Building palliative care capacity in the Solomon Islands one step at a time

An article written by Kate Reed, Palliative Care Nurse Practitioner and Authorised Voluntary Assisted Dying Practitioner, Canberra Health Services

Spending part of my childhood growing up in Papua New Guinea, my heart has always held a special place for the people, the culture, the music, the colour, the waters and energy of the Pacific. In 2023 I was given an opportunity to take my specialist palliative care Nurse Practitioner skills and knowledge fed by my passion for improving equitable, cost effective and sustainable access to palliative care and essential medicines for all, to commence co-designing a program of work to build palliative care capacity at the National Referral Hospital (NRH) in Honiara within the Guadalcanal Province: the capital of the Solomon Islands.

At the invitation of the Ministry of Health and the NRH and thanks to funding and support from Canberra Health Services, the John James Foundation and Doctors Assisting in South-Pacific Islands, I was able to join the Oncology Mission Team led by my colleague, Professor Desmond Yip, to do an in-country scoping of current palliative care need, capacity and gain an understanding of capability. I was privileged to spend time with staff and patients forming a picture that was culturally and contextual informed. In doing so, a palliative care community of practice (PCCoP) of both nursing and medical palliative care champions was formed. The PCCoP, supported by the NRH Executive, engaged online every month working on developing the skills, case presentation and management, and innovating resources needed to integrate palliative care into the NRH in a sustainable, cost effective and culturally appropriate way.

Over the last few years and subsequent visits, a medical and a nurse palliative care lead has been identified at NRH. Supported by their Executive they will lead the integration of palliative care at NRH. To solidify their learning, they were bought to Canberra and Brisbane last year for a palliative care observership and to co-present as invited keynote speakers at the Oceanic Palliative Care Australia conference. This was made possible by the DFAT funded Elimination Partnership in the Indo-Pacific for Cervical Cancer (EPICC) program for whom I am have the honour of being a palliative care expert affiliate and Palliative Care Australia who are driving palliative care collaboration between Australia and the Pacific.

The leads have now completed an American Society of Clinical Oncology palliative care course with other PCCoP members, with the nursing lead having now completing a Fellowship in Palliative Care with the Institute of Palliative Medicine with the support of the NRH. Further post graduate opportunities are being sought for the medical lead.

Working together we have adapted evidence-based tools to empower medical and nursing staff to identify palliative care needs and ways in which to address them. As I am writing this, these are being rolled out as a trial to the NRH ED, HDU and medical wards.

With further education and case discussions on regular online catch ups, education planned in Fiji with the leads as part of the EPICC consortium of Pacific countries, an in-country visit planned for later this year, I am hoping to work more closely with other palliative care clinicians to build a multidisciplinary support structure for the PCCoP along with formal education opportunities to fully integrate palliative care into NRH clinical services. In 2026, my focus is to gain a better understanding of what is needed in the Solomon Island provinces to build palliative care capacity outside of the acute hospital setting, where it is desperately needed. My hope is that this work will inform a co-design of a palliative care framework that can be applied throughout the Solomons to embed palliative care as a sustainable, accessible and attainable health service for all Solomon Islanders.

Author

Kate Reed

Palliative Care Nurse Practitioner and Authorised Voluntary Assisted Dying Practitioner

Canberra Health Services