My name is Christian Tsotie, Pain Management and Palliative Care Nurse Specialist in Cameroon. For twelve years, I have worked in palliative care, Global Palliative care Nurses Network (GPNN) member, and in 2021 I founded Soigner La Vie (SLV), an association with one mission: to spread the culture of pain medicine and palliative care across our country. We work on two fronts: training health professionals, volunteers, families, and the public and bringing palliative care directly into hospitals where it doesn’t yet exist.
This is the story of how that second front opened a door at Yaoundé Central Hospital and what it has taught me about what nurses specifically bring to this work.
Before Yaoundé Central, I knocked on five other doors. Two faith-based hospitals, a semi-public facility, a district hospital, and a first-category hospital. A few sessions, then silence. One never even started. I learned patience the hard way, and I learned that equity in palliative care isn’t just about reaching patients once a service exists. It’s about which hospitals get the chance to build one in the first place. Facilities without the right champion, the right timing, or the right internal relationships get left out, and the patients inside them wait longer for care that should not be optional.
About 18 months ago, I met Prof. Pierre Ongolo, then Head of Radiology at Yaoundé Central. We talked about palliative care for the first time. He told me it was a good topic and that we should pick the conversation up again. Six months later, he became the hospital’s Director General. A year after that, I followed up and we met within 48 hours. He called in the Director of Nursing. “Let’s hear this project,” he said. Then: “Go think about it and bring me a proposal.” When I asked when he’d like to meet again, his answer was simple: “Why not start now?” That was the green light.
Two weeks ago, we held our first session with the Director of Nursing, head nurses, and service coordinators in the room — the people who actually run patient care day-to-day. The technical goal was to set out what palliative care really means. But the human goal mattered just as much: an hour of honest exchange about unrelieved pain, about suffering, about dignity at the end of life. No lecture. Just naming what these nurses already see every single day, often without language or a framework for it.
This is where I think nursing’s contribution to inclusivity becomes visible. The session worked because it didn’t position nurses as an audience to be informed it positioned them as people whose daily observations were the evidence base. They left with a mission: to raise awareness within their own teams. The seed didn’t come from outside the hospital. It came from inside, carried by the nurses who were already closest to the suffering.
This week’s second session shifted the tone. The question on the table was: how do we actually know if we need palliative care here? We worked through the WHO needs assessment together, pulling indicators and looking at the hospital through a palliative care lens for the first time.
This is the piece I want to underline for nursing colleagues, especially: standardised assessment is what turns a felt sense of suffering into something a hospital administration, a Ministry, or a donor can act on. Nurses are usually the ones holding the lived, qualitative knowledge of what patients are going through. Tools like the WHO needs assessment let us translate that knowledge into a shared, comparable, defensible form without losing what made it true in the first place. It becomes the advocacy tool we will use tomorrow.
Field diagnosis, then training, then, we hope, a hospital-based palliative care team. I am motivated. Tired, sometimes. But motivated, because if this works at one of Cameroon’s three largest hospitals, it can travel to others in the capital and beyond.
I know this story is not unique to Cameroon. Somewhere right now, a nurse in another country is having the same conversation I had eighteen months ago, sensing that palliative care is needed but not yet knowing whose door to knock on or how many times she will have to knock. I want her to know she is not building this alone, even if it feels that way some mornings.
This is exactly why communities like the Global Palliative Nursing Network matter so much to me. Not as a place to share success stories once the work is done but as a place to share the unfinished, uncertain middle of it: the doors that close, the proposals nobody answers, and the small openings we almost miss. Nursing has always carried palliative care in its hands long before policy caught up, and we are stronger when we carry it together, across borders, comparing notes on what actually moves a hospital, a ministry, or a donor.
So to my colleagues reading this in Nairobi, in Kigali, in Cap town, in Kerala, in Accra, in Manila, in London, in every place where someone is quietly trying to get palliative care taken seriously: tell us what is working. Tell us what is not. Send us your version of the WHO needs assessment, your version of the door that finally opened. A global community of practice is only as strong as what each of us is willing to bring back to it.
If this experience gives even one of you a tool, an opening line for a hard conversation, or simply the courage to knock again tomorrow, then it has done its job. And if you have something to give back to the rest of us, the door is open.
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