The advent of paediatric palliative care was surmised to have started in the 1960’s when St. Christopher’s, the first hospice in London, was opened under the influence of Dr. Cicely Saunders. Consequently, there was also a pioneer and leader who had been a strong advocate of the children, Dr. Elisabeth Kübler-Ross, who imbued the ground, stirring compassion for children through her resolute question “What about the children?” in her works and interviews (something I learned from a personal encounter with her son, Ken Ross, and Joan Marston).
With the vision and inspiration planted by these pioneers, the movement in children’s palliative care achieved its momentum in the last 20 years and is still impetuous to this day. Its roots are now continually growing in the Southeast Asian (SEA) region as the first Paediatric Palliative Care Symposium (PPCS) was held in the Philippines led by the National Children’s Hospital (NCH) Paediatric Palliative Care Centre September 4, 2023 at the Angelo King Auditorium, in St. Luke’s Medical Centre, College of Medicine in Quezon City. This event, with the theme “Working together — improving palliative care for children in the Philippines”, was organised in partnership with Hummingbird House, Brisbane, Two Worlds Cancer Collaboration, and St. Luke’s Medical Centre, College of Medicine to create awareness the roles of different professionals can enhance the care of children with life-limiting illnesses through a collaborative team approach, and provide opportunities for local linkages engaging professionals both from different disciplines and institutions.
Prominent resource speakers were invited in the symposium namely Dr. Mari Joanna Joson, President of the Philippine Society of Hospice and Palliative Medicine; Dr. Agnes Bausa-Claudio, the technical lead in the National Program of the Manual of Operations in Palliative Care and Dr. Rumalie Corvera, one of the pioneers in the Community Palliative Care in the country and the founder of The Ruth Foundation, Inc. and President of National Hospice and Palliative Council of the Philippines; Dr. Francis Xavier Dimalanta, a Paediatric Development and Behavior Specialist, and member of the board of trustees of the Philippine Paediatric Society and Ms. Nina Nerissa Sumpaico-Jose, a Child Life Specialist from the Kythe Foundation, Inc. Government support was also very evident through the presence of the Department of Health (DOH) Undersecretary Dr. Maria Rosario Singh-Vergeire who gave her opening speech acknowledging the efforts of NCH and signifying their support to the development of paediatric palliative care in the country.
This great work was done by a leadership team composed of the NCH PPC core team: Dr. Rhea Jayma, head of the NCH PPC centre; Dr. Ma. Liza Naranjo, Pediatric haematologist and Research division head, Dr. Lannie Fofue, Dr. Adelina Uyvico, and Dr. Xiohara Gentica, PPC specialists and Administrative, Clinical, and Training division heads, respectively; Dr. Leicel Goyena, current PPC fellow; Dr. Yasmin Sulit, Paediatric anesthesiologist; Ms. Ma. Socorro Vargas and Mr. Oyo Boy Casimiro, Palliative care nurses; and Ms. Remedios Serapion and Ms. Sheena Robenta, Palliative social workers. The program was further enriched by the presence of our partners from Australia namely, Dr. Helen Irving, Pediatric Oncologist and Ethicist from Children’s Health Queensland Hospital and Health Service; Dr. Ross Pinkerton, Chairperson of the Mater Misericordia Ltd in Brisbane, Australia; Ms. Kelly Oldham, Clinical nurse and Ms. Takiko Langlasse, Social worker from the Hummingbird House in Brisbane which is the only hospice in Queensland.
Topics covered were on current status of palliative care in adults and children in the Philippines, integration of palliative care into paediatrics, and interprofessionalism in PPC with breakout activities through a case discussion, and simultaneous workshops entitled, Reframing Farewell: Reflective Discourse on Death and Dying and Therapeutic Play: A Creative Approach to Healing. The response in terms of attendance was promising with 182 participants (75 doctors, 76 nurses, 28 social workers and 3 allied health professionals e.g. chaplain, physical therapists) who attended from various government and private hospitals and institutions coming from different major islands in the country: Luzon Visayas, and Mindanao. A lot of positive feedback reflected the achievement of the major objectives of the event. Few of the comments and suggestions of the participants were the following:
“This is very meaningful because I want to improve the programs and services for our oncology patients in our institution”
“[It is] helpful in establishing the PPC”
“I would suggest/encourage everyone or let anyone know about paediatric palliative care, so everyone will understand and know how to handle those adolescents who are facing serious illness.”
One also actively suggested, “I think it would be interesting to do benchmarking on the hospitals with established Palliative Care Team”
The following days during that week were allotted to “Pop-Up” sessions of the NCH PPC team with several hospitals namely St. Luke’s Medical Centre, Philippine Children’s Medical Centre, and Philippine General Hospital discussing cases with experts and applying the principles of paediatric palliative care. Those were fruitful activities that fostered linkages, mutual desire to develop PPC teams in their respective institutions, and openness to future collaborations.
Finally, this symposium exemplified the spirit of teamwork where indeed, together everyone achieves more (T.E.A.M) and what made this really special was the participation of so many volunteers like medical students, admin assistants, and most importantly the parents who received palliative care during the last days of their children’s life. This is one of the most memorable experiences that we had as a team and it has further kindled our passion to champion paediatric palliative care in this side of the world. Many thanks to our mentors, partners, colleagues in the field who continually inspired and supported us to make these things possible and also joined us through willingly giving their special video messages that also impacted the attendees in so many ways.
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