One of the fascinating aspects of travel is being able to experience local traditions and cultures. It is humbling to be welcomed into villages and homes and to share our basic humanity as well as all the quirks and nuances that make each one of us unique. I have been introduced by a friend and colleague in India as a 'chameleon' which  think as meant to be compliment to my ability to blend in rather than a comment about wrinkles. I was talking with one of my Ugandan friends, Florence, and we spoke of the amazing differences and cultures and how this can create challenges as well as joys and her reply was 'we had better get used to it as it is a taste of heaven'. Let me share some places and people that have given me a 'taste of heaven'  these past few weeks and months.

Mhoira and Julia

Celebration with Mwazi

Early January saw the culmination of many many years of hard work for faculty and students with the first graduates from the BSc programme in Makerere University and run by Hospice Africa Uganda. Some



unfortunately could not afford the travel but we gathered from Uganda, Tanzania, Cameroon, Malawi and Kenya. MPCU (Makerere Palliative Care Unit) had 3 graduates; Mwazi Batuli, Liz Nabirye and Frida Kolya so extra special celebrations. There was also a Ian Jack Memorial special award to the student who had achieved this despite many personal challenges and this was given to our inspirational friend from Zimbabwe Franciscah Tsikai. This award was given by Prof Barbara Jack in memory of her father. Francis  I still remember your first year when you stood with me in church and wept tears as you gave thanks that God had blessed you with the fees for one year and for all his goodness.

Proud graduates and faculty

Franciscah with her award in Zimbabwe

Participants Lucknow leadership course

4 weeks in India allowed me to sample 4 climates from the foggy mornings and chilly days in Lucknow to the balmy warmth and crazy traffic of Bangalore and the cool of Guwahati. In SGPGI Lucknow we were running workshops in leadership, management, teaching, self awareness and symptom control; Cairdeas was working with Pallium India, Emmanuel Hospitals Association and SGPGI. We had an amazing time with great faculty ( thanks Chitra, Sanjay, Anne, Charu, Angela and Carl) and enthusiastic participation (spot the innovative giraffe) from colleagues across UP state but also including Assam, Mahrashtra, Bihar, Gujarat and Kerala. In all EHA sent participants from 7 hospitals (Prem Sewa in Uttarala, HBM in Lalitpur, Duncan in Raxaul, BCH in Fatehpur, GM Priya in Dapegaon and Baptist CH in Tejpur) and have already started 3 palliative care programmes with one more to follow very soon. meanwhile SGPGI is developing as a centre for palliative care excellence and we were able to work with them to plan ahead. In Bangalore we

Angela 'at home'

Chitra helping Carl and Angela to shop

Charu, Angela and I travel in style

MPCU winning poster

took part in the Indian Association for Palliative Care 20th conference and joined the celebrations of 25 years of palliative care at Kidwai Cancer Institute. MPCU had 5 presentations and sessions and managed to be awarded one of the first prizes for the posters and the oral presentations  Angela Kaiza from Tanzania joined us for the whole trip as part of our collaboration with PCPi (Palliative Care Partnership initiative and Tanga region and was able to lessons from her setting. She took to India like a duck to water - though was very happy to taste an authentic Lucknowi biriyani with plenty meat! Dr Jo Dunn was also able to join us from London and helped deliver an excellent ethics symposium.  Lastly on my tour was the city of Guwahati set on the banks of the Brahmaputra river and capital of the state of Assam. Dr Dinesh Goswami is one of the leaders being supported by the Leadership Development Initiative and it is my privilege to offer mentorship. He organised

Lakshmi puja, Guwahati

only the 2nd (last one 10 years ago) state wide meeting to discuss integration for palliative care and opioid availability as well as a workshop at the local medical college.Anyone who knows Dinesh can vouch for his gracious and dedicated spirit and he amazing work he has done.
Home via the snows of bonnie Scotland but I am realising there are too many 'tastes of heaven' for one blog post. So I will keep the tales of Scotland, Cairdeas developments and recent events in Uganda for a post next month.
Let me finish with a quote from some of our students that encouraged us and encourages all who teach;   'Thank you so much for the support you accorded me throughout the course. It was strengthening at my point of weakness and source of support when I needed it most. Your contribution was so great and words cannot explain it fully. You were great and thank you so much for that!.
This is Holy Week in the Christian calender and a time to remember the incredible hope we have in God. I pray this Easter time you find that sense of hope and meaning and spend time with people and in places to gladden the heart and encourage the soul. 

