Interview: Dr Zipporah Ali on the importance of “advocacy, advocacy, advocacy”

Categories: Leadership.

Can you tell us a little about yourself, your back ground and how you became interested in working in palliative care?

My career in palliative care started in 1993 when I volunteered to work at the Nairobi Hospice.  I was then pursing my masters degree in public health at the University of Nairobi. Volunteering at the hospice though was not a coincidence.

I had lost my only brother to cancer whom I thought deserved a better death then what he had gone through. Despite the fact that I was a young doctor, I was not able to support my brother as I would have liked to, had I the current knowledge, skills and experience I have acquired over time working with patients and families with life threatening illnesses. I observed the same with the other colleagues taking care of patients with terminal illnesses and I knew that I needed to do something to be a better doctor and also to help influence other health care providers to become better carers.

Palliative care has come a long way in Kenya in the last few years – can you tell us what you think has driven that change?

Advocacy! Advocacy! Advocacy! Making the case for palliative care, the increasing number of cancer cases and other NCDs, as well as the goodwill of those who are the decision makers at the ministry.

What role to you think regional and international partners have played in the development of palliative care in Kenya?

A big role indeed. First, they have provided the funds to support advocacy, training and education to advocate for access to morphine and the research needed to provide evidence. They have also provided technical support and assistance when needed. They have also provided mentorship and have kept on encouraging us, believing in what we are doing, trusting us to use the funds for what they are meant for. 

What did winning the 2013 APCA Advocacy Award mean to you?

It meant a lot not just for me, but it was a symbol of what we have wanted and still want to achieve: palliative care at all levels of care through integration whether in service provision or training. It also showed that palliative care has been recognised as a priority in Kenya, which means it will eventually be accessible to all in need. This is what we are working towards. 

The Ministry of Health of Kenya won the 2013 APCA Institutional Advocacy Award. Can you tell us a little about the relationship you have with Ministry of Health and how this has helped the development in palliative care?

We are now working in partnership with the Ministry of Health who, through our advocacy, have embraced palliative care. They have accepted it as a basic right for every Kenyan. The ministry recognises KEHPCA as the lead in palliative care in the country. We are involved in writing polices and strategising on Ministry of Health documents. We have a very close working relationship. 

If you had one bit of advice to someone just starting to work on palliative care in a country where there is currently little support, what would it be?

I would tell them not to give up easily. It isn’t easy, but it is possible. They should keep on talking about it even if people think they are a nuisance. One day some will listen. They should also identify people who are empathetic; these are the ones who will support them.

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