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Odisha experience, chilly Delhi and Assam adventures

Dr Mhoira Leng
23rd March 2014

Mentorship participants
Warning; Delhi in January is really quite chilly. Picture me going to sleep with a wooly hat and wrapped like a parcel in scarves. What was not chilly was meeting again with the Emmanuel Hospital Association palliative care colleagues and sharing together about mentorship.  I think
Himalayas by air

Baptist Hospital, Tezpur
this is one of the most crucial areas in building capacity. Mentorship helps another become more self aware, builds confidence, challenges and supports the identification of areas needing growth and facilitates mobilising resources and making changes. As ever Chitra and I worked together joined by Ann Thyle and Marion Mathias who is a GP from Herefordshire. We are seeking to support the development of mentorship within EHA and to offer some further external mentorship support though colleagues such as Marion. Straight away we visited one of the dedicated and visionary leaders and her team at Baptist Hospital Tezpur, but this will be retold more in a future post. However, Marion is soon doing another big challenge; the Paris Marathon. Please consider giving to Cairdeas through her justgiving page. Many many thanks Marion and power to your knees!! https://www.justgiving.com/Marian-Mathias
Claire and Beci
With Anjum, Dinesh at IAPCON
We then travelled to our 3rd state of Orissa, joined by a team from MPCU, Beci, Claire, Alastair, Julia and Ivan. I was so so proud of our team presenting 7 abstracts and 1 paper and being recognised with several prizes. EHA also presented and also shared prizes (well done Ann)and Chitra's team presented some innovative work in the area of mental health with similar recognition. It is not just about prizes of course but the opportunity to share, have work appreciated and affirmed, encourage others and continue to see palliative care developed and lives changed. Thanks to the teams from AIIMS and Bhubaneswar for organising a great conference.
For Ivan it was a journey of first experiences, not least being the sole black man at the conference. He tells me he now knows how difficult it is when people stare at you all the time because your skin colour looks different!! He has shared some of his experiences for this post.
Ivan
MPCU team in Bhubaneswar
'I was in India from the 11th-20th of February 2014 to attend the 21st Indian Association of Palliative Conference as part of the Team from Makerere Palliative Care Unit. I coordinate the team of volunteers at MPCU who are invaluable in providing practical psychosocial and spiritual support to the patients with palliative care needs. There were so many firsts for me; it was my first time to travel by aeroplane, first time to present a paper at a palliative care conference of any kind and overall it was a lifetime experience for me. I presented a paper on “Integration of Volunteers within a Hospital setting” giving the experience of Mulago Hospital where I am based. I was quite nervous since it was my first time to make a presentation at a conference of such a magnitude. I was even more shocked at the awards ceremony when I won joint first prize for my presentation. I enjoyed interacting with palliative care practitioners from various countries and India especially that has good volunteer palliative care services. It was a rich experience for me.
Ivan and Alastair at the Taj
It was not only work, together with my colleagues, we were able to experience and see some of the historical monuments of India, eating their delicacies and experiencing bits of their culture. My highlight was our visit to the magnificent Taj Mahal which left me in awe.  India is a very wonderful country, the people were warm and friendly. Overall it was an experience of a lifetime that I will live to tell my children about, and I want to appreciate all those who made it possible for me to attend the

conference and special thanks to my Boss who has been a good mentor to us all at MPCU'
As you know Ivan is one of our team members who is receiving a Cairdeas scholarship to continue his theological studies and to attend this conference. Thanks to all who contribute so faithfully in so many ways. 

Angels

Dr Mhoira Leng
26th December 2013

What has been the best story for you this year or in your family and country? People who bring news are important and in the Christmas story angels play a significant part. They announce the message of the coming baby to Mary and to Joseph, they told that this baby would be the saviour of the world, they then announced to the whole world in a heavenly choir the great news , peace on earth and goodwill towards men.
I have been thinking about the message of the angels and also how angels can become a symbol of hope and protection. I am sitting on Christmas eve on a balmy evening looking forward to a warm, tropical Christmas without the crispy snow and frost that is so familiar in Scotland. I hear this year there are even storms and severe weather. But then that first Christmas there was no snow, despite our many Christmas cards carols that say otherwise.
I have a banana fibre Christmas tree hung with African angels and several other beautiful angels made from local materials including bark fibre, safety pins and local fabric. We also have shared beaded angels on our Cairdeas stalls for some years made in South Africa and Uganda. 
There have been some precious stories of ways these simple symbols have represented love and care. One of my friends showed me the wee angel I had given when her husband was dying. She has carried in her purse as a reminder of God's care for several years. Another friend shared how her very sick friend asked to her to give an angel to each of her family so they can hang it on the tree and remember her.
We had a party with our patients at Mulago last week and so enjoyed singing in several languages, eating cake and piled high plates of Uganda food. I was sharing one of the names given to Jesus and often given as a name to boys here in Uganda. Emmanuel which means God with us. This was the profound message of the first Christmas. it is also the amazing message still here today. My Rwandan colleagues then spoke of us being little Emmanuel. Being the presence of God in each other's lives and in the lives of those who have little good news and even less peace. We think of our brothers and sisters in South Sudan and Syria and many other places of conflict this Christmas. We think of the many people ill in hospital or at home, those who are missing loved ones, those who do not have food or clothes, who do have choices over their lives.  Many of us will have an symbolic angel in our homes or on our Christmas trees this year. Perhaps we can take the good news the angels sang to heart and let it change our lives but also let it change how we relate to the world around us.  As one of the greatest global leaders said; 'Our human compassion binds us the one to the other - not in pity or patronizingly,but as human beings who have learnt how to turn our common suffering into hope for the future'.  Nelson Mandela
Wishing you 2014 full of hope.



