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Malika Ndlovu

Book launch: Griefseed by Malika Ndolvu

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I recently had the privilege of attending the book launch of Malika Ndlovu’s new book, Griefseed. Many of you will remember the moving opening performance by this writer, poet, curator, and applied arts practitioner at the 2023 Palliative Care Conference in Cape Town. 

The launch, held at Exclusive Books in Cavendish, drew a sizeable crowd. From their dress and comments, it was clear they came from many walks of life, each with their own story. During the Q&A session, one audience member shared that she had originally come to buy a book and to use the quiet space to work on her MMed thesis (she is completing her MMed in Paediatrics, as I later discovered). Curiously and unexpectedly, she found herself drawn to the launch instead, explaining, “I am actually here to work on my MMed,” she repeated. But like many of us, she was deeply moved by the conversation that unfolded between Malika and author Barbara Boswell. Indeed, we are all carrying some form of grief in our hearts.

Barbara Boswell writes: “Griefseed is a gift, an offering from the pen of Malika Ndlovu that seeks to transform the ways we think about and process grief. Multidisciplinary in scope, the text includes poems, personal essays, images, and reflections on grief that punctuate the life story of the poet, offered here as medicine. These creative pieces function as both a window onto an individual woman’s life as she has journeyed with, through, and beyond grief, as well as a mirror, inviting the reader to see their own lives and losses reflected within Ndlovu’s.”

Thank you Malika, for your ongoing inspiration and invaluable contribution to the palliative care community in more ways than one.

Greefseed Mailka Ndlovu

The book is published by Karavan Press and is available at Exclusive Books.

Woman disgusted of some cough syrup she has to drink to feel better. Woman taking cough syrup on sofa at home. Ill woman with grey scarf taking cough syrup

Addressing the Gaps in Palliative Care: PALPRAC and EMGuidance Join Forces

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Rural healthcare South Africa
A Child's Radiant Smile in a Hospital Setting: A Glimpse of Hope and Healing
Expanding access to palliative care: doctors skilled to prescribe oral morphine

Palliative care remains one of the most underutilised medical services worldwide, particularly in low- and middle-income countries (LMICs). The Lancet Commission on Palliative Care and Pain Relief’s 2017 report and the WHO’s 2023 report, “Left behind in pain: Extent and causes of global variations in access to morphine for medical use and actions to improve safe access,” highlight the inadequate access to essential pain relief including oral morphine, in particular in low- and middle-income countries (LMICs). Despite being a WHO essential medicine and included in South Africa’s Essential Drugs List (EDL), morphine remains difficult to access due to procurement inefficiencies, governance issues, and misconceptions.

In South Africa, only doctors can prescribe morphine, while nurses are limited to dispensing it. Supply chain disruptions often leave hospitals and clinics without stock. Many patients and families have to travel long distances for their medication. Additionally, inadequate palliative care training leaves many healthcare providers uncertain about proper prescribing and management of side effects.

To address some of these challenges, PALPRAC has partnered with EMGuidance to develop short palliative care training modules. EMGuidance, a widely used South African digital medical information hub, serves over 34,300 doctors, 6,200 specialists, 1,170 pharmacists, and 16,500 nurses. These modules aim to enhance healthcare providers’ knowledge and competencies in the management of pain and other distressing symptoms.

The first module focuses on the basics of morphine prescribing, dispelling myths and offering practical guidance. By improving education and equipping healthcare providers with essential skills, PALPRAC and EMGuidance are working towards better pain management and enhanced quality of life for patients in need of palliative care.

Sign up for the course here: https://academy.emguidance.com/course/prescribing-oral-morphine-in-palliative-care

Share the link with colleagues!

UCT Summer School 2025

Palliative care at the UCT Summer School

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The UCT Summer School is an annual initiative by the University of Cape Town (UCT) that brings together members of the public for intellectually stimulating lectures across a variety of disciplines. This much-anticipated event aims to make academic knowledge accessible to everyone, offering a platform for learning and discussion.

One of this year’s highlights was a lecture titled “Palliative Care: A Fundamental Aspect of Universal Health Coverage,” presented by Professors Liz Gwyther and René Krause. The session shed light on the critical role of palliative care in healthcare systems, emphasising its significance in achieving universal health coverage.

In addition, PALPRAC (The Association of Palliative Care Practitioners of South Africa) and the Groote Schuur Palliative Care Service were invited to set up a stand in the venue foyer. This provided an excellent opportunity to connect with attendees, share resources, and raise awareness about palliative care. The stand facilitated meaningful interactions with the community and allowed healthcare professionals to network and exchange ideas.

