some thoughts after a good mediattion today…
Dying with Dignity.
We all know that Death is Certain and Birth is a ‘may be’ and as highly developed species we still have not understood the fundamental truth! We celebrate Birth and go into profound mourning after the Death of a loved one. A Very Good Senior Gyn used to always say “In my 45 + years of practise , I am yet to come across a smiling new born and a crying dead body” . When a child is born, while the child cries, everyone around it jumps claps and celebrates. When a person dies, while the dead has unopposed calm, people around cry and mourn – sometimes for days…i guess the new born and the deceased both know the Universal Truth!…The new born cries worrying ” Oh NO I am back here where everyday is a struggle” and the dying soul is calm knowing “I am going back to my Real Home” … CELEBRATE LIVING EVERYDAY, NOT JUST BIRTH and when time has come CELEBRATE THE END!

The biggest challenge I faced was to figure out how to use what I learnt to help the patients and apply the knowledge in my practice.

Sekgoma Memorial Hospital is blessed with a group of enthusiastic professionals who agreed to form the palliative care team . The Superintendent of the hospital and the Matrons were the first to support such a proposal.

The team consists of

Oncologist ,Nurses (2),Medical Social Worker, Home Based Care Nurse, Palliative Care Nurse, Medical Officer, Dietitian ,Pastor.

We decided to conduct palliative  care OPD every 1st and 3rd Friday of every month where a comprehensive discussion is held with the patient and families.

The course is no easy one and is definitely very challenging added to it is the fact that many of us will be doing the course while we are working.

So the most important factor to succeed in the course is to have mentors and the faculty at UCT are more than eminent at guiding the weakest of the lot in succeeding at the course.

Dr Liz Gwyther , Dr Rene Krause(Adult Palliative care) , Dr Michelle Merring (Paediatric Palliative care), Linda Ganca (Communication Expert) are the base Mentor Team that helped me through the course.

The mentors made sure that each topic was discussed in detail and every session was interactive and engaging.

I have to mention that the support you get from the fellow students is priceless. Rene Albertyn our fellow student has helped me through all the assignments and difficult topics.At one particular time I remember being stuck in a topic not knowing where to find articles for references and after requesting Rene Albertyn for help , my email inbox had 8 articles specifically addressing my need.

We formed a whatsapp group to discuss our challenges.

Each of the 26 students have taught me in their own and every interaction has been something to learn from.

The Postgraduate Diploma in Palliative Medicine at University of Cape Town being my first International Course, I had no idea as to how the course will turn out.

I must say the course is intense , well structured and comprehensive. It requires effort to complete the necessary 1200hrs training and has the most supportive tutors/mentors to help one get through the course.¹

There are 2 contact sessions which are mandatory for the candidate to attend (Jan and June) with each session lasting for 5 days.

It is an active course with 8 Assignments and a forum topic to be discussed every other week.

The emphasis is more on how a student is utilizing the learnt knowledge in day to day practice and not just memorisation of facts.

The final exams are held in November which consists both theory and viva. The “lucky” ones graduate in December.

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1. http://www.publichealth.uct.ac.za/phfm_postgraduate-diploma-palliative-medicine

Palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.

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WHO Definition of Palliative Care for Children

Palliative care for children is the active total care of the child’s body, mind and spirit, and also involves giving support to the family.It begins when illness is diagnosed, and continues regardless of whether or not a child receives treatment directed at the disease.

(1)

1. http://www.who.int/cancer/palliative/definition/en/

Before i begin into the details of the course and how it has changed me , i must add a special post for a special person. Naomi Fray , the Programme Administrator was the first contact for me at the course and what a wonderful person Naomi is!

If there is anyone who describes the epitome of being helpful, there is none other than Naomi Fray. It was only because of her , that i got into the course hassle free. She has been there all along , helping and guiding me at every single point.

Anyone who is interested to do the course must get in touch with Naomi through email Naomi.fray@uct.ac.za

My first experience in Palliative Medicine was during my residency years when as Junior Regsitrar in Radiation Oncology in a prestigious institute (Madras Medical College) , the drive and focus is more on learning Curative Medicine.

On attending a small workshop on Palliative care , I started to think that it deals with more people who are dying and is the last hope when everything else fails.That was the last time I ever thought of palliative medicine as a branch of interest for me to dwell further.

Fast forward to December 2014 ,reading about the course in University Of Cape Town , South Africa , I started to realise it is more to deal with people who are ‘living’ rather than people who are ”dying’.

I needed answers to know how can the terminally ill patients and their relatives be better taken care of.

‘Quality of Life’ is the single most important sentence that got me to take the course.

Ever since the known existence of human beings , we have all bee  doing things with single end point in mind and that is “How can we improve the Quality of our Life?”. It holds true for all the activities we do whether it is to brush our teeth or buy that new gadget in the market.All with one purpose and belief that it will improve the Quality of our Living.

That is what is so good about Palliative Medicine , it is a Holistic Inside -Out Approach to a patient !

This blog is a treasure house of my experience and thoughts on the wonderful course at University of Cape Town – Post Graduate Diploma in Palliative Medicine!