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Dr Anne Merriman speaks to ehospice ahead of International Women’s Day

Author: Kate Jackson, editor: ehospice international edition
07 March 2014

International Woman’s Day gives us a chance to honour women who have distinguished themselves through the impact that they have had on the world.

In the field of hospice and palliative care, there are many inspiring women, but this year we honour Dr Anne Merriman, Founder and Director of International Programmes, Hospice Africa Uganda, who has just been nominated for a Nobel Peace Prize for her work alleviating the suffering of millions of people across Africa and the rest of the world.

Dr Anne has always set the needs of her patients above any other concern, particularly those of decorum and protocol. At the APCA-HPCA conference in Johannesburg, South Africa, the rest of the palliative care community were awed by the presence of Ministers of Health and their deputies from Uganda, Malawi, South Africa and Kenya. However Dr Anne reminded the dignitaries in no uncertain terms that while it is important to write and implement policy for palliative care provision and integration, we must not forget the patients and their immediate needs.

Dr Anne is a founding member of numerous national, regional and international hospice and palliative care organisations, such as Hospice Africa UK and Hospice Africa, the African Palliative Care Association, the International Association for Hospice and Palliative Care, the Palliative Care Association of Uganda and Hospice Care Association of Singapore. She still serves on the board of many of these.

In the forward to her book: ‘Audacity to Love,’ Professor Jan Stjernsward, Chief of Cancer and Palliative Care for WHO Geneva from 1980-1996, observed that: “Thousands of flowers bloom wherever she has walked in life.” This is certainly true. Wherever in the world she has gone, Dr Anne has left a legacy of improved care for those most in need of her help.

After specialising in internal medicine in the UK, Dr Anne worked in geriatric medicine between 1973- 1981. It was here that she saw people dying in pain without the specialist treatment that had been recommended by Dame Cicely Saunders since 1967. In response to this, said Dr Anne: “I read up and trained myself and began teaching it to the teams in Whiston Hospital in Knowsley where I was head of geriatric medicine.”

Moving to Universiti Sains Malaysia (USM) in Penang in 1982, and then in 1983 to National University of Singapore (NUS), Dr Anne brought her skills in geriatric medicine and palliative care to Asia. Together with a group of volunteer nurses, Dr Anne developed a morphine solution to help ease the pain of those patients who had been sent home from hospital with the tragic message that there was: “nothing more to be done”. This was the start of the home care service which would go on to become the Hospice Care Association of Singapore, a service that Dr Anne identifies as: “the best in South East Asia.”

In 1990, Dr Anne moved to Africa, joining Nairobi Hospice as Medical Director. She said: “I saw the terrible need where less than 5% of cancer patients reached oncology or radiotherapy and people were dying in pain in their homes. Recognising that this was the same in all Africa, we were inspired to commence Hospice Africa to try and reach all in need in Africa.”

In 1992, Hospice Africa started in Liverpool and was registered as a UK charity in 1993. Dr Anne explained: “The objective was to be achieved through a model in a chosen country and, after a feasibility study in four countries of the nine that had asked for my help, we chose Uganda. Uganda, which had the fertile soil of love for each other and the desire to care and relieve suffering, having just come through their war. The Minister of Health agreed to import morphine powder so we could bring pain relief. Also the country had the trust of the international community, which was ready to assist in further development.”

The impact that Dr Anne’s work has had on patients and their families has been recognised through several high-profile awards. These include: a nomination for the Nobel Peace Prize (2014), the ‘Presidential award for distinguished service by the Irish abroad’ (2013), the APCA Lifetime Achievers Award (2013), and the Individual Recognition award from the IAHPC (2001). In 2003, Dr Anne was awarded an MBE for contribution to health in Uganda. Dr Anne dedicated her Nobel prize nomination to all who have worked with her to care for those suffering across Africa and the rest of the world.

Asked to identify the most significant moment in her distinguished career, Dr Anne responded: “All moments have been significant. The joys and the sorrows on looking back have all built up to a miracle for those we see, as they recognise the little miracles in their own lives as we relieve their total pains.

“The many awards have only brought joy in that they draw attention to the great needs yet unfulfilled.”

The quiet humility of this incredible woman who has been the catalyst for immense change to the way in which people live, die, hurt and grieve is an inspiration to any woman thinking to enter palliative care, or indeed any person in the world today.

Dr Anne offered a message to women starting a career in this field. She said: “Please savour the messages that come to you from your patients. Learn from them and then see what you can do to help them and many others. The public health approach helps us to think big while recognising the smaller needs which have to be met on a day to day basis.

“This work needs dedicated doctors and nurses who will carry it forward. We as women will often be the leaders, due to the caring hearts that come along with being a woman. Palliative care is a special calling. Of all the work I have done as a doctor, this has brought me the most joy. The fire in the belly must be ignited from patient care and taken all the way to the governments, letting them see through the eyes of your personal experience, so they see how it is affordable and possible. Their time will come when they too need you.”

The face of hospice and palliative care work has been enduringly altered through the tireless efforts of Dr Anne and the teams with whom she has worked over the years.

Hospice Africa Uganda celebrated its 20th anniversary last year, along with the graduation of the first cohort of graduates with a BSc degree in palliative care from the Institute of Hospice and Palliative Care in Africa. HAU is currently expanding its teaching to reach palliative care practitioners in Francophone African countries.

Read more about Dr Anne’s work on her online biography, or on the website of Hospice Africa Uganda.

Professor Sheila Payne, president of the European Association of Palliative Care and co-director of the International Observatory of End of Life Care at Lancaster University, interviewed Dr Anne for international women’s day. Read the interview on the EAPC blog

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