Report
This report on my recent visit to Ghana is sent with grateful thanks to the IAHPC for the fellowship which made possible an exceptional experience of healthcare education.
I am sure that like many recipients of the IAHPC fellowship before me I found myself in a cycle of giving and receiving which has refreshed my professional interest in my subject and in addition has caused me to look again at what it really means to teach Palliative care which is sensitive to culture and practice.
The two weeks I spent in Ghana have also left me with a deep respect for my Ghanaian healthcare colleagues and a commitment to support them as they develop palliative care services in their country.
"What shall I bring with me to Ghana?" I asked Rev Fr Victor Sackey as I prepared to lead a team of five palliative care teachers and practitioners who would deliver sensitization training about Palliative care in the capitol city Accra.
"Bring everything you need with you and assume that nothing is available here " he replied and so it was that myself and my colleague Dr John Cresswell set off for Ghana laden with materials, laptops and projection equipment, handbooks and resources to share with one hundred Ghanaian healthcare staff who had been invited to attend the program.
We were joined in Accra by Bernadette Besemera, Jack Jagwe, and Henry Ddungu three practitioners from Hospice Uganda who would contribute so brilliantly to the first weeks’ teaching.
From the first day of the course it was apparent that group work exercises and experiential learning would suit these active learners and engage them in opportunities to discover the values and attitudes of palliative care for themselves. The learners welcomed the opportunity to contribute in many ways and their contributions were challenging and impressive. How do you manage multiple pains, how do you explain to caring family members that the patient no longer wishes to eat or drink, how do you restore the self esteem and dignity of a person who has lost two thirds of their body weight, how do you prepare the family to say farewell, how can you tell if a person is in spiritual distress, what ethical principles should guide our actions in end of life care.
This level of engagement made each day very rewarding and also utterly exhausting. We were particularly thankful that Rev Fr Sackey and his trustees from the Cancer society of Ghana made sure that in the evenings we could sit and look out to sea, unwind and enjoy some simple Ghanaian hospitality. The first weeks teaching concluded with a number of intelligent suggestions and ideas to turn theory into practice and with the recognition of a number of very challenging obstacles to be overcome before Hospice care hit Ghana.
In the second week I was invited to talk to smaller groups and to visit healthcare premises. At one teaching hospital I caught up with a course participant who said: "I have got this man’s analgesia sorted out Terry, now he gets it by mouth, by the ladder and by the clock." This was just one example of the speedy transfer of knowledge into caring actions that I witnessed.
With so many beurocratic, structural, financial, strategic, and infrastructure issues to overcome in a resource poor country and in a culture which combines traditional cultural ritual with modern medical practice, I believe it will be the indomitable spirit of these not so ordinary Ghanaian healthcare staff, Reverend Fr Sackey and his supporters, which will find an appropriate way forward for Palliative care. I have every confidence that slowly but surely they will succeed.
Thank you for making this possible.
Terry Magee, RN
Director of Education
St Helena Hospice
Submitted by: Steven Radwany, MD Medical Director, Hospice of Summa Akron, Ohio, USA
