A 'Young' Perspective
As a Palliative care nurse working in Strathcarron Hospice in Denny I was fortunate to hear about Lachie's great work in Romania, setting up a palliative care service which, unfortunately, is very sparse in Romania, due to culture, poverty and corruption.
In November I went to Romania with Lachie for a week to see how the plans were going with Diakonia, an indigenous Romanian Charity which Something for Romania (SFR) is supporting.
The purpose of our trip to Cluj was twofold. Lachie had to sort out budget plans with Arthur Sarosi (the Doctor who is managing Diakonia) for a proposed palliative care service and I was to provide a nursing perspective and assessment. This was to be done through home visits with the nurses to see how the current home care service worked and by providing my knowledge in setting up the palliative care service alongside this homecare.
"God be merciful to us and bless us, And cause His face to shine upon us."Psalm 67v1
Our accommodation on arrival in Cluj was a flat attached to the Daniel Centre which was set up by Blythswood Care as a home for boys aged 18-25 years who stay for two years learning everyday skills to help them in their daily living. This is done through the teachings of the Bible in a loving Christian environment, starting each day with prayer to which we were invited!
On the Monday we visited Dr Arthur Sarosi at Diakonia and discussed the plans for Diakonia and SFR to set up a good palliative care service. We also visited Arthur's wife Gyke who is a GP in the village of Mera about 17kms from Cluj. While I thought it wouldn't be like a clinic at home, I did expect to see a solid, heated building with reasonable facilities. What I found was completely the opposite! Instead, I found Gyke working wrapped up in two jumpers and a big quilted jacket, in a small consulting room in a building which had no roof and really was a ruin. This room had minimal heating but the patients had to stand outside in a freezing cold alleyway and the actual treatment room was indescribable - you had to see it to believe it! A real eye opener for me was when Gyke, who never complained of her working conditions, stated that instead of trying to improve the conditions for the clinic the local council are to demolish it and build a 'cultural centre' with no health facility planned for the village. This made me realise that the Romanian government are not thinking of the ethnic Hungarians and Romanian people.
I met up with the nurses who provide Diakonia's current homecare service, some of whom would later be joining the new palliative care service. We discussed their current and future roles on the start of Palliative care. The nurses were all lovely and eager to learn so as to provide the best service possible. Tundi, the nurse manager, is especially dedicated to her job and just wants to provide the best she can for her patients.
The following day we discussed the budget and the requirements to make the service work well. Having these talks really made me aware of just how little supplies they have available and how they are struggling to manage on minimal resources, such as wound dressings, pressure relieving equipment, medicine pumps and syringe drivers, to name only a few! This made me think how, in Scotland, we throw so much out and complain if we are short of one little thing! It really makes you appreciate what you have!
I went out with the nurses to see how they worked, which was such a humbling experience for me. They are very skilled doing the best job they can, considering their working environment and the resources which they have (in fact don't have). What really touched me was the nurses' desire to do all they could for their patients and do it right, but could not, due to lack of resources. Nursing care in Romania at present is what we probably had 60 years ago. Don't get me wrong, what the nurses did not have in facilities and resources they made up for in care and compassion. It is important to try and improve this situation so these girls can provide the service which they so want.
When I later met up with Lachie and Arthur they had finally agreed on the budget which suited both parties but I think there were a few tense moments until it all got sorted out! We all discussed how palliative care and homecare are different and how Lachie wants to provide the most effective and holistic service, looking at the patients' emotional, physical and spiritual care. Dobratz 1990 states that "palliative care is the intensive caring, collaboration, continuous knowing, continuous giving and providing of spiritual support."
Lachie, Arthur, the nurses and I discussed the different training courses available, the resources which can be accessed in Romania and what we could bring from Scotland. One of the Doctors whom Lachie already knew from another organisation he was supporting has decided to join Diakonia, which was great news as she is kind and compassionate and wants to help others.
