Governments have heard this. Pushed on in no small parts by grants, corporate and development programs, many countries began leveraging new technologies to increase access to government services. They’ve tried various methods to simplify procedures for citizens, expand transparency and make information available to everyone.

The blog Abugidan Info from Ethiopia draws the parallel between increasing peoples’ access to information and a more healthy political culture.

…the importance of the undeterred flow of information in the sphere of politics and governance and in improving socio-political life can hardly be exaggerated. Let us look at it this way. As in the marketplace, the impact of its lack is catastrophic, especially to the development of democracy and strengthening of respect for human dignity. In today’s society, that deficit is characterized by exclusion, inequality, the arrogance of power and problems pertaining to peace and security, stereotyping as political strategy, poor economic growth and uneven development and subjugation that eventually gives way to societal polarization and conflicts. With Internet today’s reality of our world, IF ONLY governments get their cues from a longstanding Syms’ ad, “An educated customer is our best customer”, the world would have been a much better place!

Governments' use of information and communications technologies can only go so far, says Tanya Gupta, a blogger at Governance Matters from the World Bank. She argues that many e-government programs concentrate on providing better services to citizens while they should consider issues relating to political culture.

The first is increasing participation.

Large sections of most developing countries -typically the lowest income populations- are disenfranchised, lacking political participation and voice. In fact, studies have found that greater economic inequality yields greater political inequality, thus creating a vicious cycle where the poor cannot use the political system to improve their economic situation…

This suggests that e-government can strengthen democracy by contributing to increase political participation among the poor.Unfortunately this is where we get stuck. Empirical data shows that participation is not typically an important part of e-government programs in poorer countries even though they are the ones who most needed it.

Next, she outlines the importance of openness and transparency.

In spite of many good examples of open government/ transparency, the fundamental change in mind-set that is required for a truly open government has not really taken place anywhere. In order for this to happen, each civil servant will need to relate in a very different way to data that he/she produces.

…In this process, as much data as possible should be released, withholding only confidential and personal information. To achieve this, more investment would be needed in building a better search engine and modifying social networking apps for government.

Finally, she identifies collaborating amongst diverse groups and accountability:

Although closely linked, transparency/openness and collaboration alone will not bring about accountability. Holding public servants and politicians accountable for their actions requires a robust civil society, strong judiciary and legal framework, a free and active press among other factors. However citizen watchdogs, human rights organizations, non-profits and others that track governance related actions and data can certainly use technology to demand accountability.

Case study: Uganda

Uganda’s government began working earnestly with ICTs in 2006, when the Ministry of ICT began overseeing e-government programs across state-run institutions. The country’s private sector took off some years ago, but the government is still implementing a framework to drive e-Government infrastructure initiatives, like creating communication networks and file sharing amongst all 28 ministries. The government’s strategy also includes providing access to communications, which it hopes to accomplish through school-based training.

If I had to generalize, I’d say the Ugandan blogosphere is largely unimpressed with the government’s efforts in the ICT realm. (If you have anything to say on Uganda’s effort, please reply below.)

Kato Mivoule, from Uganda, writes Mivule Tech-Africa and blames the political culture of the government.

Despite the IT infrastructure, Uganda is still reeling back and forth from forces of corruption that are in no doubt hampering the would be robust ICT industry in East Africa

…from nepotism, favoritism, power fights, mismanagement, greed, ICT in Uganda is yet to deliver, especially when it comes to helping the poor in Africa alleviate poverty,diseases, and illiteracy… Current ICT Leadership in Uganda’s ICT ministry are so full of themselves that all they are concerned with are contracts for themselves and bogus middleman IT companies that would rake in profits to their bank accounts… The people of Uganda benefiting from ICT is still a dream…

This post is admittedly a little old (from November 2008) but the issues remain relevant. It comes from Lilian, who writes From Uganda To You:

A presentation from the Ministry of ICT just confirmed my fears about their ignorance or complacency about IG issues. The presenter was just limited to the role of governments in IG yet what we wanted to hear what the Ugandan government has done as far as Internet governance is concerned. To make it even worse, he could hardly even talk about the three main bills (e-signatures, cyber crime and e-transactions). He simply put it that they were being tabled in parliament for “approval” and knowing the way in which our parliament operates, this may take forever to be finalised!

