Stephen Connor was appointed as Executive Director of the Worldwide Hospice Palliative Care Alliance (WHPCA) on 1 January 2016. Here, Stephen talks about his work in palliative care and his new post at the WHPCA.
Palliative care has been part of your life for many years now – can you tell us how and why you began to work in palliative care?
I attended a lecture in 1974 that changed my life. Harvard professor Richard Alpert (Ram Das) gave a lecture on death and dying basically saying why do we ‘westerners’ have so much trouble dealing with death? I was working in a heroin treatment programme at the time and decided that day to return home and start working with cancer patients. So it was a kind of spiritual decision to make my work parallel with my purpose in life: relief of suffering. We started one of the first hospices in the US in Monterey California in 1976 and I have worked in hospice and palliative care in many capacities ever since.
Looking back on your career to date what has been your biggest achievement in palliative care?
That’s hard. I think the creation of the ‘Global Atlas of Palliative Care at the End-of-Life’ with the World Health Organization brought to bear many of the things I had learned through my career and has been a useful baseline for the advocacy work we are all doing. Anytime you can do something that has the potential to help large numbers of people’s lives you have to feel good about that.
As a result of your work with the WHPCA and the Open Society Foundations (OSF), you have had the opportunity to travel extensively. Can you tell us about the countries that have surprised you most and the countries where you feel the most progress has been made in palliative care?
I’ve had the privilege of working on palliative care development in over 25 countries thanks to OSF and WHPCA and, fortunately, I don’t mind travel. The first country I worked in while at NHPCO (National Hospice and Palliative Care Organization) was Romania and I am still impressed with how much Daniela [Mosoiu], Malina [Dumitrescu], and the team there have accomplished for palliative care. Other notable countries include Albania, Armenia, Kenya, Kyrgyzstan, Malaysia, South Africa, and Tajikistan. Palliative care is still a challenge in all these places but there are strong leaders for palliative care there that never quit.
What do you see as the main challenges facing palliative care globally?
The public health model for palliative care development remains the most effective and simple way to understand the challenges we continue to face in advancing palliative care globally. The model shows that to implement palliative care you must have policies in place that support the inclusion of palliative care in the healthcare system, you must educate health professionals at the same time that you have essential palliative medicines available, and you need to work both from the ground up and the top down. We continue to have major problems with availability of essential medicines, the lack of integration of palliative care into health professionals’ education, and a lack of support and political will to include palliative care in health system planning and financing.
WHPCA started out conceptually as what is known as a global action network. This is a flat structure connecting people globally around a common cause. Our biggest challenge is to grow WHPCA into an international non-governmental organisation that becomes a vehicle for growth in palliative care, particularly in low- and middle-income countries. Now that we have a World Health Assembly resolution calling on all countries to strengthen and include palliative care in health systems, we can use this as a vehicle and a lever to demand change. All this requires resources and the number of funders focused on palliative care has declined, so it means we have to engage new organisations and governments to support palliative care development.
And if you ever find the time to sleep, what do you enjoy outside of palliative care?
As a licensed clinical psychologist, I have learned to take pretty good care of myself and to manage stress. I do some yoga and like to cook. I’m deeply satisfied working in palliative care and wouldn’t want to do anything else.
My philosophy about sleep is: “if you can’t be in the time zone you love, love the time zone you’re in.”