Patient Story: Fetla

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When we were in Addis Ababa earlier this year, 3 of our trustees visited Fetla. This is her story.  She is 50 years old and is married, living with her husband and their 2 children. As an Orthodox Christian, she feels supported by her religious faith.

She was recently referred to the Black Lion Hospital with a likely cancerous breast lump and the hospital made a diagnosis of breast cancer with a cerebral metastasis (the cancer had spread to her brain). The hospital had offered to do a fine needle biopsy (presumably of the breast lump) but no hospital records or letters were available to see. Fetla had received 5 doses of radiotherapy to her head.

She also received domiciliary support from her local health centre and 2 health centre nurses visited her while we were present. This is the first time we had seen an outreach team from a health centre visit a patient in their own home.

Her symptoms of blurred vision and ataxia (poor balance and coordination) improved when she started taking the steroid dexamethasone. Her constipation was treated with bisacodyl and she was also prescribed pantoprazole to protect her stomach from ulcers which could be a side effect of the steroids.  Her nausea and vomiting had improved on the antiemetic medication metoclopramide.

Nurse Kalkidan had established that Fetla had been made aware she had cancer, but not that the disease had spread to her head. She spent time talking with her providing psychological support and encouragement and will visit her again in 2 weeks.

Successful Jane Austen event raises £1560

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We had a fantastic event on Sunday 28th July with the dramatized reading from Jane Austen’s Northanger Abbey at Cromer Hall. The actors/readers were brilliant, the musicians fabulous and the high tea scrumptious. As for the setting – it was simply glorious, and we were lucky to have such wonderful weather. Huge thanks to Benjie and Dido Cabbell Manners for letting us use their beautiful home (and for providing a superb lunch for the workers). Massive kudos to script writer Margy Seale and the fabulous cast. Soprano Emma Nuule and her accompanist John Farmer were a delight, as was Jamie Mumford playing incidental music on his recorder. And then, as ever, there were all the background folk who contributed so much hard work – including the bakers, Kate, Rosie, Elizabeth and Julie and Sue, and the very hardworking tea folk, Claire, Julie, Rebecca, Steph and Rachael. And, of course, many thanks to the wonderful people who came and supported the event – raising £1560 in the process, which will make a huge contribution to support Hospice Ethiopia. The money raised is enough to pay for a specialist nurse looking after 100 patients for three months in Ethiopia.

The 2024 Jane Austen event sold out, as did the 2023 one… if you’d like to know about the 2025 event in time to grab a ticket or two, sign up to the newsletter at the bottom of this page.

Patient Story: Genet

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When we visited Ethiopia in February 2024 we met Genet, a 57 year old spinster. She is a Protestant Christian and has an adopted daughter who had recently been married.  Genet lives alone in a rented single room house. Before becoming ill, she had worked in a school, but was now unable to work and had no income, so receives a monthly grant from the Tewolde Medhane Fund (previously known as the Comfort Fund). She learned about Hospice Ethiopia from a friend so she referred herself to Hospice Ethiopia. Prior to this she had received 7 doses of chemotherapy at the Black Lion Hospital for her incurable colon cancer that had spread to multiple sites in her liver. The chemotherapy had made no impact on her disease and she had not been offered any other anti-cancer treatment such as radiotherapy.

Genet had been prescribed tramadol for her pain by the hospital for a neuropathic (nerve) type pain. When she was first assessed by Nurse Kalkidan, her physical problems were abdominal pain, fatigue, reduced appetite, constipation and intermittent vomiting. She had been prescribed a steroid medication for the vomiting by the hospital. During our visit Nurse Kalkidan adjusted her pain killing medication adding in metoclopramide and omeprazole for the nausea along with gabapentin (300mg daily) for the pain and bisacodyl to prevent constipation.

She is being supported spiritually by her religion and church connections. She was counselled by Nurse Kalkidan and encouraged to remain as active as possible (she goes to church and is able to walk around). We explained the difficulties of treating fatigue and advised eating whatever she fancied whenever she felt hungry.

