As I write this I am acutely aware the world has changed almost beyond recognition on the past few weeks. A pandemic much discussed in theory by the scientific world and the subject of movies has been unleashed by means of a tiny virus that has closed countries, pressed paused on economies, placed almost one third our world’s population into lock down. This outbreak has led to the deaths of tens of thousands…a number which is yet to rise.

In Uganda where I am also self-isolating and in lockdown I reflect that this country and its neighbours are well used to infectious disease. Malaria, HIV, TB and Ebola are well known here. Let me share a few statistics from 2018 that of course represents real people and real challenges. 37.9 million people were living with HIV and 770,000 died from HIV/AIDS. TB affected 10m worldwide with 1.5 million deaths of which 205,000 were children. Malaria, the often forgotten scourge in tropical climes, affected 229 million with 405,000 deaths and 67% of these were children.

COVID19 is affecting people accross ouir world….an infectious illness affecting people from all walks of life and all parts of the globe. This is a global humanitarian challenge with as ever those on the margins most affected. Money, position, power does not protect us and in many ways this demonstrated more than ever our shared humanity. It is also highlighting our common sense of helplessness. In low income settings the impact of COVID19 is deeply felt where there are no margins of resources. People who rely on a daily wage to provide food for families are struggling accross Africa. Transport blockades have affected migrant workers causing huge shifts of population in places like India. Struggling health systems in high income countries are well documented and the effect on poorly resourced health systems is only becoming clear for patients and families with many different health problems. Add to this refugee setting such as our partners in Northern Uganda working with South Sudanese refugees and in Gaza where they have already endured 11 years of siege and restrictions….can you imagine! We need to advocate for the ending of barriers, blocades and sanctions that are putting people are a greater risk than ever. 

Let me tell you about Ronald, one of our most dedicated and loyal volunteers in the palliative care team in PcERC in Kampala. He was diagnosed with cancer just a few weeks before he married his sweetheart Christine at the end of last year. We have been raising funds and supporting them as he completed surgery and chemotherapy but now how does he access his radiotherapy? There is no public transport, private car costs more than a day’s salary but today even that is not permitted, so he is borrowing a bicycle for the 45 minute trip each day… not an easy feat when you are unwell. Yet, he still says ‘Many thanks for all the support….MMPCU has been like a family to me’.

Dr Peace Bagasha is a palliative care and renal medicine consultant in our team, and she told me about her journey to work yesterday. ‘I was stopped 10 times by police road blocks trying to get to the renal dialysis unit. Most of the nurses are unable to attend to patients as they live on the edges of the city due to housing costs and low wages and are now struggling to get to work. We are hopeful that stickers to permit essential travel will be made available soon.’

Vicky Opia, lead palliative care nurse in Adjumnai Hospital where a COVID19 positive patient has been admitted tells me: ‘People are afraid. Can you imagine, a nurse riding a boda to work in her nurses uniform was beaten?’

Where is the hope and where is the humanity at a time such as this? I think is it right in front of us, within us and amongst us. All over the world we see how compassion and courage and kindness are lifting spirits and making unique contributions. We see a shared common experience and greater empathy for our global community and standing together. Creativity for scientists, technology experts, health care workers and families has never been higher. We are thinking about what really matters, what is the focus and source of our hope. Many are looking outwards to how we can help and encourage each other. Many are thinking about our enviromnmnet and realising our interconnectedness with the health of our planet. Many are growing spiritually and faith in God. Candles stand in windows and rainbows colour our lives.

In palliative care this language of open communication even about the tough times in life is very familiar. We hold that place of uncertainty with those facing life threatening and limiting illness. We seek to listen, show compassion, offer skilled holistic help, journey with people through the dark times and the bright times, reveal and redirect hope and support people to build resilience.

I have been moved by this meditation from William Brodrick...'We have to be candles, burning between hope and despair, faith and doubt, life and death, all the opposites. This is the disquieting place where people must always find us. And if our life means anything, if what we are goes beyoind the walls and does some good, it is that somehow, by being here, at peace, we help the world cope with what it vcannot understand'

We are working closely with our partners who areare busy developing guidelines, working out how to work through non face-to-face means, doing direct patient care and advocating for effective PPEs and showing what amazing contributions health care workers and social and pastoral support workers can achieve. CairdeasIPCT is seeking to offer more financial support and if you feel you can partner with us many thanks. You can donate here. We are seeking to address the anxiety and fear with our partner Prof Chitra Venkateswaran, a psychiatry specialist in India, leading ways to train and support families using virtual means.

Let this be a time of standing together, talking to each other, listening, sharing our common humanity, caring for our neighbour, the stranger, the vulnerable and marginalised, the broken and fearful in our communities local and global. Let this be a time for all walls and differenecs to crumble and be brought down. Let us move forward with renewed hope, deeper joy and fresh purpose.

Useful resources can also be found at www.thewhpca.org/covid-19