WWLD and WWJD

Dr Mhoira Leng
14th November 2013

Last evening I was privileged to attend a celebration of the life of David Livingstone in the soaring and chilly beauty of Glasgow Cathedral. I was then asked to be part of a debate on what would Livingstone (WWLD) do if he were alive today. All the suggestions were persuasive and compelling (eradicating HIV/AIDS; Ms Mphatso Nguluwe , ending modern human trafficking;Sir Kenneth Calman, mobilising churches; Rev CB Samuel and addressing the global pandemic of untreated pain and lack of access to palliative care; yours truly) I have included the whole of my 4 minute speech for you to review. Sorry you can't vote for the others as well. At Cairdeas we are particularly delighted to partner with EMMS International https://www.emms.org/ who are the main support behind the palliative care developments in EHA, India, that we also support, as well as in Malawi. Now to finish packing in time to catch my plane back to the tropical heat of Uganda.....
 
'My thanks to my fellow debaters for their moving and persuasive presentation, to EMMS and the organisers of this event and to Dr David Livingstone for his inspirational life and example which we have come here to honour and celebrate.
 
5 billion people in our world do not have access to pain relief and palliative care, many of these with chronic, debilitating, life limiting illness. HIV AIDS as we have already heard but also rising numbers of those with cancer, growing problems with heart disease, rapidly increasing numbers with poorly controlled diabetes, kidney failure with little access to dialysis and multiple respiratory problems due in part to cooking fires in huts with poor ventilation.
 
This burden of disease has an incalculable effect on individuals, families, communities and even national economies as it disproportionately affects those in low and middle income countries exacerbating poverty and creating a trap for many more to fall into, where meager resources are used in a futile search for help and future generations denied opportunities and hope. This global pandemic of untreated pain affects hundreds of millions of people in our world and is described by the World Health Assembly as an urgent, humanitarian responsibility.
 
 
 
Oral morphine, one of the mainstays of pain relief is simply unavailable in most of the world. Of all the morphine legally produced and used every year 94% is used by countries that represent only 15% of the world’s population. One of Livingstone’s achievements was to ensure that a simple medication made from Peruvian tree bark would be available in a safe and effective formulation. These ‘Livingstone’s Rousers’, which combined quinine and  rhubarb, were a significant advance and I think he would use same energy and determination to champion the provision of another God given medication; the extract of opium we call morphine.
 
Imagine the anguish of medical colleagues seeing patients in such severe pain yet unable to help, imagine the distress on a mothers face when her tiny daughter injured by severe burns when she pulled over paraffin lamp screams in pain without relief, imagine the quiet endurance and silent agony of a young mother whose breast cancer has spread to her bones and dares not move lest it hurt, imagine the nurse who avoids dressing the wounds of her patient as she cannot bear to hear the shouts of pain, imagine the elderly man who prays that God will take him soon to spare him further anguish and stop draining the family finances.
 
Palliative care is about quality of life and holistic support addressing the physical problems such as pain but also the isolation and financial drain of chronic illness, the loss of hope and meaning, the powerlessness and despair. It is about empowering communities, restoring dignity, relieving suffering, walking alongside those who face darkness and despair with all our medical skills and also a message of hope and promise of presence.
Livingstone engaged with some of the greatest causes of suffering and injustice in his day but above all he was concerned with what would Jesus do. WWJD leads to WWLD.
 
Livingstone was an ambassador for Christ. Taking the good news of reconciliation with God, with one another, with ourselves and with a world that is beautiful, exciting with untold riches to be explored. Livingstone was also a beacon to challenge and inspire others to be involved in this God ordained work of bringing reconciliation and healing and an end to needless suffering. Livingstone was not afraid to challenge and convict others, to stand against the prejudices of his day and to live his life in the extreme for the cause he believed in.
 
Many years ago I sat under a baobab tree in Malawi and made a decision to engage in this cause in Africa and India. It has been a wonderful adventure and tremendous privilege for me filled with challenges and blessings. This tree was over 200 years old and local legend has it that Livingstone would sit there; perhaps also contemplating the calling God has put on his life.
  
Ladies and gentleman; lack of access to pain control and palliative care is one of the most significant global injustices facing our world today.  I put it to you that freedom from pain, restoring dignity and relieving suffering would have been a concern, a motive, an imperative and a journey of untold adventure for Livingstone; as it is for each one of us.'
 
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