Successful Auction of Promises

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Hospice Ethiopia’s wine and cheese and auction of promises was a fantastic evening and raised over £2,700. Every penny of this will go to support Hospice Ethiopia. A massive thank you to the hugely entertaining Mrs Temple, for both her wonderful cheeses and her insightful presentation. Also thanks to the equally entertaining master of ceremonies and auctioneer extraordinaire David Robinson. Yet more thanks to all who donated lots for the auction and prizes for the raffle. Lastly, our thanks goes to our wonderful volunteers who worked so hard to make it all happen and all those who dug deep and bought the lots!

June 2024 news from Ethiopia

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Hospice Ethiopia UK’s Chair Sue Mumford has monthly online calls with Director of Hospice Ethiopia UK, Ephrem Abathun. Here is some of the latest news from Ethiopia:

  • Ephrem has been in discussions with the Ethiopian Ministry of Health about revising and publishing a new strategic plan for Palliative Care in Ethiopia. Crucially the provision of morphine is included for the first time in the revised plan.
  • The Minister of Health has now issued the necessary documents for the Black Lion Hospital to import morphine powder to produce oral morphine liquid. The American Cancer Society has purchased the morphine powder so we are optimistic that oral morphine solution will soon be available to relieve the pain for the dying in Ethiopia. Initially this medicine will be available for patients at Black Lion Hospital before being expanded to other hospitals in Addis Adaba and then to regional hospitals across the country.
Ephrem teaching a family to administer oral morphine solution to a patient. Photo taken in 2016, when oral morphine was still available in Ethiopia.
  • Training: Ephrem and his staff laid on a workshop for Chaplains and representatives from the Christian Orthodox, Protestant and Muslim communities. Following this a draft training manual is being produced for training religious leaders in supporting terminally ill patients. As part of this work some of Hospice Ethiopia’s patients were questioned about what spiritual care they felt is needed when approaching the end of life. All this will help deliver the individualised care that people approaching the end of life deserve.
  • Following a joint application between Hospice Ethiopia and Hospice Ethiopia UK, True Colours Trust (a UK charity that supports palliative care providers across Africa) is providing funding for a 4 day palliative care training course at Hiwot Fana Hospital in Harar later this month. Harar is a holy Islamic city in eastern Ethiopia and is known for its maze-like alleys and traditional houses decorated inside with flat baskets.
  • Hospice Ethiopia UK and Hospice Ethiopia has recently been approached by Dr Yates from Soddo Christian Hospital (situated in the Oromia part of Southern Ethiopia) to provide palliative care training for their staff. The hospital serves a population of over 20 million people. Planning is in the early stages for this training to be delivered in the autumn when some of HEUK’s trustees will be visiting Ethiopia.

Wine, Cheese, and Auction of Promises, Saturday 8th June

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Fans of local produce will want to get along to Reepham on June 8th in St Michael’s Community Hall, from 7pm. Norfolk’s very own Mrs Temple will be offering tastings of her fabulous cheeses, washed down with wine (or a soft drink).

At the same time, the inimitable Mrs Temple will give a talk on how she makes the cheese – answering all the questions people are afraid to ask! What determines the final taste and colour of the cheese? What’s the difference between Binham Blue and Gurney’s Gold? Is it important what the cows eat? Can the herds be kept in a way that helps protect the environment? She’ll also talk about ‘Green Growth’ and what it means for Mr and Mrs Temple in making their farm more sustainable.

And after that comes an auction of promises, raising much needed funds for a Norfolk-based charity, Hospice Ethiopia UK. It works on behalf of the only hospice in Ethiopia, a country with a population of more than 127 million.

There are 18 lots donated by generous supporters of Hospice Ethiopia. Would you like a holiday in Cornwall or Sunday lunch at The Saracen’s Head? Or maybe traditional Indian food is more to your taste? Do you need your garden tools sharpening or perhaps you would like a personal tour of Mannington Hall followed by tea for four? How about a painting by Norfolk-based artist Andrew King? All these and much more will be auctioned on the night.

The hospice in Ethiopia depends entirely on charitable donations from the West. It desperately needs funds to continue the care their nurses provide to some of the poorest and most desperate in their community, and the training they provide for other medics.

