Blog written by Jenny Hunt (MA, Dip HE Palliative Care)

Meeting up socially with Dr Mhoira Leng while in Uganda in May 2023 turned out to be a pivotal moment for me. When she asked if I would consider travelling to Gaza to train on grief and bereavement on Module 8 of the newly established diploma in palliative care, I rather hesitantly agreed. Recent reciprocal attacks between Israel and the West Bank presented some safety concerns for me; my previous humanitarian palliative care responses had been post-natural disasters. Having been reassured that all necessary security information and support was available, I was surprised how rapidly and efficiently plans were put in place for my arrival to coincide with Mhoira and Anna Voeuk, another faculty member. Our transfer from Jerusalem through Erez crossing was seamless and our arrival at our family- run guest house accommodation, a pleasant surprise.

My approach to this training was informed by many years of working as a palliative care social worker at Island Hospice Service in Harare, Zimbabwe. In particular, as the Bereavement Service Coordinator, I was responsible for developing bereavement training modules and support systems for a wide variety of populations, professional and non-professional. My training experiences during this time led to the development of the 9 cell bereavement tool* which aims to raise awareness of grief and bereavement within the context of their communities, rather than deliver didactic material based on Western theories. I’m grateful to have been entrusted to use this same approach within the Gaza context with no guarantee that it would be applicable. I designed a simple PowerPoint presentation for the first day, providing an overview of some necessary, evidence-based information shared within interactive discussions. The value of drawing on their personal experiences was emphasized to provide authenticity to theories. Support was provided for any emotions that arose during this training. 

The 9 cell tool was facilitated on day 2, beginning with active contributions to my request to hear what condolences are offered and received in this context, and which of these are considered helpful and unhelpful. Each participant then wrote a list of their own personal death losses on a strip of paper which enabled me to understand the levels and types of loss in the room. After reviewing the critical aspects of what had been covered on day 1 around the personal journey of grief lived out within social and cultural contexts, the participants were divided into 3 groups representing grief time lines from immediate to one year and beyond. Each group shared experiences of what is felt, what is shown to others and what is allowed and expected by one’s society, religion and culture. This information was then used for further discussion, identifying differences and unique stories all within a respectful, non-judgmental environment. Oral feedback confirmed that significant learning had taken place, and participants offered suggestions as to how they may now support the bereaved.

While there were so many aspects to this trip that deserve comment, the most powerful insight for me was the confirmation that despite cultural, political, economic, religious and geographical differences to contexts where this tool has been implemented elsewhere (Africa, India), it appears that improved bereavement support within communities can be achieved using this simple approach. It would also be useful to follow up this training with mentorship and modelling of some specific bereavement counselling techniques.

* Hunt J. (2002) The nine-cell bereavement table: a tool for training. Bereavement Care, 21 (3): 40-41.