Understanding the role of community spirit in place of palliative care in Cameroon

Categories: Community Engagement.

Cameroon is a medium sized country with a surface area of 447000m² located in central Africa with her south west province extending to the Atlantic Ocean. Her population is about 22,25 million inhabitants, made up of more than 200 ethnic groups with each having their own dialect. Most cultural views and practices are similar but differentiated by unique traditional dishes, regalia and to a lesser extent, tattoos.

These various ethnic groups in Cameroon all have a very unique, important, highly beneficial and realistic, common practice of community spirit. As religious as Cameroon folks are, community spirit is blended by the Biblical view of the phrase, ‘bear ye one another’s burden’ which is also similar to teachings from the Koran. 

In Cameroon, far greater attention is paid to the welfare of a family when an infant is terminally ill. Culturally, men do not cry whatever the circumstance, but unlike with adults, a terminal or end-stage disease or death of a child permits wailing in the whole community, including men.

It can be estimated that 90% of care and support for palliative care situations here are provided at home by families and friends. Common gestures resulting from community spirit include: costs and donations towards care for the terminally ill, especially children, volunteer caregivers outside of the family members, such as extended family , fellow community dwellers as well as friends. Volunteers and friends will often spend time together, assisting in one thing or another until the death. During burial, crowds will turn out, each contributing food, drinks, money and so on. Many would spend 1-2 weeks with the grieving family after burial.

The concept of community spirit seems to be the same in most African countries but it is more beneficial to Cameroonians as there is no free government health provision or inexpensive health insurance, there is no hospice, no grieving centres nor programmes to teach, advocate, sensitise or even provide grief management services. Community spirit has proven to be very beneficial in supportive care both to the dying and the families. The dying often consider such support as a sign that they are still valued as people within the community although comparatively the elderly receive less sympathy than do children.

Typically, once diagnosed with a life-limiting condition in a Cameroon hospital, the next step is for the medical doctor to try to stabilise the condition and then send the patient home. At home, the patient is at the mercy of untrained and unskilled family members. Because Cameroon is a very religious community, families will often seek for solutions from spiritual practices, sorcery or prayers hence either of these often prevail once they return home from the hospital. Unfortunately, these are two different, often conflicting approaches of care; hence a national paediatric hospice service and relevant professionals are urgently needed in our country.

In urban areas, the story may be a little different in that the traditional community spirit practice is dying rapidly because urban dwellers are more zealous in assimilating western culture and access to health facilities and professionals are more readily available. Community spirit plays a very positive role for the dying and grieving family members in that, almost all the dying persons and family members are consoled with the support provided. 

This may explain why depression in such circumstances is rare, even after grieving, in comparison to more western communities.

About the author
Menang Joshua Menang is a married father of three, born in Cameroon. He is a professional nurse who has worked at Central Manchester University in the UK, University Teaching Hospital in Pisa and Rosalind Franklin University in Illinois. He has completed courses in Q-Stream Breast Cancer Management, Pain Management and a Multi-disciplinary paediatric palliative care course. He is currently completing a Distance Learning Certificate in Public Health with the Global Health University. He is a member of the International Society of Nurses in Cancer Care (ISNCC), the International Association for the Study of Pain (IASP-Pain), the International Children Palliative Care Net-work (ICPCN) and International Association of Hospice and Palliative Care (IAHPC). He has actively contributed to these member organisations by attending events like conferences, online surveys, presentations and more.