Tickets for the event, which include a cheese plate and a glass of wine, are available through Eventbrite and cost £10 plus booking fee – go to this page at Eventbrite.co.uk. Alternatively, tickets can be bought direct from Hospice Ethiopia UK (with no booking fee) by emailing info@hospiceethiopia.org.uk.

The full catalogue for the Auction of Promises can be viewed here. For people unable to attend in person, we accept a completed commission bid form – please email to info@hospiceethiopia.org.uk, by 11pm 7th June.

Doctor receives palliative care training funded by HE UK

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Money raised by Hospice Ethiopia UK has been used to fund training for a doctor based in Southern Ethiopia, Dr Juhliad. His interest in palliative care started in 2019 when he received a three day introduction to palliative care at The Black Lion Hospital in Addis Ababa, delivered by Hospice Ethiopia’s Director, Ephrem. Dr Juhliad now works at Yabelo Hospital which is a town in the Oromia region, 580km south of Addis Ababa. Here he sees patients who desperately need symptom management and end-of-life care. With our help this year he has completed the foundation course in palliative medicine at Trivandrum Institute of Palliative Sciences and is now attending a Master Class course that will go on until December 2024. He will go to India for ‘hands-on’ clinical training in November 2024 as part of the course. This is what he told us:

“The hospital where I am based now doesn’t have a specific place dedicated to patients needing palliative care. And it seems difficult to persuade the hospital administrators to integrate palliative care services for now. But I am trying to integrate palliative care practice into my daily routine for patients who might be candidates for such services at a chronic disease medical outpatient department. Moreover, I am intending to launch a free telehealth service for patients needing palliative care through my social media platforms…I am also interested in providing webinars on palliative care for frontline healthcare workers.”

Ephrem visits the United States

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Executive Director of Hospice Ethiopia, Ephrem Abathun has recently returned from a 3 week visit to the United States. He reported that “it was a blessing to visit partners of Hospice Ethiopia across the country”. He began his trip in Connecticut, with a visit to Yale New Haven Hospital with Dr Eleanor Reid where he experienced first-hand palliative care being given in the Emergency Department. This has relevance for the challenges of the medical teams in Ethiopia caring for patients in their Emergency Departments where the families expect curative treatment to be provided even when their loved one is dying.

Ephrem’s next stop was Chicago to meet Professor Joshua M. Hauser from Northwestern University, who was involved in providing online palliative care training at Addis Ababa University earlier this year. Following this he met Mahlet Bejiga and her family in Boston, who have been long-term supporters of Hospice Ethiopia. They, along with other supporters, hope to start a new not-for-profit organisation in the US ‘Hospice Ethiopia USA’. In Las Vagas Ephrem continued his trip with a stay with Stephanie Council and a visit to Nathan Adelson Hospice before ending his trip in Sacramento with a visit to Snowline Hospice, who have previously provided support for Hospice Ethiopia.

Patient Story: Yoseph

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Yoseph, aged 36, lives alone and is an Orthodox Christian. He used to work as a guard and a driver on a compound but he had to abandon his career in driving as was unable to turn his head. He went to the Black Lion Hospital in Addis Adaba with a lump in his neck and was diagnosed with a nasopharyngeal cancer which had spread locally. He received only 2 cycles of chemotherapy as he was unable to pay for any further treatment. At his visit from Nurse Kalkidan, he had an ongoing odorous discharging sinus and a huge mass on the left side of his neck with secondary spread to the skin as far down as his clavicle (collar bone).

Although living alone, Yoseph has significant physical and psychological support form a network of nearby friends. His son lives with his mother and some contact remains with the patient. His voice is hoarse (probably due to vocal-chord paralysis) but interestingly he complains of no pain and the only treatment at present is herbal. Nurse Kalkidan advised him to reconsider further cancer treatment (radiotherapy might be of benefit). Apart from daily topical metronidazole which has controlled the odour, he has not been prescribed any other treatment or medication (except herbal treatment).

Hospice Ethiopia’s nurses will provide ongoing psychological support.