Two years ago Christian Tsotie began working on a plan, an ambitious plan, as he admits himself. After eight years as a nurse in the first hospital palliative care unit (PCU) in the Cameroon capital Yaoundé, Christian left his job with a bigger goal in mind.
For his last four years at the hospital, Christian was co-ordinator of the PCU and oncology day hospital, after having been head of PCU for 3 years. Now he’s working freelance, running a team of three providing home-based palliative care, visiting an average of 15 patients every week.
This is only the first step in Christian’s path. He wants to spread a palliative care culture across the country, both through education and in practice in hospitals and out in the community. It’s still early days.
Although there are now some initiatives in the field (mainly private), pallative care is a new concept in Cameroon, Christian says. In fact, before he was asked to work on the hospital ward in Yaounde, he had never heard of it.
He adds: “The director approached me saying she thought I had the skills to work there, and I was very happy with the idea. As a nurse, caring for patients is my passion and ever since I started working there palliative care has become a passion for me too.”
Education forms a big part of Christian’s model too, running workshops for hospital professionals as well as regular training sessions at three nurse training schools. “My aim is to raise awareness, to tell them what palliative care is and how essential it is for people with life threatening conditions.”
I want my team to become like the St Christopher’s of Cameroon.
It was when he first started work on the palliative care ward that Christian discovered St Christopher’s. “You cannot love palliative care without knowing and learning about St Christopher’s, that would be impossible as it is the worldwide reference,” he adds.
When Christian started planning his freelance palliative care model, he felt he needed ‘some guidance’ on the journey. He says: “Then I was looking on Twitter and I saw St Christopher’s talking about its Pioneering Nurses programme and I thought this was exactly what I needed. I think I have the potential to deliver my dream, but I needed someone to accompany me and to provide me with advice and support like a mentor.”
In December 2021 He joined an online one day conference for Pioneering Nurses run by St Christopher’s.
I couldn’t believe it. It was exactly what I was looking for. There were 100 nurses from all over the world sharing their experience. It was amazing.
Subsequently, through the assistance of Marie Cooper (Project Lead for Celebrating Palliative Care Nursing) and Heather Richardson (Chief Executive), Christian joined the St Christopher’s Palliative Care Fellowship and was three days into the week-long intensive learning part of the six-month distance education programme when he spoke to us.
This course is designed to address practical issues in organising palliative care services, particularly in low- and middle-income countries, with a problem-solving approach and is run by St Christopher’s in partnership with the Institute of Palliative Medicine – India, Sanjeevan Palliative Care Project – Pondicherry – India, and Bangabandhu Sheikh Mujib Medical University, Bangladesh.
“It is absolutely wonderful. I had no idea it would be so exciting and so practical and interactive. I now have many tools to develop and to help me to realise my dream.
“The amazing thing is that while all the nurses on the Fellowship are experiencing a different reality in their country we all share the same fundamental problems, like the taboo around speaking about death and dying. It is wonderful to see so many people trying to ameliorate access to palliative care.
What’s really impressed Christian is the way in which the Fellowship programme is absolutely not a didactic, binary or generic style of teaching for learners to follow blindly.
“The Fellowship is so good because everything we are learning is adaptive. In all of the group sessions we are looking at how we can make things work in the reality we face in our countries.
It is not generic education, rather it is about adapting the resources to suit your own situation. I will be trying my best to take as much of the knowledge as possible and transferring that into my competency.”
While Christian and his small team are 5,000 miles from St Christopher’s, he’s using every opportunity to immerse himself in the educational and networking offers it provides to learners wherever they are. As well as ‘attending’ the Pioneering Nurses conference and the Palliative Care Fellowship, Christian has also fully embraced the St Christopher’s CARE recently released App and has plans to take even further advantage of what’s available.
“When I was opening the App I truly felt like I was in St Christopher’s. I opened it slowly and quietly so as not to disturb the patients! I could feel myself reliving the history of the hospice. I now feel like I know St Christopher’s without having to travel there and really know what palliative care is.”
Next on Christian’s list is the Lantern Model Programme. This programme uses the principles of the first new model of palliative care nursing for 30 years, launched by St Christopher’s in 2021. This membership programme is designed to weave together learning, inspiration and connections amongst all nurses interested in making a real difference to people facing the end of life – exactly what Christian is looking for.
I now feel like, in St Christopher’s, I have a mentor to help me realise my dream of developing the palliative care history in my own country, he adds.
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