and nurture love, kindness, and compassion while preserving a great expectation and commitment for palliative care.”

3. What form of relaxation or self-care do you enjoy?

“Doing good deeds, being mindful, watching movies, reading, and traveling.”

4. What advice do you have for those who follow in your footsteps as a palliative care practitioner?

“Be strong for what you believe in, be resilient for challenges and barriers, and be prepared for opportunities.” 

Dr. Zemilson Bastos Brandão Souza, Rio de Janeiro, Brazil

“I have found few people more intelligent and interested than him in helping to spread palliative care and pain relief. He is generous with his time despite his multiple occupations,” Dr. Wilson Astudillo of Spain says, describing Dr. Brandão, winner of the middle-high-income category. “It is really impressive all the fields of knowledge he knows as well as his speed to answer any questions or problems that exist and to provide expert, up-to-date bibliography.”

1. Was there a particular event (or person) that drew you to palliative care?

“During my medical residency at Brazil’s National Cancer Institute, I accompanied patients in their various stages of the disease's evolution, as well as family members and caregivers who were going through great difficulties when dealing with an extremely complex scenario. I noticed that the line of care for cancer patients presented opportunities for improvement, in terms of pain treatment, symptom control, and the need for a multidisciplinary approach. In parallel to a medical residency in anesthesiology, I studied pain and palliative care with the objective of inserting pain treatment and palliative care in the line of care of oncology patients.”

2. How do you stay motivated?

“In terms of palliative care and pain management, there is still much to be developed and improved. My motivation is supported by peer relationships: people who, like me, believe that the relief of suffering is imperative so that patients and family members can move forward with perceived quality of life and care dignity.”

3. What form of relaxation or self-care do you enjoy?

“I like to travel, cook, and meet people. I read a lot and value a healthy lifestyle, with physical exercise and in communion with nature and with my family—who are my greatest asset.”

4. What advice do you have for those who follow in your footsteps as a palliative care practitioner?

“Being at the side of patients and family members, comforting and welcoming them, is just one component of a larger set of actions. Therefore, my advice to those who wish to continue as palliative care professionals is to train and study tirelessly so that we can find solutions and advance in facing global health challenges. Not only health professionals, but society as a whole needs to be willing to break paradigms.”

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IAHPC Opposes Application to Add Fentanyl to WHO Essential Medicines

The World Health Organization is considering an application to add transmucosal fentanyl citrate, for breakthrough cancer pain, to the WHO Model List of Essential Medicines. In response, the IAHPC submitted a letter on March 17 opposing its inclusion. 

“We hope that other palliative care and pain organizations will follow our lead,” says Liliana De Lima, executive-director of the IAHPC. “Please disseminate, so that your own palliative care institution/organization will submit letters.” Letters should be sent to: [email protected]

Reasons for IAHPC’s opposition include:

• its potency (50 to 100 times greater than morphine) significantly increases its risk, and potential for abuse;
• it is prone to drug-drug interactions that could lead to significant variability in serum fentanyl levels;
• appropriate prescribing requires specialist training, which is already inadequate, and complex formulation, an additional challenge to health professionals and regulatory systems;
• it is recommended for those already receiving opioid therapy but opioids are scarce in low-resource countries.

IAHPC experts reached consensus that: “morphine is the strong opioid of choice for moderate to severe pain…[and] no evidence exists to support the need for, or the addition of, another pure agonist to treat breakthrough pain.”

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Great Idea! The award-winning Powerhouse program under the Young Caregivers Association in Canada umbrella is a regional effort teaching caregivers between the ages of 5 and 25 to strengthen their capacity to cope by teaching “life and personal development skills, providing the opportunity to connect with other caregiving kids, bringing caregiving families together, and reinforcing self-care.” The general program is open to all, but has also been specially adapted for use in schools.

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Tidbits

ICPCN’s New Logo Shines

The International Children’s Palliative Care Network unveiled a new logo in March that maintains its signature colors, but now features the sun—common to all cultures and countries—whose daily rising and setting is a symbol of both hope and the circle of life.

Abstract Deadline Extended 

April 14, 2023, is the new deadline to submit an abstract to the 15th Asia Pacific Hospice Palliative Care Conference, taking place October 4-7, 2023 in Incheon, Republic of Korea.

New in Pallipedia

A few new terms have brought the total in Pallipedia, the free online palliative care dictionary, to 1,416, and its definitions to 1,792. Pallipedia is IAHPC’s most-consulted resource, attracting tens of thousands of visits monthly.

• Dyspnea: assessment tools at the end of life
• Hazardous drugs
• Health care resources
• Pharmacist

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What’s New in the Calendar

New listings

Access all items in the IAHPC Calendar of Events.

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