Rana Hammad – Director: Al Malath Foundation for Humanistic Care, Amman: Interviewed by Amanda Bingley, 12 May 2005
duration of interview: 76 minutes.

Rana Hammad talks about her early work in nursing and completing a Master’s in Nursing Research and her growing interest in caring for patients at the end of life. She describes how she was alerted to the need for palliative care in Jordan by a TV appeal about cancer research. She explains:

‘When we started, we started on October 12th, 1992, there had been a telethon on TV, to raise funds for the King Hussein Cancer Center -- at that time it was called the Amal Cancer Center and Amal in Arabic means hope, so it is the center for hope for cancer cure, and it was the first of its kind and I think it was, you know, the first, and everybody was, the whole people in the country were so enthusiastic to do something about cancer … I was one of the people who was watching the TV, you know, playing with my kids. When they started repeating the hope center for cancer cure - it was repeated for million of times - it started hitting me. The majority of cases - eight out of ten - are diagnosed late, diagnosed terminal. So then a question hit me: this center will be for cancer, what if cancers cannot be cured, where will patients go? At that time I was finishing almost my Master’s degree in Nursing Education and Research, and I was working on my thesis on empathy, and I empathized really easily at that point. Next day I was talking to a friend of mine who has a Ph.D. in nursing, and we had the same questions. And then we started pulling interested people to ask this question - we just wanted an answer to this question. And we realized, that time, that we don’t see terminal patients at hospitals - where are they? They’re not in hospitals! So where are they?

She realized that, ‘In palliative care you do really care for a human being who is really suffering. I don’t know why, maybe it’s the way, the philosophy of palliative care, makes it always easier to start at homes - it has started most of the places, the work, at homes, and it took a long time before it got integrated in hospitals.’ An important aspect of her work is to develop attentive communication and cultural sensitivity. With the support of two or three hospice workers from the US and UK to whom she feels very grateful, she was encouraged to develop a Jordanian model of palliative care that was culturally appropriate’. As she says, ‘This is palliative care; it has spiritual and cultural issues.’

Mazen Al Bashir - Medical Director: Al Malath Foundation for Humanistic Care, Amman: Interviewed by Amanda Bingley, 12 May 2005
duration of interview: 35 minutes.

Mazen Al Bashir talks about his training as a general practitioner at the medical school in the University of Liverpool, UK and later his GP work in Liverpool. With Rana Hammad he discusses his dedication to providing holistic palliative care for the patients in the home hospice, describing how he often spends long hours with patients and their families. He talks of the importance of honouring the dying process as a valid and vital part of medicine, as important as the birth process. As he says:

‘if one of my patients died without me attending, or that he died unexpectedly, without really having family around, giving all the rituals, experiencing every move, breath, whatever technique, everybody was in the same line, so at the end of the day, the relief of mission accomplished by everybody, even the family, if it doesn’t happen that way, I don’t have that - if one of them died when I’m not there, or without really anticipating the exact time of death, it’s not exactly losing one of your young, new mothers in labour - if it happened to a gynaecologist that he loses a young lady in labour, I mean, most humiliating experience, unnecessarily - the same for me. I mean, unnecessary every time, because it wasn’t foreseen, wasn’t prepared for, and so on. But that’s exactly the spirit you need in any cancer hospital or in patient facility. It’s – and the most important job is to make sure that those hours worked and this time - because it’s a crucial time – the finale - the grand finale – sort of the whole series of things. And without having the family there continuing to be party to help, their reaction and their grief response won’t be the same.’⁵¹

Amal Bandak – Associate Director of Nursing & Patient Affairs at the King Hussein Cancer Centre Interviewed by Amanda Bingley, 11 May 2005
duration of interview: 55 minutes.

Amal Bandak is leading the first hospital based hospice team in Jordan. She is Palestinian, and has lived and worked in Jordan since the late 1980s.With a background in paediatric oncology nursing and nursing education, her PhD was in maternal and child nursing. As she describes: ‘I used to teach at Jordan University until last year and then I decided I give up teaching, I want something new! Rena (the specialist nurse on the KHCC team) is one of my students; most of them are my students.’ She talks about her experience nursing patients at the end of life and setting up volunteer groups supporting cancer patients in three hospitals in Amman. She is a psychotherapist, and is committed to use these skills to build a strong team. She notes that:

‘In a short period of time we did a lot. And most important is that we are a group, very committed group working together like one family. I’m very proud of them. We have a lot of problems but through this method [psychotherapy] we are able to solve many problems … together we are able to build a very nice group.’

She is keen to promote training and has initiated positive links with palliative care courses with Frank Ferris at San Diego Hospice, US and in Canada.⁵²

Ahmad Al Khateib – Director of Nursing Education: King Hussein Cancer Centre, Amman: Interviewed by Amanda Bingley, 11 May 2005
duration of interview: 45 minutes.

Ahmad Al Khateib talks about his work to promote education and training for the newly developing services in Jordan. He has a background in oncology nursing, with a Masters in Nursing Oncology from Georgetown, US, and hospital training in palliative care and patient education. He is currently doing a Ph.D. He became involved in KHCC when he was asked to co-ordinate a course in palliative care and liaise for the Ministry of Health, WHO and KHCC. He was nominated to coordinate the training programmes and developing projects . As he says:

‘ I’m glad to do this, I found it’s very helpful … For me palliative care, I think it is part of symptom management, quality of life and not suffering. I think it is important from the belief that it is the patient’s right to be cared for even for the last minute… I might not be able to cure, but that becomes a secondary objective or goal, but sometimes at least we could help alleviate suffering. The concept of palliative care, I mean, in Jordan and maybe all over the world, but in Jordan particularly, still it’s a new concept. So it took us some time to help the physicians and nurses and health care providers to understand what you mean by palliative care and to emphasize that the patient it’s part of their lives to die in peace and dignity. So even until the last minute you have to take care of the patients. We found some people who are really interested, and we work with these people who now attended the courses, and train them, because I think these people will be very helpful, to also convince other people. So now we have programme, we have training, so things become more clear; before there was nothing.’⁵³