Saturday, December 22, 2012

Love feasts and other Christmas traditions

Christmas is a time to reflect, celebrate, enjoy friends and family and sense again the wonder of God coming down to earth as a tiny, vulnerable baby. We know the stories and the carols and we all have our own traditions. I have been privileged to spend Christmas in many different parts of the world. In India we ate fragrant chicken biryani and the CMC Vellore students came round late at night to sing carols; in Kerala the Santas wore plastic faces and surgeons gloves which was a little disconcerting. In Tunisia we had plenty choices of turkey along with spicy harissa and then sang carols on the beach. In Scotland I have been known to go paddling in the snow - in a kayak!  Here in Africa I have spent Christmas in the middle of the amazing animals, birds and scenery of the national parks of Uganda and last year saw a leopard hanging out in a tree! I also am able to join a Lugogo baptist church tradition of a Love Feast. We are invited to bring food from our national or local setting and to bless one another, care for one another, sing and dance (and Acholi dancing is AMAZING) and share the love of God within the church and with those who are vulnerable, lonely and in need. I was busy baking cakes and very happy to have some special Acholi food ; malakwang, boo and lapena! What a wonderful concept! Instead of focusing on what we get and the increasing materialism of our world we focus on what we can give, with whom we can share blessings, who needs a hug, who can we thank for all they are and all they give.

We were able to put this into practise at our first patients' Christmas party in Mulago. There is a hostel that allows women to stay who are receiving radiotherapy treatment for several months but who come from far away and cannot travel daily to Mulago. It is the only radiotherapy centre in Uganda and also take patients from South Sudan, Eastern DRC and Rwanda as they do not have any radiotherapy in those areas. These ladies bring a family member to care for them but are otherwise so far from family and friends, often worried and frightened by their illness and the treatments and with very little to encourage or support them. Our nurses and volunteer team visit regularly to offer practical, social and pastoral support. We decided to try and have a small party for the first time. Picture the scene; a very hot day, more than 50 patients and carers, singing carols and songs, sharing moving testimonies, offering encouragement, dancing, varied languages and dialects and traditions, tinsel trimmed hats, DVD with the nativity film, guests of honour from the radiotherapy department and above all food - good African food heaped as high as possible on every plate. Many thanks to Cairdeas for sponsoring the party, to the volunteers who worked so hard to make it come true and to all for sharing and loving. A true Love Feast.
There is beautiful poem by Christina Rossetti in 1893 called Christmastide that has been sung as a carol at Christmas since then. It is titled
Love came down at Christmas....the last stanza reads .....
Love shall be our token
Love shall be yours and love be mine
Love to God and all men
Love for plea and gift and sign

From all at Cairdeas and the MPCU and from myself  have a wonderful Christmas as we look forward to another amazing year with many more feasts of love!

If you want to support in any way please get in touch or go to our Christmas appeal to support training.

Saturday, December 15, 2012

Giraffe mobs and other teaching tales

Hi to my friends; after a VERY LONG silence I am going to post a few entries over the next few weeks as a reflection on an amazing year in the work of Cairdeas.
I was reminded of this quote attributed to Mother Theresa a few days ago; 'At the end of our lives we will not be judged by how many diplomas we have received  how much money we have made or how many great things we have done. We will be judged by; I was hungry and you gave me to eat. I was naked and you clothed me. I was homeless and you took me in'  and the biblical quote continues, 'I was sick and you cared for me'  I want to share some of the humbling ways we are able to work in partnership to support some of the most vulnerable in our world - those in pain.
Teaching, training and mentorship is one of the key ways we are working to build capacity for palliative care. For those who want to support our Christmas appeal to help build capacity and training please click on our link to read about 2 of our our justgiving site.
I have had the privilege this year of visiting 10 countries (including UK and Uganda) to be involved in training. A much used format is the Palliative Care Toolkit and Training Manual (find 7 different language versions at developed to support introductory learning in palliative care and to model an interactive learner centered style. This is good adult learning terminology but what does it look like in practice?
Serious planning in Mussoorie
Let me tell you some giraffe building tales. Take a few newspapers, some sticky tape, several willing (or not so willing) learners divided into groups with a good dollop of enthusiasm and give them 10 to 15 minutes to make the tallest giraffe possible to win - with one proviso; it must stand for 10 seconds unaided. The aim of this exercise is to demonstrate team working and it is amazing how many learning points emerge;
1. ensure a clear vision; a very long neck and the incredibly long legs may not support that fat body
2. planning; perhaps some thought to how to strengthen the base and legs will be worth the time taken
Jumana leaning giraffe
3. collaborate; fighting over the sticky tape means everyone is slower
4. participate; everyone has a role and something to offer even if they don't shout the loudest
5. innovate; who thought up the newspaper base to stop it slipping
6. celebrate others success; sabotage to the other teams' giraffe in order to try and win never works (or at least will be disallowed)
Hugs for the winners in Aberdeen
Sounds straightforward? Easy to describe but can go a little haywire when the facilitator (me) loses control of 40 wonderful but feisty colleagues in Ghana such that we had to remove the giraffes to prevent sabotage and actual physical harm now known as the 'giraffe mob' incident. Then we had some Swahili fun in Tanga region with gales of laughter and no giraffes left standing. High in the mountains of India in Mussorie colleagues on a leadership course wanted to argue their giraffes were tired and needed to lean on the table for some support. Easier with the UK friends who came to the annual Cairdeas gathering - with the team which included a physicist and orthopaedic surgeon winning hands down - or is that hooves?

