Meet Liz Nabirye, one of our newest Cairdeas scholars! Liz has worked with Dr Mhoira Leng for around 15 years and is the Clinical Lead for the Palliative Care Education and Research Consortium (PcERC). Liz is currently undertaking a Master’s Degree in Palliative Care at Makerere University. A highly experienced palliative care clinician, and a compassionate, generous person, we are delighted to be working with Liz as she furthers her education in palliative care.

We asked her to share a little about herself and her experience as a Cairdeas scholar so our supporters could get to know her better.

“I have worked in palliative care for 23 years and I strongly believe that my career development will greatly impact the lives of others through my role as a clinician, a trainer and upcoming researcher. As a clinical lead, I am involved in providing specialised holistic person-centred care to children and adults with life limiting illnesses with a goal of improving their quality of life and that of their families. Pursuing a Master’s Degree in Palliative Care was a dream come true through a scholarship granted to me from Cairdeas International Trust and I am very grateful for the offer.”

Liz also provided us with some details of what her work and studies involve, highlighting the importance of collaboration and mentoring,

“To ensure continuity and sustainability I am involved in knowledge and skills transfer through education and training of both nursing and medical students at different levels with ongoing clinical modelling. Doing this Master’s in Palliative Care will greatly enhance my research skills which are needed to ensure evidence-based practices. It was indeed very humbling and gratifying to win this Cairdeas scholarship for my master’s program.

I currently provide palliative care services in the Mulago National Referral Hospital and Kiruddu Referral Hospitals, which serve as training hospitals for both under and post-graduate students of the College of Health Sciences, Makerere University. I participate in teaching and mentorship of students rotating in the palliative care service, aimed at building capacity and a critical mass of palliative care leaders to integrate good practises in the health systems in their settings.”

Throughout these reflections, Liz’s passion for teaching and mentoring the next generation of palliative care clinicians shone through, as she elaborates,

“One of my most significant career aspirations is to take on a mentorship role within the organization. Throughout my career journey, I have benefited greatly from the guidance and support of mentorship and this has helped me develop both professionally and personally. I aspire to become a mentor to junior colleagues and assist them in their career growth by sharing my knowledge and experiences. I hope to inspire and empower others to reach their full potential and contribute to a more dynamic and skilled workforce in palliative care.”

Finally, Liz reflects on the skills she is developing through her Master’s studies,

“This MSc in Palliative Care will enhance my knowledge and skills in: providing clinical skills, advocacy and research within national government hospital and promoting integrated palliative care approaches and principles in the already existing systems so as to improve quality of care and life for those in need.”

We are very grateful to Liz for taking the time to help us and our supporters get to know her better and wish her great success with her studies and further career in palliative care!

We are delighted to share the publication of Dr Mhoira Leng's paper 'Evaluation of the integration of palliative care in a fragile setting amongst host and refugee communities: Using consecutive rapid participatory appraisals.’ Written in collaboration with several other authors, listed below, this publication is the result of much hard work by Mhoira and her team, and we are extremely proud of them!

The paper seeks to evaluate the integration of palliative care into conflict-affected communities, through studying one such community in Northern Uganda. The paper comes as a result of over 4 years of work, and involved close collaboration with local Village Health Teams. Utilising observation, interviews and document reviews, the paper identifies community engagement and training as key components for integrating palliative care into the health system of such communities.

Such research is increasingly important in improving access to palliative care, as conflict and climate change continue to displace millions of people globally. Differing cultural beliefs and stigmas surrounding health and illness remain a key challenge as people are forced to flee their homes in search of safety, and research such as this will help to bridge the gap between host and refuge populations and improve their access to palliative care.

Furthermore, Dr Leng’s paper has been recognised by the European Association for Palliative Care, being selected as their September Palliative Medicine Editor’s Choice. Huge congratulations go to all the team involved in the writing and publication! Read the EAPC blog on the paper here, or read the editorial discussing this and other papers here.

Contributing authors include: Julia Downing, Gursaran Purewal, Liz Namukwaya, Vicky Opia, Chitra Venkateswaran, Elizabeth Nabirye & Peace Bagasha.

We are pleased to give some updates on the Palliative care Specialist Fellowship Programme, or the PcSFP, based in Kampala, Uganda. The PcSFP has been made possible through our partner the Palliative care Education and Research Consortium, or PcERC, which works in two national referral hospitals in Kampala. 

