It was a pleasure to have Jared and Bex Cordner working with us through Cairdeas in MPCU, Kampala. They contributed with expertise, skill but also willingness to learn, building relationship and embracing the challenges and joys of life in Uganda. Jared gives us a very interesting reflection from his business perpsective. Cairdeas can find it hard to share with you the need to build capacity rather then fundraise for more concrete projects so thanks to Jared for this very helpful view on our partnership with MPCU but also the fundamental principle by which Cairdeas seeks to work globally to increase acccess to palliative care for all.

'I’m not a medic. In fact that statement goes nowhere near far enough to explain my obscene lack of knowledge in relation to anything medical, despite being married to a Doctor (Bex). I come from a business background and so when Bex and I decided to take some time off from our normal jobs to travel to Uganda to work with Cairdeas I viewed the whole thing through different lens than she did.

Firstly, when I read that Cairdeas seeks to ‘promote and facilitate the provision of high quality palliative care in the developing world where such care is limited’, my finance brain summarised this as ‘making investments, not creating expenditure’. Working in an investment bank at the time I felt comfortable that I understood that world. Now, having almost finished our 4 months here in Kampala I find myself reflecting on the investment Cairdeas is making in Palliative Care in Uganda. I’ll summarise my thoughts using some standard investment appraisal techniques.

Capital Growth or Dividends

A central principal behind investing is that in repayment for your resources you seek either a dividend, or a growth in value. The investment that Cairdeas is making is focused on seeing growth, largely through capacity building within the palliative care teams across Uganda. I’ve seen that isn’t an easy process as it requires time, money, training and energy. All of these need to be utilised in developing appropriate skills in individuals, all of whom are different, as well as impacting practices. I believe that if we are to see true development in Uganda, then this is the approach which will deliver that.

Exit Strategy

Another key area that must be explored before you buy into any investment is that of the exit strategy, it is important to be able to walk away when the time is right. The capacity building approach which Cairdeas has adopted lends itself to a clear exit strategy as it increases self-sufficiency of the palliative care units across Uganda. It has been fascinating to observe how Mhoira has maximised the impact of Cairdeas, without fostering dependency. Personally, it has been a blessing to be able to offer whatever help I can, but my goal throughout was to ensure that I would never be needed again.

Ownership

Finally, there is a level of ownership and responsibility attached to investing. An investor should ask themselves, “Am I proud to be supporting these activities”? The work which Cairdeas is investing in is something to be exceptionally proud of. Cairdeas helps meets the deepest physical, spiritual and psychosocial needs of vulnerable patients in Uganda through its development of palliative care staff, volunteers and programmes. Basic human needs are being met in a way which they may not have been 8 years ago, and Cairdeas (through their local partnership with MPCU) are largely responsible for that.

So there you have it. In the past 4 months of being on the ground in Uganda I’ve witnessed Cairdeas make wise investments and ensure growth without dependency, all towards making palliative care accessible by all.'

Jared helped us put together our Christmas appeal so not too late to invest; it can be a practical breeding pig or enaging with our capacity building through scholarships or supporting our pastoral care and social support through our volunteer programme. Please use our donate button on the websoite and then drop us an email to say what you gave so we can keep you  updated and send a photo! Lastly, do you have skills to contribute to Cairdeas vision either in the UK or in Uganda or one of the other places we work. Please get in touch and keep up with our news through this website and facebook!!

We thank you so much for your generous support over the years!  Your contributions however small they may be make a lasting contribution to palliative care in Uganda!

Our appeal this year is to ask for your support towards services of a volunteer, buying a breeding pig and training for a palliative care nurse.

Support a volunteer

Volunteers are an integral part of the Palliative care service at MPCU, they give practical, psychosocial, spiritual and practical support to our patients and their families in Mulago and now Kiruddu and Kawempe hospitals. For £10 you can pay to facilitate the services of one of the volunteers for a week.