She points out that Uganda has an internet penetration rates of less than five percent, but the number of people accessing online through web-enabled phones is quickly increasing. “Looking at these figures, I’m not exactly hearing what the government is/has done to make IG a success in Uganda.,” she writes.

Right now, I’m seated in an Internet cafe and I’m wondering how safe it is for me to work from here! That is in terms of protection of my information. All I know is that the Cyber crime bill is is waiting Parliament’s approval. So between now and then, I do not know what happens in case someone hacked into say my email account (just in case I forgot to logout) and used my private data for their own use.

[The bills remain under consideration.]

A comment from BSK argues.

That is pretty serious; i hope those people do really show some seriousness soon. Otherwise, such things as growth of ‘e’ and ‘m’ commerce (particularly given that we soon will have functional mobile money transfer systems in the region) are going to be affected big time, and the expected surge in use in the next few years could be fertile ground for all sorts of scam and fraudsters. I agree, we probably be seeing more of the mobile web, especially in the next 2 years with expected falls in bandwidth costs, and uptake of wimax and 3G.

Test Case: Kenya

E-government services on the Government of Kenya’s webpages are easy to access and, it seems, to use. Kenyans may search jobs online, track the status of their national ID and passports. Students can locate exam results and follow up on their higher education loans. Business people can submit tax returns online and apply for specific permits and reports online. Finally, anyone can log a corruption complaint through an anonymous feedbox.

Many of the services provided, the government claims, can be done online or through SMS messaging.

The blog from Jellyfish Cool Man reports that the government is even expanding its efforts, including publishing ministry procurement details and digitizing health records. What makes this task easier is that most middle-class Kenyans are already online.

…all [these] developments indicate a country intent on modernizing it’s activities. The desire for this is driven by the need for efficiency, eradication of corruption, need for socialization and most importantly a voracious need for information which will greatly boost literacy levels and hopefully lead to innovation and a more civil society. Kenyans need to have a positive attitude, realize that they have a beautiful country, intelligent people and sufficient natural resources which they can utilize to provide a high quality of life equivalent to any advanced nation on Earth.

Kenya offers an interesting case study because some of the most interesting political watchdogs don’t come from the government. Rather, the country’s robust civil society has begun using technologies to keep watch on issues like corruption and government procurement, not very different from United Kingdom-based groups trying to hold those in power accountable.

Kenya’s governments have long tried to shake off corruption allegations. The group Transparency International currently ranks the country 147 out of 180 in its index tallying the perception of corruption, sharing space with Russia, Syria and Bangladesh. (Uganda is 126.)

Recently US Secretary of State Hillary Clinton told an audience in Kenya although the government in Nairobi is slow to act, people should not give up complaining about corruption via social marketing sites like Twitter and Facebook.

The group Mars Group Kenya has exposed a number of high-priced and high-priced scandals on its “Leadership, Governance and Accountability” portal during the last few years. The group began in December 2006 to help publicize its reports on government corruption, hoping its website and forum would become a place to debate and publicize the importance of governance issues.

Recently it has found itself the target of claims it is trying to destabilize the government and Parliament proceedings regarding espionage charges.

Nonetheless, the group has friends in Kenya’s blogosphere. A Nairobian’s Perspective calls the group Kenya’s online ombudsman.

