A Reflection from Anesu Matara
During my time interning with Island, I had the pleasure of accompanying social workers and nurses on home visits and hospital rounds. I also had the privilege of participating in the monthly Chikwaka Roadside Clinic, which brings palliative care services to rural areas of Zimbabwe.
On June 25, I accompanied a team of nurses and social workers on this roadside clinic at various stops. In total, there were five stops. Most of the patients were already registered with Island, so their check-ups primarily involved continuing their medication supply. At most of the stops, I helped distribute medication and other supplies. The nurses would note the medications needed based on symptoms, and I would retrieve the appropriate items and hand them to a nurse, who would then explain how to take each one. We also visited the Shearly Cripps Children’s Home, where we distributed donated knitted blankets, dolls, gloves, and scarves.
During my time at Island I also took part in home visits. During these visits, I typically accompanied a nurse who attended either a follow-up or a new referral. For new patients, the nurse would begin by asking about the primary issue and then move on to gather family history. Throughout this process, the nurse would subtly assess the patient’s emotional and social state. Afterward, the conversation would usually shift to treatment and care that had already been received, allowing the nurse to identify any gaps that needed to be addressed. The nurse would then ask follow-up questions regarding pain, symptoms, and emotional well-being before determining an action plan. Some patients were referred to a social worker for counseling, while others were prescribed medications such as morphine for symptom management. This experience offered a valuable perspective on how care is extended into the home. I frequently heard patients express deep gratitude for Island’s services, with some even saying they might not be alive without them. It was eye-opening to witness the impact that Island Hospice has on the community.
On two separate occasions, I had the opportunity to visit the A4 Special Ward for children with cancer at the Parirenyatwa Group of Hospitals in Harare, Zimbabwe. Children from across the country are referred to this hospital for cancer treatment. During my visits, I primarily observed the physicians as they discussed each patient and deliberated on treatment plans. Knowing I was from the U.S., one physician often pointed out how a particular cancer would typically be treated in America. In several cases, patients were referred to return home and continue care under palliative management. The physician explained that while the same cancer might have a 50% survival rate in the U.S., the limited resources and financial constraints in Zimbabwe make such treatment unfeasible under those odds. In addition to observing ward rounds, I also sat in with an Island social worker who spoke with parents about their emotional wellbeing and how to better cope with the difficult circumstances they were facing.
During my internship, I collaborated with a social worker to develop a project proposal focusing on emotional counseling and bereavement support for pediatric cancer patients and their families. I also chaired a meeting centered on developing an errand service, targeted for the diaspora, designed to use healthcare professionals to bridge the gap between hospital care and home comfort. Throughout my time at Island, I took part in various workshops and lectures.
I also chaired a meeting focused on developing a product targeted to the diaspora, aimed at bridging the distance between family members abroad and their loved ones back home in Zimbabwe. As someone in the diaspora with many family members still living in Zimbabwe, my insights and opinions were especially valued in shaping the product to better meet the needs of this market.
I really learned a lot about the holistic nature of palliative care. I came to understand that it involves not only managing physical pain but also providing psychosocial, spiritual, and emotional support. I also realized that palliative care extends beyond the patient, addressing the needs of their family members as well. Through lectures, I gained insight into pain management and the importance of recognizing that pain is defined by the patient’s own report. Another key takeaway was the role of culture in medical decision-making in Zimbabwe. Learning about this in a lecture and then observing it during home visits was eye-opening. It was especially interesting to see how healthcare professionals work together to help patients and their families balance scientific reasoning with cultural or traditional beliefs.
During my time with Island Hospice and Healthcare, I gained a deep understanding and
appreciation for what palliative care truly involves. I can now confidently say that I understand
the importance of palliative care in supporting patients not only physically, but also emotionally, socially, psychologically, and spiritually. I am very grateful for the time I spent with Island, and as I continue on my journey to becoming a physician, I will always remember the meaningful work they do.