Sunset in the Himalayas
Sculpture in Ghana
All part of the privilege of being involved in international training; seeing colleagues grow and learn; mutual sharing of the joys and the challenges of palliative care where physical resources are often so limited yet spiritual and cultural resources so rich; helping train and equip leaders for the future; warm and generous welcome into so many different cultures; inspired by the people we meet and the beauties of the natural world.

As the African proverb says; 'If you want to go fast travel alone; if you want to go far go together.'
Many thanks to all who have traveled this journey with me and with Cairdeas in 2012.

Saturday, February 18, 2012

Multi-national Delhi

EHA participants
I cant believe it has been so long since I posted - sorry for those who like more regular updates. So a quick review of the past few months over the next couple of posts.
At the invitation of Dr Ann Thyle and the Emmanuel Hospitals Association we formed a truly international faculty to teach the Palliative Care Toolkit in Delhi November 2011. Let me introduce you to the faculty; Dr Ed and Penny Dubland from British Columbia who have been visiting India for some years but even better Ed speaks fluent Hindi as a legacy of his childhood at Woodstock school; Dr Chitra Venkieshwaren our wonderful Cairdeas friend and regular faculty who is based in Kochi where she leads psycho-oncology developments and services; Dr Jane Bates who leads palliative care in Tiyangane clinic based in Queen Elixabeth University in Blantyre, Malawi; Josephine Kabahweza who is the senior nurse from our Makerere Palliative Care Unit and wowed everyone with her African dress and enthusiasm; Dr Ann Thyle from India who is the director of EHA programmes in EHA and yours truly. Funding support came from several sources including EMMS and Cairdeas. We were a great team!

The participants came from across the EHA network and brought so much enthusiasm and dedication to develop palliative care. Teams came from MP, UP, Delhi and Uttaranchal; many working in rural settings where there are few options for care. We laughed, shared, played roles, sang, even cried and certainly learned so much together. EHA have plans to develop palliative care across their wide range of hospital and community programmes and we hope to be able to continue to offer training support.
Spcies galore
Visiting Mr S at home
I also had great fun introducing my Uganda and Malawi friends to my favourite parts of Delhi; dinner at Karims, smells and sounds of the old spice market, wonders of the Red Fort and Jama Masjid, goats with tinsel round their necks ready for Eid, rainbow colours of fabrics, momos for lunch, hot sweet spicy chai, transport by auto, metro, taxi, cycle rickshaw and then a classic Indian overnight train.The latter took most of the faculty to the Harriet Benson Hopsital in Lalitpur to evaluate the first 18 months of the first EHA palliative care service. What a lovely welcome and so encouraging to see how much has been achieved. We met several patients and their families who spoke so movingly about the care given to them. As the local health administrator (Add CMO) said about the PC team; 'these people look after those that everyone has rejected.'
Smiling or worried???
perhaps a good place to pause. Palliative care is reaching out to some of the most vulnerable who face suffering and distress due to chronic disease where the focus is on quality of life. What does that mean? Perhaps Mr S (seen above on a home visit) illustrates this well; he had treatment for cancer which left him tired and in pain and unable to work in his fields to support his family. In desperation he was told by a friend to come to HBM hospital. 1 year on he is free of pain and back working and enjoying the birth of his newest grandchild. In his own words 'my heart has become less heavy, I feel at peace, my pain is less.'

Makerere team with our new teeshirts

Back to Kampala where our team were able to have a special Christmas celebration. Thanks to everyone for hard work, love and care and welcome to our new volunteer team as well as the link nurses from Mulago Hospital and the deputy senior principle nursing officer as guest of honour. 37 people singing and eating and celebrating the end of a year and the hope of Christmas. The boat trip added adventure - particularly as most for the team had never been on open water before!!!!!So many challenges along the way this year yet also so much grace and joy. We are blessed indeed.

sunset Lake Victoria on the way home