…True to its adage “watching out for you” Mars Group Org has been relentless in ensuring it watches out for Kenyan Civil Liberties and freedom.The website frequently publishes reports on corruption such as Ndungu Land Commission Report, Kroll Report, extracts from Wiki leaks,Githongo's Dossier on Anglo Leasing etc…The blog also has an interactive column where members of the public air their opinion, media clips are uploaded,a cartoon column gives corruption a human face, and of course subscribers get regurlar email updates.Mars group is right on -on its spotlight on corruption. While very little is known/atleast available online with regards to Mwalimu Mati [the group’s director] one thing is certain ;he is a true defender of public interest Kudos to him!

In the field

Tracking climate change impacts generally starts in the field. James Balog, a photographer, has been to Alaska, USA, to record time-lapse ice cap melting. You can see the stunning results of his photography in this video:

If you don't have expensive cameras and spare-time to journey to Alaska, another approach would be to read the experiences of people on the frontline.

On the Frontline of the Climate Change is a project cataloging first-hand stories on the impacts of climate change, in indigenous communities, on small islands, and other vulnerable communities. The forums contains numerous recent contributions by email, mostly from South Asia and Africa. One contributor and consultant for African development, George Katunguka, writes from Uganda:

The impact of climate change has not received much prominence in my country Uganda but such changes and its effects are painfully being felt. In 2025, Uganda is likely to experience water stress according to recent report on water resources. People are dying of starvation and hunger like the recent case in Teso Region, Eastern Uganda; there are changes in water ecosystems like the dwindling levels of Lake Victoria; unpredictable seasons, loss of soil fertility and loss of agricultural output and hence increased household poverty and its implications. What are we doing to avert this looming catastrophe?

From outer space to Google Earth

Observation from the field can be double-checked from high ground. Space is the lookout from which to observe and analyze earth as a whole. It's difficult to get a seat on a spaceship, but fortunately, it's easy to find online satellite images from above.

Besides space agencies and companies offering their services to NGOs, scientists and common people, the United Nations Environment Programme created an online atlas indexing the changes occurring in different parts of the world through decades. All the satellite pictures can be viewed on Google Earth's virtual globe, as their official blog reports:

In collaboration with the Danish government and others, we are launching a series of Google Earth layers and tours to allow you to explore the potential impacts of climate change on our planet and the solutions for managing it.

Many more resources can be found on blogs and websites of international organisations. Readers, feel free to add your own sources in the comment section.

Science for decision makers

Observation is a core issue for decision makers. Governments initiate surveys to understand the phenomenon and how to mitigate the impacts.

The European Commission and European Space Agency initiated a space program in 1998, called the Global Monitoring Environmental Security (GMES), to sketch real-time changes from multi-source data. The project is due to report back in 2014, with an annexed security segment.

Developing countries impacted most directly by climate change, have taken a similar steps like the recent satellites launch by India to study climate change. Such information can help countries plan for new environmental and economic policies.

In South Africa, a new economy-oriented tool has been created for exactly this purpose. AllAfrica reports :

Now, an analytical tool based on a study, Mapping South African Farming Sector Vulnerability to Climate Change and Variability, has been developed to help policy-planners identify the communities most vulnerable to climate change and help them prepare for radically different farming conditions.

The multiple laws that I will be breaking as soon as the president signs this law. Well, our detractors had already said that we would be stiffed with a tougher law, but this goes way beyond that. If I attempt to commit the offense… (god, the number of times that I have made passes and they have been rejected!) Each of those times was worth 7 years in jail. Good heavens!!!! Before, we could be liable to life imprisonment. gug hereby declares that, when the President of the Republic signs this law, gug will be liable to the death penalty… because I and my lover are serial offenders, breaking this law.

The bill further prohibits adoption by gay couples; any person who aids, promotes counsels any acts of homosexuality in any way will face up to seven years imprisonment, or risk a fine of sh100m. It states the ill effects of homosexuality as:

Research indicates that the homosexuality has a variety of negative consequences including higher incidences of violence, sexually transmitted diseases, and use of drugs. The higher incidence of separation and break-up in homosexual relationships also creates a highly unstable environment for children raised by homosexuals through adoption or otherwise, and can have profound psychological consequences on those children. In addition, the promotion of homosexual behavior undermines our traditional family values.

