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.

EHA participants

Faculty

I cant believe it has been so long since I posted - sorry for those who like more regular updates. So a quick review of the past few months over the next couple of posts.
At the invitation of Dr Ann Thyle and the Emmanuel Hospitals Association we formed a truly international faculty to teach the Palliative Care Toolkit in Delhi November 2011. Let me introduce you to the faculty; Dr Ed and Penny Dubland from British Columbia who have been visiting India for some years but even better Ed speaks fluent Hindi as a legacy of his childhood at Woodstock school; Dr Chitra Venkieshwaren our wonderful Cairdeas friend and regular faculty who is based in Kochi where she leads psycho-oncology developments and services; Dr Jane Bates who leads palliative care in Tiyangane clinic based in Queen Elixabeth University in Blantyre, Malawi; Josephine Kabahweza who is the senior nurse from our Makerere Palliative Care Unit and wowed everyone with her African dress and enthusiasm; Dr Ann Thyle from India who is the director of EHA programmes in EHA and yours truly. Funding support came from several sources including EMMS and Cairdeas. We were a great team!

The participants came from across the EHA network and brought so much enthusiasm and dedication to develop palliative care. Teams came from MP, UP, Delhi and Uttaranchal; many working in rural settings where there are few options for care. We laughed, shared, played roles, sang, even cried and certainly learned so much together. EHA have plans to develop palliative care across their wide range of hospital and community programmes and we hope to be able to continue to offer training support.

Spcies galore

Visiting Mr S at home

I also had great fun introducing my Uganda and Malawi friends to my favourite parts of Delhi; dinner at Karims, smells and sounds of the old spice market, wonders of the Red Fort and Jama Masjid, goats with tinsel round their necks ready for Eid, rainbow colours of fabrics, momos for lunch, hot sweet spicy chai, transport by auto, metro, taxi, cycle rickshaw and then a classic Indian overnight train.The latter took most of the faculty to the Harriet Benson Hopsital in Lalitpur to evaluate the first 18 months of the first EHA palliative care service. What a lovely welcome and so encouraging to see how much has been achieved. We met several patients and their families who spoke so movingly about the care given to them. As the local health administrator (Add CMO) said about the PC team; 'these people look after those that everyone has rejected.'

Smiling or worried???

perhaps a good place to pause. Palliative care is reaching out to some of the most vulnerable who face suffering and distress due to chronic disease where the focus is on quality of life. What does that mean? Perhaps Mr S (seen above on a home visit) illustrates this well; he had treatment for cancer which left him tired and in pain and unable to work in his fields to support his family. In desperation he was told by a friend to come to HBM hospital. 1 year on he is free of pain and back working and enjoying the birth of his newest grandchild. In his own words 'my heart has become less heavy, I feel at peace, my pain is less.'

Makerere team with our new teeshirts

Back to Kampala where our team were able to have a special Christmas celebration. Thanks to everyone for hard work, love and care and welcome to our new volunteer team as well as the link nurses from Mulago Hospital and the deputy senior principle nursing officer as guest of honour. 37 people singing and eating and celebrating the end of a year and the hope of Christmas. The boat trip added adventure - particularly as most for the team had never been on open water before!!!!!So many challenges along the way this year yet also so much grace and joy. We are blessed indeed.

sunset Lake Victoria on the way home

2nd years at Mulago

2nd years at Mulago

52 students from 10 Africa countries; 10 weeks of intensive teaching; committed faculty dealing with last minute crises and problems; international faculty from the UK augmenting the expertise and adding to the rich mix; learning from an inspirational group of colleagues; singing every morning; dancing together in church; speeches, cakes, first ever clinical OCSE exam....we are nearly at the end of the 2011 face to face teaching session for the BSc in Palliative Care run by Hospice Africa Uganda and offered by Makerere University.

Charity concert with 3rd years

It is always an intense few months with many challenges but as before the inspiration of working in a committed team and with such inspirational students is humbling and rewarding. Many of the students are experienced palliative care colleagues and leaders in their own settings and bring their wealth of knowledge yet are still willing to learn and share. For some this is a new opportunity to travel and learn. Let me do some introductions. In the 1st year group are Eric and Eric from Cameroon. They had never had passports before let alone traveled by plane. Joining them from Zimbabwe is Chengerai and together they had great singing voices and joined me in our church thanksgiving service.

Malawi 2nd years

Lois

Our first Cairdeas scholarship students, Lois and Gertrude were part of this group and were proud to share in the visit to Mulago - their place of work too. In the second year were some familiar faces as well as many newcomers. 5 from Malawi showing the huge commitment to training and developing palliative care across that country and especially good to see them all back in Uganda having visited most of them last year. Christopher spoke of the way he has grown as a leader through the course. Then the 3rd years; pioneers having to manage the many glitches of a new programme with forbearance and tackle new subjects such as research and mentorship and doing so with enthusiasm. For many balancing the demands of work and family and study and finances are so challenging. Supporting one another and forming close bonds of friendship. Amos and Willy singing duets to calm the nerves before the first OCSE (Clinical ) exam; and who was more nervous; the students or the examiners most of whom were new to this style of assessment.

Prof Barbara Jack and myself relaxing

Prof Anne, Jo, Zena, myself and 1st years farewell cake

What of my fellow faculty members? Still smiling and supporting even when the challenges have been many and the many new members at Hospice Africa Uganda working well together. Working long hours and giving of themselves in many ways too. Sharing expertise especially with those from the UK who are part of  THET link project. Some old friends such as Prof's Scott Murray, Julia Downing and Barbara Jack but also new colleagues in Libby Ferguson and Ruth Adams.

2nd years and faculty

End of Children's module teaching

Prof Anne Merriman was speaking to the students at a reception in her home and reminding them that the word 'hospice' shared a derivation with the word 'hospitality'. Opening our homes and our hearts to those in need and supporting one another. It is sad to be saying goodbye to colleagues and friends yet the friendships and bonds made during these weeks will remain and grow and we are richer and more blessed for the meeting of hearts and minds and cultures. We also as a MPCU team are very sad to be saying good bye to Dr Jo Dunn  who has been such an important part of the team as well as friend for the past year. We wish her every blessing in settling back in to London life and a huge thank you for all she has given to us and to Uganda. We also welcome new members with Dr Jack (Ugandan) and Dr Lesley (UK)
Meetings and parting remind me of the motto of Aberdeen city; 'Bon accord...happy to meet, sorry to part, happy to meet again.'