Palliative care in the Palestine-Gaza Strip

Hammoda Abu-Odah is a nurse from Palestine who is currently in Hong Kong where he is a PhD candidate at the School of Nursing, The Hong Kong Polytechnic University. Here, he explains the motivation and basis for his doctoral studies, which will consider the implementation of palliative care in the Palestine-Gaza Strip.

Hammoda Abu-Oda.

It is not easy to imagine how cancer patients live with their disease path unless you have been involved in their daily lives. I lived with them as a family member and as a nurse. As a family member, when I was a second-year undergraduate student, my cousin, 19 years old, was diagnosed with cancer. He asked me to stay with him for most of the time, which I could not decline. Living with him was a journey as we lived through his declining health and the use of morphine to treat his severe pain. I witnessed how oncology nurses struggled to alleviate his pain and, at the same time, tried to prevent him from being addicted, an often inaccurate consideration among many health professionals as I know now. Two years into the illness trajectory, his left leg was amputated, and he later passed away. It was a real struggle for me as I tried to navigate and balance my emotions as a nursing student and a relative. In the end, my undergraduate studies were severely affected.

These experiences still resonate with me today as I journey through my doctoral studies. I imagine how families who do not have a healthcare background also experience such illness trajectories, severe pain episodes, and, most importantly, the end-of-life phase. Currently, another set of emotions has been set in motion as my grandfather struggles with leukaemia. Hopefully, this time around, with my in-depth experiences and support, it may be easier to navigate and live through.

After graduation in 2009, I worked as a nurse in the Emergency Department. I treated many cancer patients who visited the department seeking pain medication drugs. I saw the stressful and exhausted looks on the faces of the patients, families and significant others.

With my lived and professional experiences so far, I am naturally drawn to focus my research on patients with life-threatening illnesses, including cancer. I had previously worked with my supervisor in Gaza on the evaluation of palliative care services provided to cancer patients (Abu Hamad, Skaik, & Abu-Odah, 2016). This was the starting point to look for a PhD programme in a field related to enhancing the lives of patients, families and healthcare professionals. In 2018, I was selected by the Hong Kong Research Grants Council to receive the Hong Kong PhD Fellowship Scheme to study in the School of Nursing (Transitional, Supportive and Palliative Care research theme), under the supervision of Prof Alex Molassiotis and Dr Justina Liu.

With both supervisors, and after rigorous discussions, we decided to contribute to understand better what it takes to implement a palliative care programme into the healthcare system of the Palestine-Gaza Strip. Although several actions have been launched in Gaza seeking to introduce palliative care as a new approach, these have so far been limited to a conference (Islamic University of Gaza 8th healthcare conference) and education of some medical students.

While education is one of the crucial components of the successful development of palliative care, other components are still missing and should be considered while provisioning palliative care. To have a better understanding of the relationship between the different components, we have constructed a conceptual framework based on the findings from our recent review (Abu-Odah, Molassiotis, & Liu, 2020), the WHO Public Health Palliative Care Model (Stjernsward, Foley, & Ferris, 2007; World Health Organization, 1990), and the Socio-ecological model (McLeroy, Bibeau, Steckler, & Glanz, 1988). A combination of both models provides a more concrete understanding of components that play crucial roles in developing palliative care services.

Policies, patients, human resources, system issues and education are the five main components that should be borne in mind while exploring the factors associated with the development of a palliative care programme. These components interact with and dynamically influence each other; for instance, patients respond to the system in which they receive treatment, and the healthcare organisation (physicians, nurses and other healthcare professionals) responds to policies that, in turn, influence patients’ care. These components provide an effective strategy towards establishing a palliative care programme into a country’s healthcare system. All these components will be taken into account in this PhD project.

References 

Abu-Odah, H., Molassiotis, A., & Liu, J. (2020). Challenges on the provision of palliative care for patients with cancer in low- and middle-income countries: a systematic review of reviews. BMC Palliat Care., 19(1), 55. Retrieved from https://doi.org/10.1186/s12904-020-00558-5. doi:10.1186/s12904-020-00558-5

Abu Hamad, B., Skaik, N., & Abu-Odah, H. (2016). Evaluation of Palliative Care Services Provided to Cancer Patients in the Gaza Strip. Journal of US-China Medical Science, 13 (2016), 95-107.

McLeroy, K. R., Bibeau, D., Steckler, A., & Glanz, K. (1988). An ecological perspective on health promotion programs. Health Educ Q, 15 (4), 351-377.

Stjernsward, J., Foley, K. M., & Ferris, F. D. (2007). The public health strategy for palliative care.. J Pain Symptom Manage, 33(5), 486-493. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/17482035. doi:10.1016/j.jpainsymman.2007.02.016

World Health Organization. (1990). Cancer pain relief and palliative care: report of a WHO expert committee [meeting held in Geneva from 3 to 10 July 1989].

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This entry was posted in EDUCATION & TRAINING, NATIONAL & INTERNATIONAL REPORTS and tagged . Bookmark the permalink.

3 Responses to Palliative care in the Palestine-Gaza Strip

  1. Great article. Thank you so much for your work.

    • Hammoda says:

      Thank you so much, Prof Pettus, for accepting my work to publish in EPCA. Gaza needs more towards the development of a PC. Promise to do the best. Again thank you!!

  2. Riyad Salah Omar says:

    Dear Dr.Hammoda,
    I am completely impressed by your research studies abuot palliative care for client with cancer because we in palestine and mainly in Gazs suffer big shortage in this type of care and services…
    All the best for you and your supervisor.
    Well dine,a lively choice.👍👍🌺🌺💕

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