Teaching pediatric pain management in Zambia: Spirituality in the context of pediatric palliative care

Dr. Stefan Friedrichsdorf, director of Pain and Palliative Care and Integrative Medicine at Children’s, is on a two-week trip overseas to train caregivers about pediatric pain management.

This week, he’s in Zambia, Africa, for the  1st Annual Pediatric Palliative Care Symposium. He will teach more than 150 professionals at an event sponsored by the CDC/Atlanta and the US President’s Emergency AIDS Fund. Next week, he’ll be in Cyprus for “Advanced Pain Medicine & Palliative Care for Children: Workshop for Professionals in Pediatric Hematology / Oncology,” where he’ll teach the Middle East Cancer Consortium about pediatric pain management, teaching Israelis and Arabs in the same room, united by a desire to help children in pain.

Wednesday, Nov. 23

Quotes from a panel discussion about spirituality in the context of pediatric palliative care here in Zambia:

“Dead ends a life, but not a relationship. Loss and grief starts at time of diagnosis — everyone is dealing with it their own way. ‘I felt like having a hole in me’ — deep grief. If you lost a child, you’re wounded for life. Woundnessness is nothing to be ashamed about.”

“In Zambia, the vast majority go to church — blessing and baptizing are very important. The best gift we can give to siblings and class mates is to talk about them. Good teachers may say ‘Hey, it’s been a month since Zimarace has passed away. Let’s talk about him — let’s draw a picture. How he is in heaven.'”

“In African tradition, there are powerful traditions right after death of a loved one: Mourn very hard for a very short time, but then be expected to be ready for normal life on the outside. But on the inside it takes years and years … . One of many traditions: one year after death, there is a gravestone laying.”

“In our hospice we assess the children and their spirituality by asking them to draw a picture.”

“Isn’t it great we have emotions? Laughter, love … and deep grief. We have children who lost their parents and now are loosing a sibling -– they feel guilty about not being HIV positive. I have cared for children who were in boarding school and were not told their mother died. She went to the village.”

“How do we support HIV positive siblings who saw family die — hopefully with dignity, but maybe not. How about children at school who had a classmate, and suddenly don’t have her anymore? How do we allow them to show their feelings, through music, drama … it’s a challenge.”

“Most people get support from their community — only few display complicated grief and might need a therapist.”

“What to do about grieving families who want to remain in contact with the hospice teams, but they are too busy and need to move on. Successful models, e.g. in South Africa, Uganda, Malawi, seem to include network with the community and especially the powerhouses in Africa, the churches.”

“Most of us pastors are poorly trained — often a good preacher but poor training. Most of us are afraid to go hospitals.”

“Queen Elizabeth II said ‘Grief is the price we pay for love.'”

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