Towards the end of 2019, a team travelled to Gaza to deliver teaching in palliative care to first year medical students and take part in the first palliative care conference to be held in Palestine. Among this group were Cairdeas Medical Director, Mhoira Leng, and Trustee, Elizabeth Swain. In this blog, Elizabeth shares her experience teaching palliative care skills in a war-stricken country and reflects on the role of compassion and humanity in dealing with trauma.
Dr Abdel’s Mum invited us all for tea at the family home in Gaza City just near the Commonwealth Graves Commission Cemetery. “Remember, Abdel, you are human too and so treat all your patients as you would treat me”. This is what she says to him each day he leaves the house to go to the hospital. What generous hospitality and what a delightful evening we had. Dr Abdel had been “lent” to us from the University as a teaching assistant but he did so much more and kept us out of trouble. He and his Mum made sure we sampled many of the delights of Gazan cuisine.
We shared his Mum’s good advice with the 132 first year clinical students at the Islamic University of Gaza who we taught for a week in palliative care. What a delight they were – keen, enthusiastic, hardworking and “big eyed” to have a team of 6 foreigners teaching them. Maybe it was the first time they had experienced working in small groups discussing case studies of patients with life limiting conditions, seeing patients on the hospital wards and considering spiritual as well as the physical and social concerns of their patients, and they responded enthusiastically.
Perceptive, sensitive and caring youngsters – a career in medicine ahead of them in a very tense part of the world where the care of trauma patients is more in demand than in those with palliative care needs. Their feedback of the values they had seen demonstrated in Palliative Care - love, joy, humility, justice, hope, empathy, compassion, team work, humanity, respect - brought US much joy and were hugely encouraging.
Mhoira, Alice and I were privileged indeed to be invited to take part in the first ever Palliative Care conference held in Palestine at which we all presented papers. We were part of a small cohort of overseas speakers and as such had very much front row seats in the conference hall which made us vulnerable to the many photographers in attendance!
Gaza’s population is made up of 70% refugees from the war of 1948 and their educational and health needs are the responsibility of the United Nations. I was delighted to go with a very senior nurse to visit a couple of the primary care centres. There is a keenness to explore the possibilities of Palliative care but a funding crisis in 2018 prevented progress in this. Janet – one of the team spent a happy and productive time talking with a group of nurses keen to know much more.
It is a troubled part of the world and care of trauma casualties takes a lot of resources, but in terms of pain management and compassion there are transferrable skills and attitudes.
Mhoira and her co-authors Rachel Coghlan Omar Shamieh, Khamis Elessi, and Liz Grant bring this out in a letter recently published in the Lancet and suggest, too, a role in conflict management. (Read the full letter here)
“To claim that palliative care alone could be the solution to the conflict in the Gaza Strip and other conflicts like it, which often seem like intractable political calamities, would be naïve and careless. Yet we do believe that the compassion and humanity intrinsic to palliative care affords it a powerful role in working towards conflict resolution.”