Given Uganda’s historical, legal, cultural and religious values which maintain that the family, based on marriage between a man and a woman is the basic unit of society. This Bill aims at strengthening the nation’s capacity to deal with emerging internal and external threats to the traditional heterosexual family. These threats include: redefining human rights to elevate homosexual and transgender behavior as legally protected categories of people.
There is also need to protect our children and youths who are made vulnerable to sexual abuse and deviation as a result of cultural changes, uncensored information technologies, parentless child developmental settings and increasing attempts by homosexuals to raise children in homosexual relationships through adoption, foster care, or otherwise.

Producers, publishers and distributors of material containing homosexuality especially if a business, an NGO will have its certificate or registration canceled and the director will face seven years in prison. That includes gay blogs in Uganda:

Poor sympathizers. You are not left to love us. No, all lovers of gays, and gays in Uganda will suffer, and be punished by this law. Any press conferences? Not by gay Ugandans. You see, we are a pariah people that will never be like all other Ugandans. Ha ha ha ha ha!
Oh, the gayuganda blog is one of the things which are illegal, as per that bill. I am furiously promoting homosexuality on this blog, complaining about a law like this. So, 5 years in prison, and my (non existent) bank balance will be set back by 100M Uganda shillings…! And the people who dare to give us condoms and lubricant for sex… Or, if you dare to have an HIV prevention program for homosexuals in Uganda… or even try to teach safer sex. Well, the penalties are stiff. Very stiff. Jail, and jail and other things.

Here are the objective of the bill.

3.1. The objectives of the Bill

The objectives of the Bill are:

(a) To protect marriage as that only between a man and a woman in Uganda;

(b) To prohibit homosexual behavior and related practices in Uganda as they constitute a threat to the traditional family;

(c) To safeguard the health of Ugandan citizens from the negative effects of homosexuality and related practices;

(d) To establish progressive legislation protective of the traditional family that can serve as a model for other countries;

(e) To prohibit ratification of any international treaties, conventions, protocols and declarations which are contrary or inconsistent with the provisions of this Act;

(f) To ensure that no international instruments to which Uganda is already a party can be interpreted or applied in Uganda in a way that was never intended at the time the document was created;

(e) To withdraw from any international agreements to which Uganda already is a party, or file reservations to them, which are re-interpreted to include protection for homosexual behavior, or that promote same-sex marriage, or that call for the promotion or teaching about homosexuality as being healthy, normal, or an acceptable lifestyle choice, or that seek to establish sexual behavior, sexual orientation, or gender identity, or sexual minorities as legally protected categories of people; and

(f) To prohibit Uganda from becoming a party to any new international instruments that expressly include protection for homosexual behavior; promote same-sex marriage; call for the promotion or teaching about homosexuality or homosexual relations as being healthy, normal, or an acceptable lifestyle choice; and/or seek to establish sexual behavior, sexual orientation, gender identity or sexual minorities as legally protected categories of people

Gay Ugandan is urging you to take this cause with him and asks you if he deserves to die because of this:

If you are outside the country, why, that is very good. Your congregation can be made aware of all the good things that some Christians in Uganda wish some sinners called gay Ugandans. I am sure your outrage will help. A letter, a protest match, questions to leaders of Uganda, religious and otherwise traveling outside the country. This is a moral question, how can they justify killing me because I am gay, living in a gay relationship with another gay man?

# Ok, what of gay people in other countries. You are our friends. Yes, we dare to ask our gay brothers and sisters for help, especially when our countrymates believe we should be patriotic enough to ‘die’ in the name of their moral uprightness, for god and country.
Tell your local gay group about it.
Organise protests, big and small. Educate any who doesnt know about it.
Write letters of protest. Be courteous, (the framer of the bill says that we homosexuals want to kill him. He says we have already written him ‘threatening’ letters.)

