PhD student lays the foundation for palliative care in Palestine

Mr Hammoda Abu-Odah [our PhD student; CS: Prof. Alex Molasiotis, Co-S: Dr Justina Liu] gained six overseas scholarships from 2014 to 2018, but he lost those chances to study abroad, simply because of the blockade in his hometown, Palestine-Gaza Strip, a place where confrontation and strife are almost part of everyday life. “I needed to have a permission from the Israeli authority to travel. The airports are in Jordon or Egypt, but the Gaza border was closed, and I could not leave Gaza.” Said Hammoda. After receiving the Hong Kong PhD Fellowship Scheme in 2018, it took him another three months to sort out issues related to travelling out of Gaza, before arriving in Hong Kong to embark on his PhD study*.

Previously an emergency nurse in Gaza, Hammoda is going to be the FIRST nurse in Palestine with a PhD degree, specialised in palliative care. Driven by his experiences of caring for his cancer relatives, Hammoda is determined to use his research findings to promote the development of the first-ever palliative care programme in Gaza.

In Gaza, healthcare priorities are given to emergency care, primary health care, and mother and children's health, leaving cancer care fragmented with limited resources. There are about 8,000 cancer patients, but only two nurses who have received three-month special training in palliative care. Medication for pain management is insufficient for advanced cancer patients. Services relevant to palliative care are provided within the general oncology services, and no specific structure nor department is available for this service.

Hammoda’s research on ‘Factors Associated with the Successful Development of a Palliative Care Programme into Palestinian Healthcare System’ has been providing important information and statistics for the Palestinian Ministry of Health to review cancer care services. In his study, Hammoda found that 96.8% of the interviewed advanced cancer patients (N=379) in Palestine experienced “moderate to severe” UNMET supportive care needs and high psychological distress. Among the 169 Gazan health care professionals (nurses and physicians) interviewed, 57.2% of them have shown knowledge deficits about palliative care. He places training for healthcare professionals top of his list of positive factors for developing a palliative care programme in Palestine. “The relationship between healthcare workers and patients are reflective. Healthcare workers have to understand the physical, psychological, and sexual needs of their patients first.” Said Hammoda.

Hammoda’s research findings have led to some changes. Recently (in October), the Palestinian Ministry of Health has established a new committee for palliative care. “This was a very good sign. My findings have given evidence, and the officials have to face the problems.” Said Hammoda. With the support of an international humanitarian organisation, a new palliative care unit will also be opened inside a hospital in Gaza to provide the services. Thrilled by this new development, Hammoda has no hesitation in taking up the trainer/educator role and is delivering two online lectures monthly to 15 health care professionals. He hopes that the health care professionals that he has been training will provide quality services in this Palestine’s first palliative care unit.

Next year is the final year of his PhD study, Hammoda, however, is busy learning new practical knowledge. Next month, he will be on a 1-week placement in the Jockey Club Home for Hospice (click here for more information about the centre) to learn more about the operation of this first-rate hospice care centre, such as the administrative and discharge procedures. He is also thinking of developing a screening tool to be used during patient admission to identify those in need of palliative care in Palestine. “Perhaps, in the future, I can act as a bridge to liaison between Hong Kong and Palestine for placement or learning opportunities so that more healthcare workers can come here to learn.” Hammoda said.

In reality, the Palestinian Government has to make a lot of effort on the policy level, to develop a palliative care programme into the health care system. The political and economic situations in Palestine make it harder to predict the future of palliative care. However, we can be sure that the effort given by Hammoda has begun to bear fruit as some nurses have been trained to provide quality palliative care.

*With the help of Gisha, an Israeli not-for-profit organisation, the process of granting leave permission to cross the border was accelerated for Hammoda. Without their support, Hammoda would have lost the opportunity to study his PhD in Hong Kong. Hammoda would also like to thank Prof. Alex Molasiotis for keeping the PhD candidacy for him until his arrival.