Since March 2022, PcSFP plans were officially commenced with an international steering group and dedicated staff. PcERC, with a grant from Cairdeas IPCT, held an education coordinator position to develop materials and support the PcSFP steering group in the curriculum, framework, and programme proposal. Much has been accomplished and we now prepare for the accreditation and establishment of the PcSFP as the first specialist fellowship in palliative care in sub-Saharan Africa. Here’s what you need to know about the PcSFP (to date) and our next steps in launching the fellowship.

Curriculum and Framework

In our last update from July 2022, the initial workings of a curriculum were formed in a benchmarking and writing process by Drs Liz Namukwaya and Kate Howorth, overseen by Dr Mhoira Leng, the Cairdeas IPCT Medical Director. The Association of Palliative Medicine (APM) in the UK supported us to solicit experts of palliative care education in Africa to help design the knowledge, skills, and attitudes and behaviours listed in the curriculum. We also shared the curriculum for independent expert review in the UK as well as a senior faculty review from the Department of Medicine, College of Health Sciences at Makerere University in Kampala, Uganda. The final result is a twenty-page curricula document, rich of global expertise and Africa-specific applications, organised into four domains and twenty-five themes, with learning objectives and their relevant knowledge, skills, attitudes, and behaviours.

As the curriculum underwent final reviews, Dr Liz Namukwaya and Hannah Ikong prepared a competency framework aligned to the curriculum. This framework not only listed the standard for a fellow to complete each theme in the PcSFP, but the standard that must be met by fellowship instructors or lecturers themselves. Competencies are quite important measures in this clinically heavy PcSFP and all competencies include the important attitudes and behaviours associated with transformational learning.

Proposal for Accreditation

Our programme proposal has been built a layer at a time, drawing from deliberations from the international steering group of palliative care specialists in Uganda, the UK and Ireland as well as continued research into accreditation in Uganda. Colleagues who have founded similar sub-specialist clinical fellowships in Uganda (such as Cardiology, Onco-Gynaecology, and Pulmonology/Respiratory) have been helpful resources in sharing their approach to clinical fellowships and accreditation pathways. 

Our proposal, originally written by Dr Kate Howorth in 2022, remains a living document as we discuss options with the Uganda Medical and Dental Practitioners Council (UMDPC) in country as well as the option of later expansion with the East, Central and South Africa College of Physicians (ECSACOP). Last year included networking and stakeholder involvement, such as when  Dr Peace Bagahsa, board co-chair of PcERC gave a ECSACOP conference presentation for our fellowship in August, or Dr Liz Namukwaya and Hannah Ikong introduced the PcSFP to the Uganda Ministry of Health Assistant Commissioner in November. 

Way Forward

2024 has quite a bit in store for the PcSFP! On the accreditation side, we plan to finalise discussions with stakeholders and host institutions in this year, so we can apply for accreditation with the UMDPC and, with time, ECSACOP. Conversations with other palliative care associations and possible education partners are paramount, as well as establishing the partnership with the Uganda Ministry of Health. We also continue to invite international collaboration and discuss virtual contributions such as recorded instruction or one-on-one mentorship of fellows.

In March 2024, the education coordinator for the PcSFP was handed over from Hannah Ikong to Bernadette Basemera, an experienced palliative nurse who has recently supported another institution to accredit their palliative care education programmes. The steering group committee, PcERC and Cairdeas IPCT are all excited to welcome Bernadette to the programme and support this crucial stage in the PcSFP. 

As friends and donors of Cairdeas IPCT, we thank you for your continued support in our vision of a world where palliative care is accessible by all. The PcSFP will met the need for specialist palliative care physicians in Uganda and, we hope someday soon, in East, Central and South Africa regions through ECSACOP.

Acknowledgements

All figures included in this blog post are from the poster of "International collaboration between Uganda and the UK to design Sub Saharan Africa’s first Palliative Care Fellowship programme: mutual benefits and learning." The poster was designed in October 2022 for the Palliaitive Care Congress of the Association of Palliative Medicine by Dr Kate Howorth, Dr Elizabeth Namukwaya, Dr Kathleen McGeough, Dr Kalyani Snell, Hannah Ikong, and Dr Mhoira Leng.