Afrogay another Ugandan blogger compares the Ugandan to the government to the Nazis, he says the time to flag down the bill is now:

Again, as I have argued here and elsewhere, we are best advised to keep our powder dry for the real battle if the bill is ever passed and signed into law. So, I for one don't plan on saying too much about the nuts and bolts of what is wrong with it. And the reason is simple: if we point out what is wrong with it now, our detractors will use what we say to clean up the bill. Best then to shout foul as loud as we can on the discriminatory elements of the bill without guiding them around the glaring technical, legal, constitutional and human rights minefield they are sleep-walking towards with this bill.

A Nigerian blogger Anengiyefa thinks the bill is flawed and the panel who made the bill are ignorant about homosexuality, He says homosexuality cannot be an offense, you cannot punish someone for having sexual feelings for another person:

Mr Bahati goes on to demand the death penalty for what he calls “aggravated homosexuality”. I read this and I wondered if the said Mr Bahati has ever had the opportunity to sit inside a classroom in his life, given that unless he is starkly illiterate, he ought to know that there are no law books in any Common Law jurisdiction, (including Uganda), that refer to an offense known as ‘homosexuality'. Homosexuality cannot be an offense! You cannot make it an offense and punish a person for having feelings of sexual and emotional attraction towards others of the same gender. You cannot prove ‘homosexuality' in a court of law to the standard of proof that is required in a criminal court.

Anengiyefa sees that Uganda has just seen hypocrisy of MPs who have unified and are ready to pass a law victimizing homosexuality in the name of morality: this beats the purpose why the system is so anxious to criminalize consensual sex amongst two adults of the same gender and omitting important issues like ethnic violence, tribalism, AIDS, child rape etc:

This outbreak of frenzied homophobia is the epitome of the hypocrisy that pervades political life in Africa. At a time when expensive legislative time should be judiciously expended on the issues that really matter to the people of the country; when Ugandan lawmakers and the Ugandan government should be concerned about the welfare of vulnerable Ugandans, (including those same-gender loving men and women in their society, who are susceptible to wanton physical abuse and discrimination); when the Ugandan authorities should be looking to protect those of the country's citizens whose welfare is their responsibility; when the challenges that face our continent in this 21st Century are enormous; what we hear of instead is an Anti-Homosexuality Bill being introduced to Parliament. This bill is deemed necessary according to the MP David Bahati who introduced it. He claims that the purpose of the bill is to protect children and the “traditional family”.

Blog Action Day 2009 was an online event organized by Change.org. It was a virtual gathering of voices discussing climate change. Bloggers from a sampling of countries in Sub Saharan Africa were among those who posted their thoughts, and in this post, we get to listen to their voices.

Kenya

The blogger at Theatre of Inconveniences reminds readers to also think about wildlife and the species threatened with extinction due to climate change. The blogger also looks at the extreme weather situation in Kenya, with a drought that has lasted many months and the expected heavy rains.

In Kenya recently, prolonged drought – and we can not rule out the effects of climate change as the cause – first killed livestock, then pushed the livestock into wildlife habitats, then killed the wildlife. Now Kenya is – ironically – waiting for El Nino rains to settle in so that it can save people, their livestock and wildlife. But the El Nino could be made more severe by the effects of climate change. So more people, livestock and wildlife will die. Iregi Mwenja, a Kenyan bushmeat researcher posted pictures of the onset of the El Nino rains in Voi today. One of the casualties of the big water was a masai goat that died in the floods.

The blog Sukuma Kenya took UNEP (United Nations Environment Program) to task on its use of gas guzzling SUV's that release more CO2 into the atmosphere than smaller cars. The blogger wonders whether for one day, the UNEP officials would heed their own advice to cut CO2 emissions.

The blogger on Katch up shares their experience climbing Mt.Kenya, one of the few snow capped mountains in Africa. The blogger mentions changes in the ice coverage as pointed out by the tour guide, and also notices other changes in the environment. A brief story from the blogger's mother illustrates just how fast the environment has changed.