A special thanks to Dr Melodie Wessels for her advocacy and dedication to palliative care, ensuring its inclusion in platforms like the UCT Summer School.

We can affect the journey

Palliative Care Awareness Day in Polokwane: A Heartwarming Success

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The PALPRAC team was excited to head to Polokwane for a Palliative Care Awareness Day, hosted on the 5th of December 2024 in partnership with the Limpopo Department of Health. This event brought together participants from all corners of the province, with some travelling from as far as Groblersdal to join the occasion. Participants were enthusiastic and friendly, setting the tone for an impactful day. (We must admit, the PALPRAC team gave themselves a little pat on the back for the smooth rollout of our new GlueUp electronic registration process!)

It was obvious that a solid foundation for palliative care had already been established in the region. Prof. Gert Markinowitz, Dr Thamba Khangale and the team have been successfully running online palliative care training sessions for healthcare professionals in Limpopo, many of whom were present at the event. Adding a splash of inspiration to the day were the vibrant t-shirts designed by Dr Rapudi Morifi, Clinical Manager of Polokwane Provincial Hospital, featuring the slogan: “We cannot change the outcome, but we can affect the journey.” Worn proudly by the team, these t-shirts effectively create awareness for palliative care in their place of work.

The turnout was encouraging, with around 72 healthcare professionals attending. Despite a packed schedule of lectures, the hall stayed full until the very end—perhaps the superb lunch helped keep everyone going!

The agenda featured expert-led discussions on essential topics, including pain management, advance care planning and ethical decision-making in palliative care. During the Q&A sessions, attendees opened up about the challenges they face in the field, including the lack of awareness about palliative care among colleagues, patients, and families, which often leads to late or missed referrals. Access to oral morphine was highlighted as another significant challenge requiring urgent attention.

Despite these hurdles, attendees displayed a strong commitment to improving palliative care services in the region. Their collaborative efforts and clinical leadership continue to advance access to care for patients in Limpopo, even in the face of resource constraints.

Palliative care isn’t rocket science, but it is complex, focusing at its core on providing compassionate support to individuals with serious illnesses. However, it can sometimes feel like an uphill battle within a healthcare system that is so heavily focused on curing diseases. Events like this are instrumental in fostering networks of support, enabling practitioners to exchange ideas and strategies, and reinforcing a sense of shared purpose. The palliative care community’s strength lies in its collaboration, resourcefulness, and dedication to patient-centered care, as this event aptly demonstrated.

The PALPRAC team extends its gratitude to our colleagues in Limpopo for their efforts in organizing this event and to all the attendees for their active participation.

If you’re interested in hosting a similar awareness day in your region, don’t hesitate to reach out to PALPRAC—we’d love to explore how we can work together to make it happen!

Watch this short video of the day’s highlights:

Celebrating World Hospice and Palliative Care Day 2024 with PALPRAC

Celebrating World Hospice and Palliative Care Day 2024 with PALPRAC

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A huge thank you to everyone who contributed to PALPRAC’s e-book project in celebration of World Hospice and Palliative Care Day (WHPCD)! This year’s theme, “Ten Years Since the Resolution: How are we doing?”, encouraged us to reflect on how far we’ve come since the 2014 palliative care resolution, while acknowledging the ongoing challenges we face.

Our new e-book is more than just a publication; it’s a heartfelt tapestry of essays, artwork, and personal reflections that capture our shared passion and commitment to advancing palliative care. Each piece highlights the strides we’ve made, the patients we’ve supported, and the resilience of our community.

We invite you to explore this unique collection through the link provided here. We hope it inspires you to keep pushing forward in this field and reinforces the power of compassionate care. Let’s continue working together to enhance the quality of life for those who need it most. Thank you for being part of this journey with us!

PAINSA

Highlights from the 2024 PainSA Congress in Durban

The 2024 PainSA Congress recently took place in Durban (17th-19th May 2024) and was a resounding success. Esteemed colleagues from around the world gathered to share valuable insights and discuss advancements in pain management. 

PainSA, the South African chapter of the International Association for the Study of Pain, aims to enhance pain management across Southern Africa. This year’s theme, “Personalised PAINCARE,” focused on a biopsychosocial and spiritual approach to pain management. The congress featured comprehensive assessments and individualised management plans to reduce pain and reintegrate patients into society.

A significant part of the event was dedicated to palliative care, with sessions for both adults and children. These sessions were well-attended, showing a growing interest in and recognition of the importance of palliative care.