Christmas is a time to reflect, celebrate, enjoy friends and family and sense again the wonder of God coming down to earth as a tiny, vulnerable baby. We know the stories and the carols and we all have our own traditions. I have been privileged to spend Christmas in many different parts of the world. In India we ate fragrant chicken biryani and the CMC Vellore students came round late at night to sing carols; in Kerala the Santas wore plastic faces and surgeons gloves which was a little disconcerting. In Tunisia we had plenty choices of turkey along with spicy harissa and then sang carols on the beach. In Scotland I have been known to go paddling in the snow - in a kayak!  Here in Africa I have spent Christmas in the middle of the amazing animals, birds and scenery of the national parks of Uganda and last year saw a leopard hanging out in a tree! I also am able to join a Lugogo baptist church tradition of a Love Feast. We are invited to bring food from our national or local setting and to bless one another, care for one another, sing and dance (and Acholi dancing is AMAZING) and share the love of God within the church and with those who are vulnerable, lonely and in need. I was busy baking cakes and very happy to have some special Acholi food ; malakwang, boo and lapena! What a wonderful concept! Instead of focusing on what we get and the increasing materialism of our world we focus on what we can give, with whom we can share blessings, who needs a hug, who can we thank for all they are and all they give.

Hi to my friends; after a VERY LONG silence I am going to post a few entries over the next few weeks as a reflection on an amazing year in the work of Cairdeas.
I was reminded of this quote attributed to Mother Theresa a few days ago; 'At the end of our lives we will not be judged by how many diplomas we have received  how much money we have made or how many great things we have done. We will be judged by; I was hungry and you gave me to eat. I was naked and you clothed me. I was homeless and you took me in'  and the biblical quote continues, 'I was sick and you cared for me'  I want to share some of the humbling ways we are able to work in partnership to support some of the most vulnerable in our world - those in pain.
Teaching, training and mentorship is one of the key ways we are working to build capacity for palliative care. For those who want to support our Christmas appeal to help build capacity and training please click on our link to read about 2 of our our justgiving site. https://www.justgiving.com/operations-cairdeas
I have had the privilege this year of visiting 10 countries (including UK and Uganda) to be involved in training. A much used format is the Palliative Care Toolkit and Training Manual (find 7 different language versions at  https://www.thewpca.org/resources/) developed to support introductory learning in palliative care and to model an interactive learner centered style. This is good adult learning terminology but what does it look like in practice?

Serious planning in Mussoorie

Let me tell you some giraffe building tales. Take a few newspapers, some sticky tape, several willing (or not so willing) learners divided into groups with a good dollop of enthusiasm and give them 10 to 15 minutes to make the tallest giraffe possible to win - with one proviso; it must stand for 10 seconds unaided. The aim of this exercise is to demonstrate team working and it is amazing how many learning points emerge;
1. ensure a clear vision; a very long neck and the incredibly long legs may not support that fat body
2. planning; perhaps some thought to how to strengthen the base and legs will be worth the time taken

Jumana leaning giraffe

3. collaborate; fighting over the sticky tape means everyone is slower
4. participate; everyone has a role and something to offer even if they don't shout the loudest
5. innovate; who thought up the newspaper base to stop it slipping
6. celebrate others success; sabotage to the other teams' giraffe in order to try and win never works (or at least will be disallowed)

Hugs for the winners in Aberdeen

Sounds straightforward? Easy to describe but can go a little haywire when the facilitator (me) loses control of 40 wonderful but feisty colleagues in Ghana such that we had to remove the giraffes to prevent sabotage and actual physical harm now known as the 'giraffe mob' incident. Then we had some Swahili fun in Tanga region with gales of laughter and no giraffes left standing. High in the mountains of India in Mussorie colleagues on a leadership course wanted to argue their giraffes were tired and needed to lean on the table for some support. Easier with the UK friends who came to the annual Cairdeas gathering - with the team which included a physicist and orthopaedic surgeon winning hands down - or is that hooves?

Sunset in the Himalayas

Sculpture in Ghana

All part of the privilege of being involved in international training; seeing colleagues grow and learn; mutual sharing of the joys and the challenges of palliative care where physical resources are often so limited yet spiritual and cultural resources so rich; helping train and equip leaders for the future; warm and generous welcome into so many different cultures; inspired by the people we meet and the beauties of the natural world.

As the African proverb says; 'If you want to go fast travel alone; if you want to go far go together.'
Many thanks to all who have traveled this journey with me and with Cairdeas in 2012.