Bridging Compassion and Care

When Carrie Cormack, DNP, APRN, CPNP-BC, FAAN, Associate Professor and Distinguished Professor in Palliative Care, first envisioned a cross-continental partnership to strengthen palliative care in Eswatini, she knew it would require more than just funding -  it would take collaboration, compassion and community. Today, her vision is taking root through a partnership with the End-of-Life Nursing Education Consortium (ELNEC) and a Global Collaborative Palliative Care Nursing Education Initiative, a grant-funded project that brought an intensive palliative care symposium to Eswatini, Africa.

Held February 18–20, 2025, at Good Shepherd College of Health Sciences (GSCHS) in Siteki, the three-day, in-person ELNEC training gathered 57 health care professionals from all four regions of the country: Lubombo, Manzini, Shiselweni and Hhohho. From nurses and physicians to social workers and physical therapists, participants came ready to learn, connect and lead.

The symposium was the result of years of vision, partnership and persistence. Spearheaded by Al and Kathleen Hartmann and supported by Dr. Betty Ferrell, Ph.D., MSN, CHPN, founder of the ELNEC program.

Despite traveling long distances in adverse weather conditions, participants arrived on time each day, remained engaged through every session and actively contributed to both formal discussions and informal peer exchanges.

The train-the-trainer training included 11 didactic lectures, two hands-on labs on pain and symptom management and featured four expert speakers from the United States, Carrie Cormack, Patrick Coyne, CNS, MSN, AAS, Judy Paice, Ph.D., RN, and Keith Swetz, M.D. These interactive sessions focused on the foundational elements of palliative care: effective communication, cultural sensitivity, pain control, ethical decision-making and end-of-life planning.

As part of the program’s long-term impact, participants were charged with bringing what they learned back to their own facilities and communities. Equipped with training materials, case studies and presentation slides, they are expected to lead peer education efforts, initiate local case discussions and advocate for improved care delivery.

Throughout the symposium, attendees and facilitators alike confronted the stark realities of providing palliative care in a resource-limited setting. Among the concerns: the lack of access to morphine, essential for managing pain in patients with advanced illness. For many clinicians, the inability to ease suffering due to systemic barriers has been a source of moral distress.

Home-based and community care, crucial in rural areas where patients may never reach a hospital, also faces significant challenges, including a shortage of trained personnel and limited access to transportation. In some areas, palliative care providers must traverse unpaved roads with few supplies and no specialized vehicles.

Yet these challenges also present opportunities for innovation and advocacy. The symposium provided a platform to raise awareness among leadership, including dignitaries from the Good Shepherd Board of Directors and representatives from Eswatini’s Ministry of Health. Their presence sent a strong message: the need for palliative care reform is recognized at the highest levels.

 

Bringing the Mission to Life

During their time on the ground, the ELNEC team had the profound honor of joining a family meeting of a gentleman with end-stage liver disease. During this meeting, the team was able to help fulfill his final wishes, ensuring that his only child – his son – would be safe and cared for after his death.

The next morning, on the first day of the course, the team learned that the patient had peacefully passed away in his sleep that night. Many of the local care team members reflected that because of the compassionate leadership and guidance provided during the meeting, he was able to find closure and say goodbye. This moment brought deep meaning to the entire visit, powerfully illustrating why building palliative care capacity matters so profoundly.

Meanwhile, the partnership between Good Shepherd College of Health Sciences and the U.S.-based ELNEC faculty continues to flourish. Faculty leaders from Good Sheperd are working with Dr. Cormack and palliative care expert Pat Coyne to embed ELNEC content into the college’s nursing school curriculum.

Together, they have outlined a long-term virtual collaboration with timelines, learning outcomes and structured support for ongoing faculty development.

Looking ahead, the team envisions expanding this initiative to actively involve students through clinical immersion and cross-cultural learning opportunities, with hopes for a return trip to Eswatini that would further strengthen bidirectional exchange and capacity-building efforts.

In another key development, the ELNEC team spent time in the field with the Good Shepherd Home-Based Palliative Care team to co-develop a business plan. The goal is to ensure the long-term sustainability of these services by addressing operational needs and securing funding for transportation, staffing and supplies.

Throughout the event, one constant theme remained: community. From the leadership of Good Shepherd College of Health Sciences who provided event space, equipment and meals, to the participants who braved complex journeys and the international faculty who brought knowledge and humility, this initiative underscored the power of global collaboration in health education. The symposium was a moment of transformation that empowered health care professionals to lead with empathy, advocate for change, and reimagine what’s possible for palliative care.