Dr Cynthia Goh (1949- 2022) died in February at the age of 72. Cynthia was the founding president of HCA Hospice Care, Singapore’s largest hospice homecare provider, and she led the Department of Palliative Medicine at Singapore’s National Cancer Centre. Her work enabled palliative medicine to be recognized in Singapore as a medical sub-specialty. In 2014 she was inducted into the Singapore Women’s Hall of Fame in 2014 for her tireless work in furthering pain relief and hospice and palliative care in Singapore and beyond. Ednin Hamzah, Chair of the Asia Pacific Hospice Palliative Care Network, pays tribute to Cynthia.
‘Do you have time to chat?’ A text that I have come to expect every few weeks over the years. It was an opportunity to delve into the mind of an extraordinary person, who also happened to be a palliative care pioneer, and share a space and thoughts with her – Associate Professor Cynthia Goh.
Those training in palliative care have a great deal of knowledge and skills to acquire. One of the issues often discussed with palliative care students is the nature of palliative care work – what does it look like, the meaning of this vocation and what it does to your own life?
In early 1997 when I was embarking on my own work in palliative care as the Chief Executive Officer of Medical Director of Hospis Malaysia, and without any formal training in the field, I was told that I should go to Singapore and meet Dr Cynthia Goh, the then Medical Director of Assisi Hospice, Singapore. Thus began the start of a professional mentorship and personal friendship that would endure until her untimely passing on February 13, 2022.
Cynthia was a pioneer in palliative care in Singapore and had a role in the establishment of many of the current palliative care services in the country. She was the consummate clinician, at ease in making patients and family feel cared for and comforted. Watching her at work was a privilege and she always made time stretch endlessly. One can’t help reflecting on the World Health Organisation definition of palliative care (‘an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual’) and seeing it in practice.
The late Dr Shigeaki Hinohara, Chair of the Life Planning Centre, Japan had a vision of the benefits of a regional grouping and in this, Cynthia saw possibilities in developing palliative care in the region. Palliative Care in the Asia Pacific was fragmented in the late 1990’s with many isolated practitioners and services. Cynthia galvanised key leaders in several countries to work together and in 2001, the Asia Pacific Hospice Palliative Care Network (APHN) was born.
Cynthia recognised that what the region needed to improve palliative care access and care for patients and their relatives was education, training and capacity building. APHN was designed as a network connecting trainers and healthcare workers across the region. She also recognised the need for gentle advocacy in her meetings with policy makers. As tireless as she was in her clinical work, she was also this in her advocacy work. Her communication to policy makers focused on the elements that were necessary to allow a better understanding of the positive effects of palliative care to all stakeholders. She knew who to approach and how to influence them in order to advance palliative care.
This education and advocacy became a feature of the work that she and other members of the APHN did through the Lien Collaborative, a capacity building and education programme supported by the Lien Foundation, that started in 2013 with projects in Bangladesh, Myanmar and Sri Lanka but has now grown further.
Cynthia’s work was also recognised globally and she helped establish the Worldwide Hospice Palliative Care Alliance and she was the first co-chair with David Praill. She collaborated with many other global leaders and helped voice opinions from the Asia Pacific to global pain and palliative care networks and conversations.
An enduring memory for a young healthcare worker is the opportunity to work alongside an experienced practitioner such as Cynthia. So often at the end of the day after a meeting and often over a meal, came the lesson through conversations. Hereby lies the learning, the inherent ability to deliver palliative care intuitively, not just in the clinical arena but also though teaching and advocacy. Over the years, the lessons passed to many of her colleagues has helped shaped the way we practice and will further her legacy.
Despite her illness, Cynthia continued to work. She mentioned to me after she did a teaching session a few weeks prior to her death was ‘They don’t know I’m on my last legs, will you let them know?’. Cynthia Goh chaired APHN from 2009 to 2020 and was Chair of the Advisory Committee at the time of her death. The world of Palliative Care is less through her death but enriched through her lifetime’s work.
- To share memories of Cynthia, Asia Pacific Hospice Palliative Care Network @APHPCN have set up an obituary page.
- Asia Pacific Hospice Palliative Care Network
- Lien Collaborative
- Worldwide Hospice Palliative Care Alliance
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