CEO of the Ministry of Health addresses hospice and palliative care conference in Belize

Categories: Leadership.

Dr Allen thanked the organisers and commended the speakers and delegates, saying that they represented: “some of the most remarkable minds and hearts in all of Belize.” 

His speech is reprinted below with the permission of BHPCF.

Dr Peter Allen keynote address

To cure sometimes, to relieve often, to comfort always – this is the work of the Belize Hospice Palliative Care Foundation.

There are many important technical aspects of that work, including the way the broader community perceives patients with life threatening illness. But for me – far more important is the attitude which is conveyed in the wise words of my favourite prayer which – if you will forgive me – I begin with this morning:

Lord, make me an instrument of your peace.

Where there is hatred let me sow love.

Where there is injury, pardon.

Where there is doubt, faith.

Where there is despair, hope.

Where there is darkness, light.

And where there is sadness, joy.

O Divine Master, grant that I may not seek to be consoled, as to console;

To be understood as to understand;

To be loved, as to love;

For it is in giving that we receive;

It is in pardoning that we are pardoned;

And it is in dying that we are born to eternal life. 

The prayer of Saint Francis of Assisi of course. I was so pleased when the first Pope from the Americas chose this blessed name – but of course prayer is for all people, for all religions – it was the great Mahatma, Ghandi, who told us: Prayer is not an old woman’s idle amusement. Properly understood and applied, it is the most potent instrument of action.

Prayer is a powerful tool, not least in the challenges faced by palliative care providers like you.

Defining palliative care

World Cancer Day was Wednesday 4 February. We have come so far, and yet there is still so far to go. You know, some people think of palliative care as just a response to cancer patients – but as you all know it goes far beyond that important boundary.  

It has been said that the true measure of a society is how it treats its most vulnerable. To take this a step further: the measure of a society, of its moral maturity and of the point it occupies on the scale of civilization is found in whether and how it provides physical and spiritual comfort to those in their final days of life; physical and spiritual comfort.

Palliative care is not just about pain control. 

There are lots of definitions of course – and sometimes a lack of clarity and understanding on what exactly we mean by “palliative care.” However, one definition that I like is this:

Palliative care affirms life, while helping to ease the physical, emotional and social distress of the patient and his or her family. Terminally-ill patients look to focus on creating life-affirming moments that bring great satisfaction, closure and even joy. Our focus should always be on the patient and their family of course, palliative care providers walk beside them and support them through… the process of dying.

Remembering the heart

Now – looking through your agenda, I can see that you have the opportunity for many technical presentations coming from wonderful people today and tomorrow which will provide you with information and essential tools with which to become even better care providers.

Team building, recruitment and retention are fascinating challenges in all health systems and are especially difficult in palliative care. Pain management, therapy and equipment are all important topics.

But for my brief comments this morning I would like to suggest to you that – in all health care but most especially in palliative care – what is most important is that which is already in your hear. Back to prayer again for a moment: 

Prayer is not about asking for things. Prayer is a daily communication, a daily admission that we need help. Those much wiser than I have made it clear: it is better in prayer to have a heart without words than words without a heart. 

Care and affection is not a business where you give and get. It is a truly beautiful feeling for any of us who like to give, even if you don’t get, and we are blessed if we are gifted with the opportunity to give. 

The need for palliative care services

Most people of course – older persons, most patients – would rather spend their last days in the comfort of their homes, pain free, with the required services, surrounded by family and loved ones. But this unfortunately is not the reality for many. Despite the amazing work of the Foundation, we all know that there is a lack of palliative care services and many people do not have access to the support needed.  

We are an imperfect world – but relief from pain is a basic human right.

The Declaration of Montreal, adopted on 3 September 2010 at the 13th World Congress on Pain, affirms – among other things – “the right of all people with pain to have access to appropriate assessment and treatment of the pain by adequately trained professionals.”

Palliative care is part of a movement toward fundamental justice and basic human rights for citizens facing the last fragile stage of life.

The principles of palliative care challenge old, impoverished and dehumanizing ways of dealing with dying in a way which also challenges some of our customs and cultural beliefs in uncomfortable ways. 

As long ago as 2003, the European Committee of Ministers affirmed that “palliative care is… an inalienable element of a citizen’s right to health care.”

Developing public policy to champion the vulnerable

Now, as part of my job, I help to develop public policy, but part of my job is to identify weaknesses in our own systems and the truth is that public policies in general tend to be insensitive to human fragility. Public policy decisions tend to reflect a compromise amongst a broad cross section of groups, none of whom are particularly vulnerable, and none of whose economic and political interests naturally coincide with those who are. The most vulnerable in society are not part of the day to day experience of policy makers. It is for those of us in this room to become advocates and champions of the vulnerable.

Enormous challenges

Palliative care remains relatively unknown and little understood. Despite the good progress that is being made by all of you – all those working hard to raise its profile as an emerging health care issue – palliative care has yet to reach a threshold in public awareness that would prompt governments – including our own – to accord it the attention and funding it merits.

The result is that only a small percentage of those Belizeans who will die this year will have access to palliative care. Moreover, the care that is available is distributed unevenly across the country, with access, in essence, a function of where you live.

So the challenges are enormous, but resources are not counted only in dollars. The most important resources are indeed the fathomless depths of courage which we find only in the hearts and souls of volunteers like yourselves.

For some reason, people seem to focus on all that is bad in the world when all around us, including, perhaps especially in this room, there are examples of great goodness.

Service to humanity

Like all of you, I have been a volunteer of one kind or another for most of my life. When I was 16, my school started a social club for children with mental and physical challenges. I ran the club for a couple of years and of course found that the greatest gift was always the joy that the volunteers received from the children and their parents – the love and the fellowship made us better people.

I volunteered during college; I came to Belize as a volunteer; I have volunteered with various organisations since then. My friends, the story has always been the same – those who give of themselves get much more out of the experience than they put in.

In service to humanity, we all become richer. First of all richer within ourselves, but ultimately richer as a community. All of you in your own way have already realized the importance of compassion, of humility, of respect, and of the great gift we can give to ourselves when we give of our self to others.  

To cure sometimes, to relieve often, to comfort always – this is the work of the Belize Hospice Palliative Care Foundation. 

Lord, make me an instrument of your peace.

Where there is hatred let me sow love.

Where there is injury, pardon.

Where there is doubt, faith.

Where there is despair, hope.

Where there is darkness, light.

And where there is sadness, joy. 

Thank you all for everything that you do each and every day – never give up! 

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