Sunday, October 22, 2006

glimpses of africa

How can I sum up my short trip to Africa? I can only add to my previous posts with some glimpses of Africa that touched my heart, inspired me and will make me hope to return. I visited 3 countries over 6 weeks - South Africa, Uganda and Rwanda. I met so many people committed to palliative care and doing much to improve the access for those in need. As ever there are many difficult memories too. There are many who are hungry and trapped by poverty. There is a shocking lack of justice in how the world's share of resources are shared. There is the huge burden of illness and in particuler HIV/AIDS. Visting the genocide museum in Kigali is so essential in understanding something of the horror yet is an emotionally draining experience. What do you think of when you think of Africa? Let me give you a glimpse through my eyes.

Africa is a land rich in its natural beauty. A beauty which is at once accessible and yet wild. Seeing these giraffe up close was amazing - how did God dream up that neck? A rhino waking from it's slumber is an awesome beast; spotting the zebra so carefuly cammoflaged a delight. Beautiful sunsets, thundering rivers, peaceful lakes. I am glad to have survived my Nile kayaking adventure - and thanks to my guide through the grade 5 rapids. Amazing to think of those great explorers spending their lives finding the source of the Nile and here I am paddling down in a small piece of plastic.

Africa's richest beauty is in it's people. Warmth and smiles and help for a 'poor Mzungu' like me. Amazing colours and hair fashions. Bright, curious children; enthusiatic church services (they even asked me to preach!!); great food - especially when you can add some firey piri-piri; talented craftsmen producing work both ancient and innovative; history going back to the cradle of hunmanity yet modern and devloping. So many impressions! Let us hope that Cairderas is able to work with friends and colleagues to support palliative care developments in this amazing continent.

Saturday, October 21, 2006

world hospice day, rwanda(2)

October 7th was the second World Hospice day. This is a global event that seeks to raise the profile of palliative care needs across the globe and this year had a theme of 'Access to care for all'. We had been visiting some of the support groups for people living with HIV/AIDS. Let me tell you about one group that was called - 'Trust in God' this group had approached a local pastor who also lived with HIV to ask for help. They told us that they has found hope. Hope in God and as a result hope for living. Un,like many such groups they had a sense of energy and self-help which was inspirational and infectious. Micro-enterprise projects such as shoe making, sewing and baking bread were all underway. We were invited to share the first bread and, as it was to be on World Hospice Day, we had a joint celebration. You can see the photos; and I hope sense the fun and the hope. The wee lad on my lap is pretty ill but loved cuddling the 'mzungu' and sharing the warm bread. This group are part of the area of Gikondo in Kigali which is the district where there is a possibility of a hospice service., There was real enthusiasm for this project and a willingness to be part of the community training. Their only request was that I shared their experience and asked that others would pray for them. A very moving day!

Friday, October 13, 2006


Only 2 weeks in this tiny country in the heart of Africa - le pays du mille collines. I was visiting for cairdeas at the invitation of Signpost Rwanda - a charity with it's based in Dundee, Scotland, who are involved in projects for children and vulnerable women in Rwanda. They have achieved much and have a great team in Rwanda, Here is Pastor Nathan, Karen, Doreen, Janet, Josh (the computer whizz) and little Shema - Janet's son and my play mate while visiting. The Rwanda team have been challenged by the need for hospice and palliative care in their country and I was visiting as part of the feasibility planning and research. Thankyou so much for taking me to your hearts. I was able to meet so many people who are part of the new Palliative Care Association of Rwanda and hear something of their plans and vision. They have government support and undergone initial training supported by the African Palliative Care Association. The need is very clear with around 3% HIV/AIDS prevalence as well as a rising incidence of cancer and other chronic illnesses. So far there is very limited access to oral morphine and no palliative care service. However, there is a real sense of working together. My visits included the university hospitals in Kigali and Butare (here is Dr Cwynya-ay in his paediatric ward in Butare) ,senior nursing colleagues at King Faizal hospital and some of the key networks for supporting those living with HIV/AIDS. I wish them every blessing in their planning and have offered support from Cairdeas as needed (and available). I am sure much will be done to change the face of those suffering with palliative care needs in Rwanda over these next years, so that children like this little one can have the help they so deserve.

Wednesday, October 11, 2006


Uganda was described by Winston Churchill as the 'pearl of Africa' I have only had a short time to explore this beautiful country but I very much hope to be able to spend more time here in the future. Here is sunrise over Lake Victoria. In palliative care history it holds a special place. In 1993 Dr Anne Merriman and her team, with the support of the government, opened Hospice Africa Uganda. This has developed into a model of care that has met the needs of so many here in Uganda but also formed the basis for training and service support across Africa. It is a busy yet welcoming place where you can be sure of excellence in clinical and educational skills, a deep sense of faith, great food from the tiny kitchen and the brightest morphine bottles you have ever seen. This picture shows how simple tools such as used water bottles, mixed with ingenuity and simple morphine powder can provide affordable oral morphine solution to those in pain. 10 days of morphine is equivalent to the cost of a loaf of bread. Patients are seen at the clinic or by one of the outreach teams. There are also 2 linked units and a network of trained community volunteers. This lady has her oral morphine at home - helped by a friend who took her to the clinic, as she had no family suuport. Her cancer pain is now under control. As in India, care can be offered at an affordable cost with the support of trained health care workers, and community support. My thanks to Drs Anne, Lydia and Ita and the rest of the team for their warm welcome and wilingness to share. I have long wanted to visit and was in no way disappointed. It is so useful to Cairdeas and so humbling personnaly to see what you have achieved and to learn of the resouces available - particularly in education. I look forward to being able to stay in touch and possibly work togetherin the future. Off to tandem kayak the source of the Nile!