The high burden of grief and bereavement in Sub-Saharan Africa, largely attributable to HIV, cancer, and other non-communicable diseases is, unfortunately, not met with adequate interventions to improve end-of-life experiences that promote patient and family-centred models of care to improve the quality of death and dying, as well as grief and bereavement outcomes for those affected.
African Palliative Care Association (APCA) is implementing a 3-year programme entitled “Improving end of life care experiences, quality of death and dying, grief and bereavement outcomes for patients living with advanced disease and their families using a health-systems strengthening approach”. The programme recognises the crucial role played by community lay members in providing peer bereavement support, and, as such, one of its expected outcomes is communities that are empowered to support bereaved community members and to respond to emerging grief and bereavement needs.
Strengthening Community Capacity
On May 8th and 9th, 2023, APCA conducted grief and bereavement training sessions in the Buddu region of Uganda, facilitated Jenny Hunt, an expert in death and grief. Representatives from the surrounding Kyotera, Lwengo, and Masaka districts attended. These sessions were based on a 9-Cell bereavement module approach which encouraged the participants to detail their experiences of grief and loss with charts. They were urged to freely voice their emotions, recall any advice from friends, and distinguish between what was helpful and what was not in terms of dealing effectively with these emotions.
The session was interactive and informative, pushing the participants to openly discuss their stories of sorrow and mourning. By doing so, the attendees were able to relate to each other, encouraging both understanding and empathy.
It became clear that grief has many stages and affects people in many ways. Seeking help and guidance from others was regarded as essential. Ignoring the important emotions and pain that comes with loss can have detrimental effects on mental and physical health, with extensive research linking conditions such as stroke, hypertension, depression, and anxiety to unresolved grief.
It is common for people to advise a bereaved person to “stay strong” because they do not want to see them cry, and they believe they are helping. Participants were urged to teach people out there that crying is very fine and it’s a mechanism that allows the body to release pain. Crying is a natural physiological response that allows the body to release emotional pain and stress, and suppressing these emotions can have negative impacts on mental health. Encouraging individuals to embrace their emotions and express them in healthy ways can ultimately lead to greater emotional resilience and overall well-being.
The idea that memories must be cherished and the legacies of the departed must be kept alive was also discussed at this session. Participants were encouraged to share stories about the person they have lost and partake in activities that could help them cope with the sadness and preserve the special memories created. Teaching children about the deceased is an invaluable experience for them, aiding the grieving process while providing them with memories that will last a lifetime.
The knowledge gained from the session was meant to help the participants cope with their personal grief, while building a kinder and more supportive community.
With a strong focus on personal healing and well-being, Jenny Hunt assessed the psychological needs of the members of the trained community. She emphasized the importance of learning to process and heal from their own individual losses before providing support to those in grief. Participants were encouraged to be empathetic and understanding to those in need while approaching their roles supportively. These measures ensured that they were adequately prepared to handle the emotional obstacles that would come with aiding others in the grieving process.
Participants were urged to approach bereaved families with kindness, respect, compassion, genuine interest, be non-judgmental and to be active listeners, thereby creating a safe and supportive environment where individuals can feel more comfortable to open up and express their feelings.