Global learning to make a local difference

Heather Richardson, joint CEO of St Christopher’s Hospice in south London, has recently returned from a fellowship programme that aims to help participants develop palliative care services in undeserved areas. Here she tells ehospice about her inspiring fortnight in Kerala.

The last two weeks witnessed the coming together of 38 people from 13 countries at the Institute of Palliative Medicine (IPM) in Kerala, India – a World Health Organisation (WHO) collaborating Centre for Community Participation in Palliative and Long Term Care. All participants were committed to the development of effective and sustainable palliative care services in low and middle-income countries, and have signed up to a six-month journey together to this end.

The course, led by Dr Suresh Kumar and Dr Libby Sallnow, is a partnership between the IPM, St Christopher’s Hospice in London, the Bangabandu Sheikh Mujib Medical University in Bangladesh and Sanjeevan Palliative Care Project in Pondicherry. Set up at the request of the WHO It has been designed to build leaders who will bring strategic focus and new ideas to areas currently underserved by palliative care services. The 2020 course builds on the inaugural course of 2019, attended by 40 people from nine countries. They completed the course in August last year.

At the heart of the Fellowship is a commitment to community development. The programme helps participants to create a vision and plans for palliative care characterised by community participation. It draws heavily on the learning from the Palliative Care Network in Kerala and other examples across the globe.

The multi professional faculty – drawn from India, Bangladesh, UK and Australia, brings a breadth of experience on which participants are invited to reflect and adapt for their area. Subjects covered are broad in nature, spanning population-based need assessments; the benefits of working in or out of the system; volunteer management; integration of services; opioid availability; leadership and management; rehabilitative palliative care, change management and evaluation. The style of learning is highly interactive – pushing participants to draw on their experience and that of others, apply new learning to their context and plan change accordingly.

The relationships established between the participants and the faculty in the fortnight they spend together are one of the most highly evaluated elements of the programme. Working six days a week between 9.30 am and 6.30 pm with assessed group work and many other challenges, the group quickly becomes close – exchanging ideas, explaining different cultural norms, supporting each other to grow and having fun. In the course of the last two weeks strong personal connections have been established, email addresses exchanged, a WhatsApp group created and promises of shared learning have been made.

At the end of the fortnight together this group of people disband and return to no less than five different continents – to busy jobs in hospitals, community services, paediatric as well as adult services, paid and voluntary roles, all committed to completing the course and engaging in developments that they believe could really make a difference locally.

None of this is easy. As well as an exam completed on the last day they have five further assignments to undertake remotely that they must pass to receive a certificate of successful completion. They must also all engage in peer evaluation of others’ work and join regular zoom meetings to review progress. They have access to mentors drawn from around the world, including some graduates from the same fellowship a year ago. The faculty remains involved also, keen to see growth and enthusiasm in individuals and the group as a whole continue.

It’s not just the students who benefit. Being on the faculty is an educative and inspiring experience. This is a group of game-changers and their tenacity, creativity and optimism is infectious. Their attention and conviction to grass roots involvement is inspiring and instructive. At a time when so much of end of life care feels like an uphill challenge in the UK, it is good to be reminded of the scale of change required elsewhere with relatively little resource.

I look forward now to the Fellowship of 2021 which begins on the February 1 next year, and hearing about progress from the alumni of 2019 and 2020 in the meantime. To find out more about the Fellowship or apply for a place contact fellowship.palliativecare@gmail.com