Hospice in Ethiopia – a Mission for Medical Education: An Interview with Dr. Karen Ogle
By Paul Johnson
Dr. Karen Ogle, formerly a professor of family medicine at Michigan State University’s College of Human Medicine, is a long-time advocate of humanism in medicine, and has been practicing palliative care techniques to reduce pain and improve quality of life since 1986. In January, 2011, she went to Ethiopia to share her knowledge of palliative care medicine with the staff of Hospice Ethiopia.
+ What goals did you have when you set out for Ethiopia?
I just wanted to use whatever knowledge and skills I have to help with the development of palliative care in Ethiopia.
+ Did you achieve them?
We have just gotten started – we did a lot while we were there, but we learned much more than we gave or “taught.” We plan to have a long-term relationship with Hospice Ethiopia and the Ministry of Health to continue assisting in the development of palliative care in Ethiopia.
+ What attitudes towards palliative care did you encounter in Ethiopia? Did you see a change over time due to your presence?
Health professionals were very interested, especially in learning about pain relief, our major focus during this trip. The feedback was incredibly positive, but the real measure of success will come when we start to see reports about morphine use by the physicians and clinical officers we worked with. We had not planned on any formal work with residents or students while we were there, but we did end up giving medical grand rounds for the Internal Medicine residents and students – the response was very heartening and we hope to do more with them in the future. One of the residents described the topic as “the forgotten heart of medicine.”
+ How did patients respond to the idea of palliative care interventions?
They were very receptive as well as appreciative. There were no concerns about opioids like we commonly see here In the United States.
+ Can you share an example of a patient who benefited from palliative care?
I think the best example may be the woman with colon cancer who did so well with morphine and then moved to the hospice residence – it is all on my blog.
+ What barriers to healthcare existed in the hospital where you worked, and how did they change the way that you worked, as compared to being in the US?
Ethiopia is one of the poorest countries in the world. It is hard for Americans to really comprehend the incredible gap in resources available for health care between Ethiopia and the US, without visiting for a while. Literally everything you might think of is either not available at all, or supplies are limited. One example: there are four oncologists (chemotherapy and radiation therapy) for a population of 85 million.
+ Do you have any advice for US medical students who are interested in international work later in their careers?
Get as many experiences in international work as you can in medical school – student aid often helps with these costs. Learn about the culture where you are a guest. Keep an open mind and spirit. Don’t think you have all the answers. Appreciate that you will always get more than you give. And thank you for being a person who wants to contribute to the lives of others.
+ Will your experience in Ethiopia change the way that you practice medicine in the US?
I think it has definitely broadened my perspective on our system, but mostly I find that I continue to learn more about my fellow human beings in everything I do – and that increased understanding is something I use every day at work.
+ The need for palliative medicine is long term- can you describe the ways in which you’ve enabled Ethiopian physicians to provide long term palliative care?
It is all about helping Ethiopians develop their own skills and systems in the way it works for them. Our focus is on training and development. Direct patient care is a very limited way of contributing – capacity building is what longer term assistance has to be about.