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Retiring Chair’s Annual Report
This is my third and final Chair’s report, as at the close of this meeting I am standing down as Chair, although I will remain as a Trustee. So I would like to take this opportunity to thank all my Trustees - colleagues and friends as they are - for all their hard work and support. It hasn’t always been easy as Chair to find a consensus, but it has certainly been a privilege to lead PCW for these past 10 years.
Our main training activity this year has been focused on the project in Ethiopia. Since last September’s report we have been out to Addis twice, once in November 2017 to deliver a week’s TK training to health and social care staff from four hospitals in Addis, and secondly, to deliver an intensive 3 day Training of Trainers course to 16 participants, most of whom we had previously met on the November TK course. This was followed up by two days of visits to the participants’ hospitals. As George, Ruth and Stephen will elaborate on that week’s activities, I won’t say any more, except to announce that we expect to make a 4th and final visit on behalf of Rotary, our funders, in June of next year, 2019.
Three of our Trustees were part of a teaching team that went out to Bethlehem in April, and again, we will hear more of that later from Jane. It seems likely that PCW will be called on again next year.
We are also sponsoring a bid for work in Nepal and you will hear more about that this afternoon.
Some of the Trustees, notably Karilyn and Richard, who sadly can’t be with us today as they are in Tanzania, put a very substantial amount of time and effort into writing a bid for a DfID grant of £50,000, to develop palliative care in south-east Tanzania. While the feedback from DfID was positive, we didn’t actually succeed in getting the grant! Undeterred we have done further work on our application and have resubmitted it, for the second round. There is a third and final round on offer if we do no better in this second round
Given that PCW came into existence in 2008, it seemed timely, ten years on, to review our work and in May we held a Blue Skies Day, ably facilitated by Mike Wooldridge, and generously hosted by Ruth, and Mike. This was a stimulating and challenging day, and has hopefully energised us to strengthen our endeavours to support the development of palliative care in resource poor countries.
In July we welcomed the Lancet Report on PC, and PCW was ably represented, first at a planning workshop organised by Claire Morris from WHPCA, and later at the launch of the report itself at the House of Commons. Nevertheless, in the light of the meeting that one of our Trustees, Ruth, organised with Claire to discuss support for PC within DfID, which was strong on warm words and weak on specific action, we are unsure of what practical impact the Lancet report will have.
In the last two weeks we have been disappointed, dismayed and indeed outraged by the denial of visas to respected PC colleagues in Zambia and Ethiopia, who were coming either to attend the St Christopher’s conference and this conference today, or other meetings and a speaking tour about PC. We, as a Board, have written to the Immigration Minister, Caroline Nokes, to protest at the arbitrary decisions that are hard to categorise as anything other than a part of the ‘hostile environment’ policy of this government. To date we have had a response to say that our letter has been logged and they expect to respond within 20 days. We are considering writing to the Guardian, Times - maybe others - on this issue and would warmly welcome the signatures of those of you here, either in an individual capacity or as representing your organisation. If you would like to see and/or contribute to the draft letter, please do let any one of the PCW Trustees know and we will circulate a first draft.
Finally, it is a pleasure to see so many colleagues and friends here, all bound together by a common concern to spread palliative care to those who need it most.
At our one-day conference at Sobell House, Oxford on 24th September 2016 we once again welcomed Associates, Friends, and visitors from overseas.
Conference delegates included participants from Bangladesh, India, Romania, Burundi and Malawi. Their presentations describing the PC situation in their countries were prepared for St. Christopher’s Hospice, and are available here in .pdf format
- Community Based Palliative Care Services – Pondicherry
Ms Anu Savio Thelly, India
- Palliative care situation in Burundi: success, challenges and opportunities
Ciza Bonne, Burundi
- Hospice Emanuel Foundation
Daria Barna, Romania
- Palliative Care : Malawi
Mwandida Nkhoma, Malawi
- Palliative Care in Bangladesh
Dr Rubayat Rahman, Bangladesh
Powerpoint presentations, by principal speakers at our September 2015 conference in Birmingham, are available to download below.