Ronald has worked with the MPCU volunteer team for 3 years now. He says; “I have dedicated my time, knowledge and skills in helping the terminally ill patients who are in too much pain and almost dying. I dedicate 3 days a week to offer psychosocial, spiritual and practical support to these patients.   Still so many times I have worked with patients who have no carers and I have to offer much time in helping them with services like collecting medicines for the pharmacy, taking them for investigations like x-rays, scan and helping them with physical exercises if needed. I also work with service providers in the hospital such that I am able to link my patients to them in case they need those services. Again in some cases patients are discharged from the hospital and are referred other health facilities near their homes where they can continue with medication so I do follow up on such patients to ensure they continue taking their medication”

Donate a pig 

We are also starting our new pig farm project so as to provide a sustainable source of funds for our pastoral and social support programme. This is an exciting new venture as we try to achieve sustainability. For £40 you can donate an adult breeding pig to help us kick start the project which will go on to provide the volunteer programme with long term funding.

Train a staff member

Building capacity within team members is vital if we are to see palliative care develop within Uganda. For £300 you can provide a scholarship for one month of a palliative care degree for a team member.

Esther received a five day link training in 2012 by the MPCU team and has since then been working on the surgical ward as a link nurse, giving generalist palliative care and referring complex cases to the MPCU team. In April this year she joined the MPCU team! Esther says  “Before I had the training patients who were dying could be neglected as the staff thought they could do nothing for them. But since the teaching I realised there is much I can do for these patients. I can allow them to die in peace and though they were suffering they had a smile on their face because of the care they received. Since working with the team I have learned much more. Before on the ward most of the times I would have worked alone but now I work as a team who have much knowledge that I can learn. I learn how to council them, how to care for all patients with life-limiting illness. It has changed me. It has changed my attitude.”

Esther now needs to enrol for an advanced training in Palliative care so she can provide better service to her patients.

Please consider supporting by clicking on our support button and donating online https://cairdeas.org.uk/get-involved/donate or by cheque to
Cairdeas International Palliative Care Trust 15 Kings Cross Avenue Aberdeen. AB15 6FS.  Drop us an email operations@cairdeas.org.uk so we can acknowledge your gift and also send you progress update and a photo!! 

We have been privileged to welcome mentors to Uganda as part of a Nurse Leadership Development programme which is supported by a partnership led by the University of Edinburgh and Makerere University (Palliative Care Unit) and funded by UKaid (DFID) through THET. Berit came for several months and contributed to the life of the MPCU team as well as her specific mentees. Here she talks of her experience.

'The opportunity to work in a completely different environment came right at the end of my working life. I have worked as a specialist palliative care nurse in London since 1989 and have retired three times! On my retirement from the NHS I said that my dream was to work in Africa.  I never thought the dream would become true.

But here I am in Kampala. It is certainly both a professional and personal challenge. At a personal level it is about daily living – shopping, travelling, risk taking, being in a minority, time keeping and just being here without my family. At a professional level there is a range of challenges, such as the balance between being supportive and paternalistic, adapting the UK knowledge and experience with so far only quite a superficial understanding of the Ugandan reality.

It would be easy to focus on the lack of resources, training needs, perceived inefficiencies and lack of planning.  However, as we talk about shared learning in mentorship relationships I would like to reflect on the learning I can bring back to the UK. I will leave the personal learning aside in this blog. Maybe in my next blog?

I strongly feel UK nurses could learn a lot from the Uganda. I am so impressed with the knowledge and experience the specialist palliative care nurses have of research, presenting papers and posters. In the UK we often say we don’t get the time to do this, but it is clear that it is a question of priorities. As many specialist nurses in the UK feel that there is a lack of career progression this could be a way forward. The investment in staff training and support in palliative care at all levels is remarkable.  You visit a small hospital far from Kampala. The palliative care office is the size of a cupboard and there are the palliative care training certificates of the staff on the wall!

The nurses also have a huge sense of pride in their work. One particular image comes to mind of a palliative care nurse in small hospital proudly showing us the locked wooden cupboard for the morphine. Their resilience to work with  limited resources with patients who are very ill, far from hospitals is outstanding.  As a visitor you think the presenting patient and his/her needs are overwhelming, but after a consultation with the palliative care nurse you realize that a lot can be done and you see the relief of the patient and the family. This could be prescription for morphine, information about the illness, support available at home.

Finally, and I never thought I would say this as a nurse without a faith, but the prayers and in particular, the singing at the beginning of a working day or meeting is powerful. It gives you time to reflect, focus and feel part of that particular group.

A big thank you to all the nurses, clinical officers, doctors and volunteers I have met in Uganda.'

Thanks so much Berit; haste ye back!!!