PALPRAC members made a strong impression with their presentations on various topics such as dignity in care, cancer pain management, the pain ladder, and addressing burnout in ICU and neonatal care. These discussions underscored the necessity of interdisciplinary approaches in managing severe and complex pain cases.

In addition to the enriching presentations, the congress served as a platform for networking, allowing attendees to form new relationships and partnerships aimed at advancing pain management practices. For more details on the sessions and speakers, see the full programme on the PainSACongress2024 website https://painsa.org.za/2024-painsa-congress/

This year’s congress highlighted the ongoing need for innovative approaches and collaborative efforts in pain management, ensuring that patients receive holistic and effective care tailored to their unique needs.

 

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Breaking the Barriers: Promoting “phila unethezeke” (palliative care) Awareness in Khayelitsha

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According to community members, palliative care in Khayelitsha has long been associated with death, making it a sensitive topic for the community. Cultural and spiritual beliefs about death contribute to barriers in accessing palliative care resulting in many community members avoiding discussion and options for palliative care. Our goal in Khayelitsha is to change the community’s perception and tackle some of these barriers, as many palliative care patients only receive support from immediate family members, not the wider community.

Health Promotion Day in Khayelitsha: Who Was Involved and Why?

Health promotion enables people to make informed decisions regarding their health. The health promotion event was organised by fourth-year medical students from the University of Cape Town (UCT) and Judith Mahlangu, Khayelitsha Site Facilitator and Researcher at UCT’s Department of Family, Community and Emergency Care, in partnership with The Association of Palliative Care Practitioners of South Africa (PALPRAC).

A diverse group of participants were invited to join the Health Promotion initiative. There were two components to this initiative. First, students and PALPRAC spent the morning on the live, local radio station, Zibonele FM, to introduce the topic of palliative care to listeners, who had the chance to send in their questions.

Some of the questions and concerns raised by the community:

-Palliative care is not for everyone; my child suffered and was not supported after being released from hospital. (Concern from the radio audience)

-Some families believe that if someone is serious ill, people should not be visiting the sick patient because they bring bad spirits.

-Why is it important that we are talking about caring for people who are dying?

-How do we (carers and general community) help someone who needs palliative care?

-What can we do, because we are supporting our family member who is sick, but the community is scared because they think a sick person is bewitched?

The second half of the project included an information session where community member, persons with disabilities, the elderly, carers of palliative care patients, community health workers (CHWs), and neighbourhood watch members could join the team to discuss the basics of palliative care. Bringing this community group together was crucial for raising awareness and giving marginalised, vulnerable individuals a platform to express their concerns. We aimed to promote inclusion to ensure that everyone felt heard and supported.

Goals and Achievements of Health Promotion

The primary goal was to challenge the barriers surrounding palliative care in Khayelitsha. The project created a space where the community could ask questions and discuss palliative care openly, marking a significant step towards normalising conversations about palliative care and providing better support for the community.

Our long-term goals for the Khayelitsha community includes; continuing to raise awareness about palliative care, starting support groups, and ensuring that local resources in Khayelitsha include palliative care support. We aim to have local clinics deliver essential palliative care medication to patients at home and support patients and their families emotionally and physically, addressing issues like poverty and mental health. Academically, we want to include the community’s voice in the curriculum, collect evidence on the impact of palliative care, and present our findings at conferences.

Gratitude

We extend our heartfelt thanks to Sr Shole of Khayelitsha District Hospital, Community members, Zibonele FM, PALPRAC, and UCT for their support and sponsorship. Together, we are working towards a future where everyone can, in palliative care, “phila unethezeke” –live comfortably.

Dr Clint Cupido

BizCommunity reports: “Unveiling the heroes: A look behind the scenes of integrating palliative care into SA’s public health system.”

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Dr Clint Cupido is a trailblazer in the palliative care community in South Africa. In an interview with Dr Clint Cupido, director of Abundant Life, a palliative care programme at Victoria Hospital in Wynberg, published by BizCommunity, he explains how patients living with serious illnesses and their loved ones are supported through their programme. It is one of the first such programmes to integrate palliative care services into hospitals. As he explains in the article, this is not the norm. “From just 30 patients attending in 2009 and 100 in 2010, this number skyrocketed to 850 referrals in 2023. Last year, Abundant Life Palliative Care had provided care for a sum total of 10,000 patients.”

Read the full article here:

Unveiling the heroes: A look behind the scenes of integrating palliative care into SA’s public health system

 

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