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A 'sponge' for the ways of giving dying dignity

A Nigerian nun will carry hospice lessons learned in Citrus County back to her homeland .

By ELENA LESLEY
Published January 1, 2007

In Nigeria , there are few dignified options for end-of-life care.

"People die at home. They die in the streets. They die alone," says Sister Osheiza Ann Otonoku, a nun who works in Gwagwalada, Nigeria. "They get dumped in the hospital by relatives who can't pay the bill."

Africa's most populous nation is a place where polio still threatens and average life expectancy hovers at 47. It's a place that desperately needs hospice.

And that's why the Nigeria native ended up in Citrus County. As part of her mission to establish end-of-life care in her home country, Sister Ann just completed two weeks of training with Hospice of Citrus County, learning everything from business management to spiritual counseling.

"I've been telling so many people for so long about the need for hospice care," says Sister Ann, who travels throughout Africa and the world as part of her work with her order, the Handmaids of the Holy Child Jesus. "Finally, it happened to fall on rich soil."

It was the Rev. Charles Leke, a Cameroon native and priest from Inverness, who helped make the Gwagwalada-Citrus connection. A benefactor of the Handmaids, he heard a nun from Nigeria was interested in studying hospice care. Since he often visits Hospice of Citrus County patients, he asked the organization's staff if they would be willing to host Sister Ann.

"We said 'absolutely,' " says CEO Anthony Palumbo. "Part of hospice's mission is education."

The Handmaids paid for a plane ticket and, a little over a month later, Sister Ann is mingling with Hospice staff and patients.

She's already won strong local support for her project.

"We want to do everything we can to help," Palumbo says.

And Sister Ann is determined to learn all she can. Her persistence is admirable, Palumbo says.

She rises every morning before dawn and, in full white habit, wakes up Father Charles to say Mass. Turning down lunch invitations on Kings Bay, she insists on visiting hospice patients.

"She's a real sponge," Palumbo says.

For good reason.

Though starvation, malaria and HIV, among other illnesses, can be death sentences in Nigeria, the concept of hospice care is relatively foreign.

"It's been slow to develop," says Jennifer Tymon, program coordinator for the Foundation for Hospices in Sub-Saharan Africa. "But it's recently been making major strides."

Among them, relaxed regulation of opiates and an increased interest in the concept among health care professionals.

Still, there are few palliative services available and the concept is not widely recognized among members of the general public, Sister Ann says.

Even many rich Nigerians must travel outside the country to receive care for terminal illnesses. Often, Sister Ann accompanies such patients.

"I leave with them on the plane, and come back with them in baggage," she says. "Why can't people die in their home country?"

As new as the concept of Hospice is in Nigeria, it's not much older in the United States, says Bonnie Saylor, Hospice of Citrus County's director of operations.

The first American hospice opened in 1974 and Medicare began funding the service in the early 1980s.

The Nigerian hospice movement is "similar to what hospice was 20 or 30 years ago here," Palumbo says. "People were starting to realize that hospitals are not good places for the terminally ill to be."

Sister Ann first learned of hospice around eight years ago, while studying in the United Kingdom. When she returns to Nigeria, she plans to start offering home hospice care along with other nuns from her order. Her long-term goal is to raise funds to build a hospice house.

Hospice of Citrus County has "adopted" the project, Palumbo says. While the hospice will not divert resources from its own patients, staff plan to raise funds for Sister Ann as well as provide administrative support and constant communication.

Technology will play a key role in the effort.

Telehealth services, which enable health care workers to communicate with each other and patients over TV screens, are available in Nigeria, and Citrus County staff will use them to guide Sister Ann.

"Technology will help fill in the gaps," says Palumbo, who has warned Sister Ann that she has her work cut out for her.

"It's going to be an uphill climb, but sister has the heart" for this work, he says. "She doesn't just want to start a hospice house. She wants to grow a movement."

Elena Lesley can be reached at (352) 564-3627 or elesley@sptimes.com.

[Last modified January 1, 2007, 01:28:35]