I come from a cold place and my mother tells me how fast certain types of crops used to grow, rain was abundant, seasons were more than one and it was colder. Not anymore. Those days were definitely better and we have been losing.

South Africa

Rory of Carbon Smart writes about community empowerment and climate change. The effects of climate change on the majority of Africans will be severe, and any strategies at dealing with climate change should provide support to the communities.

In Africa particularly, stresses are already being felt - climate change is not something that relates only to the future. The most vulnerable communities are those who struggle the most, as they are living on the edge - quite literally on the periphery of economic activity, whether they are subsistence farmers or urban slum dwellers. In this position, they don't have ‘wiggle room', or the flexibility to adapt their lifestyles to the changes they are experiencing. As a result, strategies for climate change adaptation must ensure that communities do have the means and understanding and support structures to enable them to keep ahead of environmental changes. A key point to be made is that the answer lies not primarily in technology or aid, but crucially in building relationships - institutionally, socially and financially.

Poetry and Poesie shares a poem on global warming

The bergs look limp
to me nowaseasons,
I shouldn't read
National Geographic,
that once was a tree
now covered in blinding shots
of glaciers gliding all the more
readily
sweating in the gloaming -
a new word I coined
for global warming.

I don't need to read
journalistic twilight musings,
I can see when a bear
is panting to death,
I can see the whales flail
in the a-krillic blue sea,
I know the götterdämmerung
is going to be a hot event
Inuitively.

Uganda

Climate Change. Its not just Koalas.

Rebecca writes on Jack Fruity about her experience in the Global Change exchange program, that will be documenting the effects of climate change and partnering with established bloggers in the Global Voices community.

It can be easy to forget that climate change is about more than trees and cuddly animals and fish swimming around in some distant ocean — all of which I care about, don't get me wrong (especially the cuddly animals). But climate change also has real, physical effects on humans: it's altering weather patterns in unpredictable ways, causing crops to fail for lack of rain in some places while floods wash away entire fields in others.

Ghana

Jemila Abdulai writes on Circumspecte blog, she looks at the climate change deniers, and those who believe it to be a hoax, debunks their arguments and sets forth the lessons for Ghana and Africa. The lessons include Information, Education and Accountability.

Ghana and other African countries are relatively better-off (I think) when it comes to pollution. How can we reduce what pollution we have, and how can we prepare for the future?

We should be doing our research and looking at all these models (failed or otherwise) to inform our own policy decisions. If we don't keep ourselves informed, we will have a situation similar to our current economic systems; we'll have policies, laws and structures that do not work for us. Already, many multi-lateral companies get away with polluting our countries without so much as a slap on the hand for this. That's where our concern should be: strengthening our legal structures to protect our environment and consequently, our population.

A great roundup of Ghanaian blog posts on Blog Action day is done by Mac-Jordan of Accra Conscious.

We end with the voice of ‘cuppatea' on the blog A colourful life of a Gay Kenyan:

So in summary, stop polluting, plant trees and be nature friendly! It will save mother nature and planet earth and you'll make nature fans like me globally happy! The future generation depends on nature. Positive action today, Better tomorrow for future generations.

Note: For previous Global Voices posts, kindly see these links.
- Reading the world on Blog Action Day
- Israel: Blog Action Day for the Environment

- Rising Voices summarizes blog posts from its grantees.

World Hospice and Palliative Care Day, which takes place today, seeks to change that by celebrating and supporting hospice and palliative care globally. While it's true that one day is not enough to create real change for the millions of people who rely on or need this type of care, it can help bring much-needed attention to the issue. Not only are these stories largely omitted from news headlines, one study finds that even online educational materials about the topic need to be revised to make them more understandable. Throughout much of the world there's a lack of understanding about this type of care, as well as a lack of access to these services.

