Reflections on the International Symposium: "Volunteers at the heart of hospice and palliative care"

The aim of the conference was to promote development and raise awareness and understanding of volunteer hospice and palliative care work and to share knowledge, experiences and ideas on an international level.

The presentations were either in English or German and were translated simultaneously via individual headphones.

The morning was dedicated to presentations, the most powerful one for me being the first presenter of the day, Dr Rajagopal who is known as the founding father of palliative care in India. Dr Rajagopal talked of Compassionate Communities in Kerala, where there are 300 community based organisations, as primary care is minimal in Kerala. Dr Rajagopal talked about the growth of "love and humanity".

He said one of the things they don't see (which is more common in Western hospitals/hospices) is loneliness which reminded me of this quote: "Some people are rich, and some people have money"

The next speaker Fatia Kiyange from The African Palliative Care Association in Uganda told us that "taking care of the sick is part of the African culture". Fatia talked about the high burden of disease, HIV and mortality in her country which has accelerated involvement of volunteers for whom poverty is very common.

This was a real eye opener to me, just how fortunate we are to be able to not only access some of the best healthcare in the world but be supported by a huge army of volunteers in a position to give of their time and experience to help others.

I learned of volunteer engagement in Germany where medical students attend classes in pain and palliative medicine which has led to an increase in the number of physicians and the bold statement that "volunteering in Germany is the heart of hospice work".

Interestingly in Germany female volunteers outnumber males by 6:1 (which was similar to many other countries). They are also keen to involve young volunteers as the average age group in Germany is from 51-70 years. Colleagues in Austria too were keen to involve more men and informed us that volunteering was included in the curriculum.

In Belgium they wanted to see the model of partnership in care provision in relation to volunteering and stated that "Volunteers are more valued when people choose to take up care, valuing the human element".

I found out that in France volunteering is embedded in law in that you would not be able to open up a new unit or facility if you did not have a contract with volunteers.

In the Netherlands patients are supported at home by one medical practitioner and the rest is supported by volunteers. Italy has a tradition of volunteers in palliative care, however they would like to work towards one programme that fits all. Spain have some communities trained in palliative care but it is not consistent across the country.

I learned there are few hospices in Croatia and none in Zagreb, patients are either visited in their own homes or taken in elderly care homes.

The thing that hit home just before we broke for lunch was when Ros Scott said that "without volunteers some countries in the world would receive no palliative care"

Just before lunch we heard directly from some volunteers themselves, ranging from a therapet from Innsbruck, a volunteer from Austria who discusses the equivalent of Anticipatory Care Plans with patients and a young brother and sister from Hungary baking and selling cookies and their motivation for doing so.

Time to break for lunch and it couldn't be more typically German. We were served some kind of yellow soup where you then added some grilled frankfurter slices accompanied by a Bavarian pretzel from a wooden stand. No choice, no frills but I loved it for that!

The afternoon continued with a variety of presentations:

• the EAPC Atlas of Palliative Care in Europe in which 50 countries participated
• how volunteering is changing, opportunities and challenges
• the EAPC Madrid Charter on Volunteering in hospice and palliative care

However the stand out session for me was in the "World Café" where I attended a discussion "Being There" and what that meant of each of us round the table. It was such a privilege and honour to share experiences with likeminded colleagues from France, Poland, Germany, Italy and Belgium and I quickly came to the realisation that we all shared the same passion and values about the importance of volunteering in the palliative care setting.

I left the congress having met some really lovely and inspiring people, with lots of food for thought but more importantly with a heart full of love.

I managed to cram in 4 hours of sightseeing and found a café recommended to me by Morven for the obligatory apple strudel.

Thank you CHAS for the opportunity and thank you Berlin what an interesting city to visit although I had tapas for tea as I was staying at a Spanish hotel chain to keep the international theme going.

Jill

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