All in all it was a very successful trip and hopefully will soon make a difference to the care being provided for patients. I found the Romanian people very friendly and kind and I feel they deserve to get the best Palliative care possible. Unfortunately, at least in the near future, they won't receive this from there own healthcare service and government. So it is up to us to do what we can.
"Give to him who asks you, and from him who wants to borrow from you do not turn away" Matthew 5v42
We returned to Romania principally to see the new palliative care service with Diakonia had started on the 1st of January. Before going to Cluj we called in Brasov to visit Hospice Casa Sperantei, where the first hospice was set up with one British and one Romanian nurse working in a one bedroom apartment. Now, 12 years later it has grown, into a recognisable charity run hospice with facilities and resources similar to what we have in Scotland.
This was very interesting and great to see the amazing work done there. As I noticed on my last visit the people are very passionate about their work and want to help putting others before themselves. Even although they seem financially better off than Cluj, there is still so much that they need in the way of resources which would make their work easier! I am becoming more aware of just how well off we are in Scotland -free National Health Service and a country which gives freely to charity!
On returning to Cluj there were no huge changes to be seen in the project as there was only one nurse trained in palliative care (training for others would not start for another two weeks) neverthless they had started the service and had a few patients. Our visit was definitely worthwhile as there were a few issues with education and service provision for palliative care to be resolved together with advice on accessing resources to help it run efficiently, ranging from health professionals such as oncologists to volunteers.
Together with Lachie and Arthur I spoke to pastors of the Hungarian Reformed Church and some of their congregations about the great need for people to volunteer and do such things as visiting patients, doing their shopping, driving, etc. All of these things are so important to help the service function. Unfortunately due to the culture in Romania it is very difficult to get people to understand the concept of volunteering when they feel they have enough troubles of their own! I tried to give a bit of insight into the work at Strathcarron Hospice and how only one third of costs is paid by the Government, the rest being provided by Charity, and only through the help of volunteers does the hospice survive! There are nearly twice as many volunteers as paid staff!
Lack of resources such as pressure relieving equipment and dressings for wounds continue to be the main source of frustration for nurses. When Lachie asked the nurses if they could have one thing to make their work easier, they all said RESOURCES. Resources which we take for granted, would help patients with pressure sores and bad wounds, but instead these get unmanageable and infected. Awful to experience, as not only do patients suffer, nurses' morale is undermined with frustration due to limited resources. A suggestion that we might bring material and equipment in May raised their expectations and boosted their morale. Please pray for God's continued hand in the work that their expectations be not dashed!
Christina Ghiran, Nursing Director from the Hospice in Brasov, visited Diakonia. This was very productive, as she can prove that it can be done with hard work and many challenges!
All in all we had another enlightening and successful trip. Yet again I have seen God working in Romania and I feel so privileged to be involved in the work of SFR and to see Lachie working so hard for the Lord. It is a great inspiration to me as a young Christian.
We also visited Casa de Copii, a home for 14 children aged from 5 to 18, in the mountain village of Bratca, which SFR supports. This was a good experience! In the UK, when we hear about Romania, we automatically think of children and orphanages from the Ceausescu era. Although these orphanages do still exist it is not all as we might imagine. This home which we visited was run by house parents, Stella and Calin, who are so loving towards the children and have created a family environment for them.
All the children greeted us with hugs and hello and when I left I had 5 soft toys as gifts from them. This felt strange as I should have been the one giving gifts, not the other way round! This was very humbling and I feel so blessed to have this opportunity to help out in Romania with SFR.
Christina Young
(Palliative Care Nurse)
"Come and see what God has done, how awesome his works on man's behalf! He turned the sea into dry land, they passed through the waters on foot—come, let us rejoice in him. He rules for ever by his power, his eyes watch the nations—let not the rebellious rise up against him. Selah" (Ps 66:5-7 NIV)
Christina has become very involved in the work of Something for Romania having volunteered, despite indifferent health, to go to Romania and work with Diakonia for a year. She has shown real fortitude and commitment through her fundraising activities and would covet your prayers of support.
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