The rewarding two-way street of international care

August 03, 2023
A close up of a health care worked holding the hands of an older patient.
Palliative care, often mistaken as interchangeable with hospice care, is the field of medicine focused on providing support to patients and families living with serious illnesses. iStock

Pat Coyne had just finished speaking at a cancer conference when a woman approached him. Though Philadelphia wasn’t exactly the clinician’s back yard, the woman standing in front of him most certainly had him beat on travel expenses. She had endured more than 20 hours on a plane – spanning two days and nearly 8,000 miles – to be there. 

Her plea was direct: Come to Tanzania and help to improve the country’s pain management problem. 

“I said sure,” Coyne recalled, thinking back to that conversation in 1994. “It sounded like an adventure. But I had no clue what I was getting myself into.”

When he landed, he quickly realized how dire the situation was. Tanzania, a developing country located in the southeast region of Africa, didn’t have so much of a pain management problem as it had absolutely no pain medication whatsoever. “Help” wasn’t the right word. What the country needed was Coyne to create something out of nothing.

mugshot of pat coyne 
Dr. Pat Coyne

“It was a rough go at first, but over the years, we really started to feel like we were making a difference,” he said. 

And so began a passion for helping others that has now spanned four decades and scores of exotic locations across the globe. Today, it’s more than just a solo act; the MUSC College of Medicine assistant professor and doctor of nursing practice’s cadre has grown to include a host of clinicians, volunteers and experts, all of whom share his love of giving back to those in need. One member of that ever-growing posse is College of Nursing associate professor Carrie Cormack, DNP, who has helped to broaden the University’s outreach, expanding from pain management to even more complicated topics like palliative care education. Palliative care, often incorrectly confused with hospice care, is the area of medicine that focuses on providing support to patients and families living with serious illnesses.

“Sometimes that trajectory can be short, sometimes it can last years – even a lifetime,” Cormack said.

mugshot of carrie Cormack 
Dr. Carrie Cormack

The group’s main focus is teaching health care professionals and leaders in other countries everything they have gleaned from – and put into, for that matter ­– the End-of-Life Nursing Education Consortium, what Coyne and Cormack refer to as “the gold standard for palliative care education.” 

Just this year alone, they have visited Albania, Austria, Greece, Romania – and the list goes on. Whether presenting at conferences in those countries or going directly to the places in greatest need, the group brings with it a wealth of resources in areas like critical care, pediatric care, geriatric care – even bereavement. 

“We don’t just come in and do it for them,” Cormack said. “We show them how they can do things themselves. Not only is it more sustainable that way but it allows them to take pride in knowing they are picking themselves up.”

the inside of a very basic hospital room, with no privacy dividers and mosquito nets on all the beds 
A photo from one of Coyne's earlier visits to Tanzania, when things were much more spartan in their hospitals. Photo provided

And every year, more countries are lining up, looking to MUSC for assistance in getting their own palliative care systems up and running. 

The group teaches a range of skills from symptom management to any ethical or legal problems they may encounter as well as effective communication and the best way to deal with grief. And that teaching doesn’t just happen abroad; right here at home, on the Charleston campus, MUSC has integrated palliative care education into all of its relevant programs, even creating a specialty track in the College of Nursing, a post-MSN to DNP in palliative care. This has led to MUSC being considered one of the foremost international leaders in the world of palliative care. 

“I love my students, but the incredible affirmation and reward I get doing this global work is just hard to describe,” Cormack said. “I feel like every word we speak is soaked up. They’re just longing for the education. And they are so incredibly appreciative and grateful; it just fills me with pride to be working with them.”

Not so surprisingly, that excitement is a two-way street. Nicoleta Mitrea, a Romanian nurse, expressed her gratitude for the help Coyne and Cormack’s team provided. “This experience absolutely changed my world.” Her sentiments were echoed by Irena Laska, a nurse from Albania. “This has been extraordinary. In the short amount of time since that visit, I have helped my country understand the importance of palliative care. I am so grateful to have been a part of this.”

Never in a million years would Coyne have thought that that random encounter 30 years ago in Philadelphia would have led to the worldwide health care transformation he’s seeing today. 

“It is beyond rewarding to see that these people are taking what they’ve learned from us in the classroom and bringing it back to their countries,” Coyne said. “And the best part is they’re actually making a difference.”