Hello, Franciscah, and thank you for finding the time to talk to me. I’d just like to congratulate you first on your recent graduation, as well as the awards that you have received in recognition of the important work that you are doing.
You graduated with a BSc in palliative care from the Institute of Hospice and Palliative Care in Africa at Hospice Africa Uganda (IHPCA). Can you tell me a bit more about that?
Yes, I graduated with a bachelor’s degree and we were the first class in Africa to get the degree in palliative care. Also I felt privileged to have been part of that class. I am a nurse by profession and it is my 22nd year practicing palliative care. The bachelor’s degree gave me an opportunity to upgrade my knowledge in palliative care, so with that I will be able to impart this to others.
I felt that was a very good move from the IHPCA to offer that degree, and I would like to do a Master’s degree then I will be able to teach palliative care to others.
Zimbabwe was the first country to have a department of palliative care, in 1979, but in terms of development, we are still lagging behind. If you look at Uganda, they started in the 1980s, but they have managed to develop palliative care in their country.
In terms of development we are lagging behind for various reasons. One will find that getting to work is difficult, there is no funding to do the training, and there is the issue of a lack of funding to train the leaders to set up palliative care at a higher level; there are very few palliative care trained professionals within the country who can then be trained to train others at a higher level.
I believe that the environment is now conducive to start training other students. At the moment we train undergraduate medical students, but during the whole course, their training in palliative care is only eight hours.
We also train other professionals, such as nurses. The kind of training that we provide is very short; it is an introduction to palliative care, but we follow up with supervision. We hope that through this we will be able to impart practical skills in palliative care. That will also be an opportunity for us to model the kind of palliative care that we would like them to practice. Because palliative care is not theoretical, we need training on the ground to see how you do it.
Because of what is happening in Zimbabwe, the country cannot afford to provide drugs for the people, for the patient. They are giving paracetamol for pain management. Sometimes we don’t have money to buy morphine. So you have the palliative care knowledge, but not the drugs.
So I was saying that with this training, I have skills to train others, to be involved in advocacy and also we were taught so many things so that we have the freedom to become leaders in palliative care organisations.
One advantage of the IHPCA course is that it brought people together from many different countries. We were able to share, not only our experiences and our learning, but also our cultural values.
We had leadership training, to enable us to mentor other students, and also other heath professionals who are practising palliative care. In Zimbabwe, and in other countries, we often also have to train community caregivers. We teach them when to refer, how to refer patients to palliative care services.
So you need the community a lot in order to improve the quality of life for the patients.
You received the Ian Jack Memorial Prize, an award that recognises that the recipient has overcome many difficulties to complete the IHPCA distance learning programme, and were also nominated and received second prize in the category ‘Educator of the year’ at the recent IJPN awards in London.
I read that you were instrumental in developing palliative care education in both Namibia as well as your home country of Zimbabwe.
Could you talk a bit more about your work in palliative care education in these two countries?
Yes, I provided palliative care training for nurses. We were using a Namibian organisation to spearhead Namibian palliative home-based care. We would go every few months to mentor the nurses and the community carers.
I’ve also worked in other countries within the region, such as Mozambique, Swaziland, and Lesotho.
Here in Zimbabwe we are always training nurses. But sometimes there are no palliative care medications, and sometimes it really affects me to see that a lot can be done to improve the patients’ quality of life, if we only had the resources to do it.
My greatest wish is to go for a Master’s degree so that I will be able to develop the level of teaching in Zimbabwe and start more training in Zimbabwe.
Can you comment on the importance of palliative care education in Africa?
I think palliative care is very, very important. In Africa you find that many of our patients present very late. With enough resources and enough information we would be able to improve the quality of life of these patients.
We find that education does help, but there are no medications to give to patients. Also, often the patients will not have the money to afford chemotherapy, so we need to be able to provide good palliative care.
In Zimbabwe, even the pastors are trained in palliative care. In palliative care there is the multidisciplinary approach, and pastors will be trained in communicating, as they are the one who will prepare people for death.
We also have to train faith healers and traditional healers, as they have a very important role to play in the community, and most people will go to them first. I am sure that training these healers in the community will affect the quality of life of the palliative care patients.
But the training must also be supported by policies. We must make sure that everybody supports palliative care training.
Is there anything else that we haven’t spoken about that you would like to add?
I just wanted to say that I was honoured to hear that I been nominated for these awards. When I heard that I got the award, I felt touched, I felt humbled. I wanted to thank all the people who have supported me along the way.
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