Palliative care trainings in Malaysia August 2nd till August 17th 2009
Conducted by : Dr. Sue Marsden, palliative care consultant and Liese
This is the third time Sue and myself have been working with Hospis Malaysia in Kuala Lumpur, on invitation of Dr. Ednin Hamzah, the clinical director.
Our work schedule:
Monday 3rd August:
Briefing with Dr. Hamzah
5 hour facilitated team building session with the non-clinical team at the hospice
Tuesday 4th August:
Making house calls with the community hospice nurses, working together in assisting families.
Wednesday 5th August:
One day team building with the clinical team, addressing issues such as burn out, complicated grief, team dynamics.
Thursday August 6th
Making home visits, housecalls with Dr. EdninHamzah, exploring the facilitation and support possibilites in working with complicated family dynamics.
Meeting with the Chairman of the Hospice Board, exploring future requirements for ongoing training.
Friday 7th &8th August 2 day workshop “Grief and Suffering”
Attended by 50 participants from several hospitals and hospice, mainly Nurses and medical specialists, as well as some social workers and counselors.
Sunday 9th August
One day workshop “Facilitating Hope in Advanced Illness”
55 participants similar to the 2 day workshop.
Monday 10th August
Ward round in Palliative Care Ward of the Universiti Malaya medical Centre in Kuala Lumpur.
Tuesday 11th August
departure for Kota Kinabalu, Sabah.
Wednesday-Friday August 12th till 14th rest-days
Saturday/Sunday August 15th & 16th
Two-day residential retreat with volunteers and clinical staff of the palliative Care Association of Kota Kinabalu, Sabah.
Some background information about Kota Kinabalu Palliative Care
Hospice movement took off in Sabah in 1993 as a home care program, The first Palliative Care Unit in the country was set up in Kota Kinabalu in 1995 to back up and support the Home Care Program. The Home Care Program was registered as a non governmental organization - the Palliative Care Associaton of Kota Kinabalu in 1998. They have steadily grown. They have to raise all their funds and offer their service to patients and their families totally free.
Currently they have about 70 patients at home at anyone time. Recently they started taking on children. There are 12 beds in the Palliative Care Unit attached to the general hospital. They also run a day care programme which is fully run by volunteers.
Volunteers have always played a key role right from the beginning.
I think they are a role model for the country with a referral system in place in the hospital and a clear flow chart. Patients usually come into the Palliative Care Unit and then are referred out to the Home Care program or to the districts.
They have never been able to get all those who deliver Palliative Care under one roof to inculcate a common philosophy, motto and goal.
To understand how each one is contributing to the relief of suffering - and that each one is interdependent with independent roles.
The Palliative Care Unit is a governmental organization and the Palliative Care Association is non governmental. Rules and regulations, incentive to work , working-conditions etc are different. It has been a struggle for all of them to work as a team. Stress is an important factor, as often they are over worked. Friction in the teams is common. A smooth working relationship with each one, being sensitive to each others goals and motives is important.
Burn out is a problem - though not obviously manifested. Till recently they have had a rapid turnover. At present they seem to have stabilised.
Volunteers need much support. They come from different backgrounds, different faiths yet they have been doing a great job. There has been a turnover among them because the work is so demanding.
The 2 day residential retreat was attended by 50 volunteers and staff. We worked together with all of them on issues like communication, team work, cultural differences, facilitating hope, how to work with grief and bereavement in their community.
The group was very responsive and interactive and looking at the feedback, found the workshop very positive and informative.
The same goes for Sue and myself, we always come out of this work so enriched.
We asked both Dr. Hamzah from Hospis Malaysia and Dr. Ranjit Matthew Oommen from the Palliative Care Association in Kota Kinabalu about what was most needed in further development of hospice and palliative care in Malaysia.
Their response was very similar: local and overseas resources and expertise for further continuing education.
Again it has been a real privilege to work with such a diverse group of very dedicated people, it has given all of us many new insights in working with cultural, religious diversity in resource poor settings.