- Global Palliative Care – working towards sustainability: Achievements and
Prof. Julia Downing
- Adapting to a changing global and local landscape – alliances and wider players
Carolyn Miller CBE
- How can a sustainable model of Palliative Care in the Community that includes Social Work,
be developed in Poorly Resourced Areas
Angela Kaiza Kangalawe
- Crossing Continents … Sustainable Services
Dr Karilyn Collins MBE
- Sustainable Palliative Care Projects in India
Dr Stanley Macaden
- Sustainable Palliative Care Education and Training
Dr Fiona Rawlinson
- Integrating palliative care into undergraduate medical education
Dr Kaly Snell
- Visit to Rwanda to support pharmacists and medics training in use of opioids in palliative care
Julie McCarthy & Victoria Smart
- The Palliative Care Toolkit – a manual for all settings
- The Present – using the Toolkit in East and West Africa
Conference delegates included participants from Cameroon, Burundi, and the Seychelles. Their presentations describing the PC situation in their countries were prepared for St. Christopher's Hospice, and also given at our Birmingham conference:
- Palliative Care Situation in Cameroon
Ossematou Damenim Therese, Cameroon
- Palliative care in Burundi: success, challenges and opportunities
Dr Roger Ciza, Burundi
- Palliative care in Seychelles: Challenges and Opportunities
Yvonne Telemaque & Agnes Marielouise, Seychelles
Mentoring in Palliative Care
The following ‘top tips’ were devised during the November 2013 conference, and are offered by PCW and Cairdeas to those engaged in mentoring palliative care practitioners who are working in situations where physical and technical resources are limited. The advisory points are aimed at:
a) For the Sending Organization it is important to:
- Set out clear objectives for the programme (i.e. define clear goals, articulate a positive vision, and identify the tasks involved)
- Give full attention to the cultural orientation and preparation of mentors.
- Provide suitable basic language training appropriate to the nature and duration of the mentoring contact.
- Provide a flexible budget (so as to give practical support, and maintain transparency about funding)
- Explore the mentors’ expectations before their overseas visits, and if necessary harmonise them with the host’s expectations.
- Provide opportunity for contact with ex-mentors and fellow mentors and, if appropriate, with the host organization.
- Ensure that all Visas, professional certification requirements, etc. are obtained in good time.
- Check that the timing of the mentoring visit is appropriate for the host, and that the host team has ring-fenced the period.
- Provide all necessary practical support on the mentor’s arrival overseas and during the placement; and debrief them on their return home.
- Ensure that the mentor’s accommodation is fully prepared, including provision for health issues and security.
b) For the Receiving Organization it is important to:
- Define their expectations prior to the visit of the mentor(s), in negotiation with the sending organization, the national association and other relevant parties; and in a spirit of flexibility.
- Ensure that the role of the mentor (what they can and cannot offer) is understood by all the team.
- Be clear and open about what is wanted and not wanted from the mentor (i.e. ensure that clear goals and tasks are communicated to all).
- Allocate time for the training of the team members, where this is appropriate and/or necessary.
- Have the team ready and waiting when the mentor(s) arrive, ensuring that key people are available and are committed to the mentoring timetable.
- Identify what the team members have already achieved.
- Identify possible problems and issues (e.g, morphine supply)
- Ensure that safe and suitable accommodation is ready for the mentor(s), with a named person responsible for dealing with any problems.
- Inform mentor(s) of any potentially unacceptable or inappropriate practices or behaviours, in keeping with local cultural norms and beliefs.
- Welcome the mentor(s) appropriately, and arrange early introductions to key people
- Provide the mentor(s) with information about basic services, local conditions, infrastructure, travel, etc.
c) For Mentors it is important to:
- Read the Palliative Care Toolkit, and take both English and local vernacular version (if available). Familiarise yourself with web resources, national web sites, local guide lines, etc.
- Learn some basic phrases in the local language, in order to facilitate some non-technical discussion.
- Establish communication with the team prior to the visit by email, phone or Skype.
- Be clear about necessary documentation and registration, and beware of legalities concerning visas and possible accreditation requirements back in the UK.
- Find out about the composition of the team (and their working timetable if available)
- Find out about the area in which you will be staying, and the accommodation provided for you.
- Obtain a dongle and sim card (for an unlocked mobile) in the host country, so as to facilitate practical planning and communication, and contact with home.
- Travel with flexible expectations and cultural sensitivity; and be respectful.
- Make realistic and achievable plans with your hosts on arrival, and manage everyone’s expectations
- Adapt the pace of your activity according to the length of your stay. In general, take things gently.
- Find the key people early on, and introduce yourself to influential people.
- Acknowledge successes, however small; and avoid criticizing the host organization or individual mentees – though be prepared to challenge, if necessary.
- Beware of potential problems and have realistic personal expectations ( work on peoples terms)
- Be true to yourself and value your skills and experience; but be humble, and aware that you don’t know everything (or even much!).
- Share and discuss your problems and anxieties with fellow mentors, colleagues or family back home. Have a named contact in your sending organization.
- Establish the limits or extent of any ongoing involvement with the host organization, before you return home.
- Take some time out from the mentoring, perhaps by spending the weekends away from site; enjoy the host country’s sights and hospitality.