Thursday 20th June 2013
Macmillan nurse Kathryn Hamling and her husband carry out a long-held desire to share their professional and palliative care expertise overseas.
My husband Peter and I had always considered doing voluntary work overseas after we retired. He’s a professional manager and I’ve been a Macmillan Clinical Nurse Specialist for more than 15 years. Being passionate about cancer and palliative care, I wanted to find something that would allow me to use the skills and knowledge I have developed through my work with Macmillan.
I knew a little about Ndi Moyo Palliative Care Centre in Malawi through its connections with Highland Hospice in Inverness. With no other motive at the time apart from interest in what they were doing, I visited their website. Immediately a dropdown box informed me of their quest to find a volunteer operations director with palliative care experience.
This I felt was a call for our combined services.
My husband quickly dampened my initial excitement by pointing out we needed to work at least another two years to add to our rather meagre pensions. But, as we explored further, his interest gradually picked up and we made the decision to visit the centre in November 2012.
One of a kind
Malawi is one of the poorest countries in the world. One-third of its population of 15 million people live with HIV/Aids. Many of these people are affected by cancer, particularly Kaposi’s sarcoma, and oesophageal and cervical cancer.
The infant mortality rate is 120 in 1,000, and average life expectancy is just 42.
Ndi Moyo Palliative Care Centre, the only centre of its kind in the country, is set in the district of Salima. The district has a population of more than 300,000, mostly subsistence farmers with an annual income of less than £100. Hospital care is provided at the general hospital, which has no resident doctor and poorly motivated nurses. No consideration is given to palliative care.
Ndi Moyo was founded by Lucy Kishindo Finch, a Malawian nurse who trained in the UK, then worked in many parts of the world, including Uganda, where she learned about palliative care and its benefits. On returning to Malawi, she was appalled by the lack of resources and poor quality of care for the dying. She began to buy drugs to treat those in the villages around her home, initially using her own money. Her family then helped her develop the charity, Ndi Moyo UK Ltd.
With this help, and additional support from Hospice Africa, the Ndi Moyo Palliative Care Centre was built. It opened its doors in 2006.
A model of care
Since then, the centre has treated many hundreds of people with advanced disease using a very basic stock of core drugs - weak oral morphine solution, amitryptyline, ibuprofen, metoclopramide and steroids, as well as a growing number of homegrown herbal remedies, such as artemisia and moringa for malaria, lemongrass as a diuretic and paw paw for constipation.
The work is inspirational and a bright light of hope amidst the darkness of utter poverty and overwhelming disease. People walk great distances to be seen at Ndi Moyo and wait hours for consultations and treatment.
All speak highly of the difference the centre has made to their lives.
Lucy and her husband Tony are now past retirement age and are keen to work towards making the centre sustainable and, eventually, Malawian led and funded. Much work is needed. Their dream is to use Ndi Moyo as a model to spread the philosophy of palliative care throughout the country to other rural areas.
A two-year journey
Our visit to the centre touched my husband and me deeply. It also allowed us to see how we could help drive this project forward by volunteering to work with Lucy, Tony and their staff - three nurses, one clinical officer, a number of support workers and assistants, and many volunteers – for the next two years. We were approached by another volunteering agency, Voluntary Mission Movement (VMM) as potential partner agents for this venture and have been very fortunate in gaining their support for the time we are at Ndi Moyo.
I will take on a clinical role encompassing education and research. My husband will be operations director, focusing on strategic development and negotiating with the Malawian government for greater support and a steady supply of essential drugs and dressings.
I am very fortunate in that NHS Highland, where I have worked for 25 years, has offered me the opportunity to take sabbatical leave for this venture, allowing me to return after two years to share my learning with others.
Email Kathryn Hamling, Macmillan Clinical Nurse Specialist.
Please visit the Ndi Moyo Palliative Care Centre and VMM International websites.
To donate to Kathryn and Peter’s work, visit their sponsorship page.