The theme for this year's World Hospice and Palliative Care Day is “Discovering your voice,” so organizers asked people from around the world to make their voices heard and submit their stories online. In response, people from countries ranging from Portugal and India to Malaysia reflected on the issue. Beatriz Thompson, for example, of Belize shares this account:

“This is the story of a brave little boy. His name is Julian Wohler. At the age of one and a half year he was diagnosed with neuroblastoma. Julian fought this cancer for 4 1/2 years. He underwent 5 surgeries cycles of chemo and radiation in Merida Yucatan, Mexico. Julian had to travel 11 hours from Belize to go receive treatment every 2 weeks. When the tumor came back for the last time Julian told his parents he was not going back for anymore chemo or surgery. He wanted to stay home and enjoy himself.”

Hospice Casa Sperantei in Romania

“My disease began last year with partial paralysis. I did 10 sessions at the hospital and I felt like everything was changing for the good. Three days later, I was in the kitchen and I fell down. Since then no more stability and I am very weakened. Firstly it affected me in a psychological way, like I was being destroyed. I was on the verge of disappearing, I wanted anything to happen, just to escape, because it is torture, a very hard torture.”

Judi Chamberlin, blogging in the United States on Life as a Hospice Patient, also shares the ups and downs of having a life-limiting illness. She suffers from a chronic lung disease and lung infection, among other health problems. In this recent post, she talks about feeling discouraged and reflects on her father:

“I find myself saying so many of the things my Dad used to say in his final months–he used to talk about feeling weary, and now I know just what he meant. Everything, even the most mundane activity, like going to the bathroom, becomes a major production. When someone would point out some nice upcoming activity he would say “hallelujah” or “whoop-de-doo,” hating to be diverted with something that felt so minor in the grand scheme of things. And although he was eighty four when he died, and I'm not quite sixty five (my birthday is October 30th), I know just what he meant when he would say, “I've lived too long.” I always planned to live to a ripe old age, but that was only if it was an active, busy life–the life I used to lead, the life I loved.”

In addition to firsthand accounts of living with a disease, many palliative care-related blogs, videos and other new media also share the views of caregivers, health care professionals and family members of someone with a life-threatening disease. In Uganda, patratm, a doctor and hematologist, tweets about various palliative care issues. In South Africa, a video shares the story of Zodwa Sithole over images of hospice care. Sithole watched her sister die of cancer at a hospice and is now part of the Hospice Palliative Care Association of South Africa.

Risa Denenberg, blogging on risa's pieces in the United States, is a nurse who looks after patients with life-threatening illnesses. In her blog she reflects on her experiences as a palliative care provider. In this post, she talks about the pain of losing a patient:

“Pager bleats its rising and lowering notes (de-da-do-da-de). Familiar as my name, but as I am wading from sleep to wake…It's the nursing home, telling me he has died. It's 2:15 am…

…The hardness was that he didn't want to die, wasn't ready, much too young, much too much undone, had just started over, this thing caught him in the neck and strangled him without so much as a warning punch. And the pain. Was terrible. Even on the highest doses of opioids I have ever prescribed. Pain mixed with fear, anger, angst. I think I loved him for these few weeks, a helpless sort of love because I couldn't make it better. I thought.

Daughter said to me: “He liked you. Really liked you. That's a big complement, you know. He sees right through shit, and you were real to him.”

shantanu.dutta, blogging on Mutiny in India, talks about a friend who died of cancer at a hospice. At the time, there seemed to be only one hospice in New Delhi, where space opened up when a patient passed away. He says he learned the value of hospice firsthand through that experience:

“The famous psycho-oncologist Buckman…said that “there was one missing chapter in Harrison's Textbook of Internal Medicine. The missing chapter was, ‘What do you do when all the treatment advised in all the other chapters fail?'

Palliative care is that missing chapter. It is missing in our planning, priorities and programs but is fast emerging from the shadows as an urgent necessity as we and our loved ones live longer and become more and more prone to debilitating and life threatening diseases that can not be perhaps be cured but with some a professional approach endured, and possibly endure well.”