A Liverpool woman's African legacy

By Simon Hart

Anne Merriman has a tale to tell about an encounter with a scientist from Finland. 'I was at a conference in London and this lady came to me and said, "Would you mind if we nominated you for the Nobel Peace Prize?" When they picked me up off the floor and dusted me down, she talked to other people there who thought it'd be a great idea.'

That nomination, in 2014, was for the contribution that the Liverpool-born Dr Anne Merriman MBE (to use her full title) and her team have made to palliative care. It is an exceptional contribution and one celebrated closer to home last month with an ecumenical thanksgiving service at Christ the King parish church in Liverpool to mark the 25th anniversary of Hospice Africa, the charity that Anne established in 1993.

'We saw the first registered patients on 23 September 1993,' she elaborates and in the quarter-century since, Hospice Africa has provided care to 32,000 cancer sufferers in Uganda, as well as supporting initiatives in 32 other countries. 

Anne, now 83, had first travelled to Africa as a Medical Missionary of Mary, before working back in Liverpool as a consultant and senior lecturer in geriatric medicine on returning to secular life. It was on taking up an academic post in Singapore in the 1980s that her work in palliative care began. 'We commenced the Hospice Care Association from my flat,' she says. It was there too that she created a formula for the affordable oral morphine so pivotal to her work in Africa.

On her subsequent appointment as medical director of Kenya's newly opened Nairobi hospice in 1990, she insisted she 'wouldn’t go there without the morphine'. She adds: 'This formula changed the face of palliative care in Africa because the low economies cannot afford oral morphine manufactured and imported from abroad.'

Hospice Africa today has 70 people working across three sites in Uganda. She continues: 'Our oral morphine in Uganda has four ingredients, including cake dye to differentiate the strengths. It's now used in 21 African countries.' And it is produced by Hospice Africa staff. 'We made it at the kitchen sink for 17 years and then the American Cancer Association came in to help us manufacture it with a contract with the Ministry of Health for the whole country.'

It figures on a long list of success stories. Hospice Africa established the Palliative Care Association of Uganda. It has trained thousands of health-care professionals, having established an institute that confers degrees and diplomas on nursing staff. 'We have a diploma they can do – it's a year and allows them to prescribe morphine. That has helped a lot as 90 per cent of districts have at least one person who can prescribe it.'

Yet a year's training costs $2,500 and Hospice Africa requires fresh funds. Its volunteer-run shops in Old Swan and Ainsdale contribute around £4,000 per month but a ten-year partnership with international development agency USAID has now ended. 'Donors are now in recession and have reprioritised what they do with their money,' says Anne. 'Palliative care is their lowest priority. For this coming year we're short of £300,000.'

Anne missed last month's 25th anniversary celebrations, including a ball at West Lancs Golf Club, owing to ill health, yet her first two Ugandan nurses, Rose and Martha, flew in to attend – a measure of what her efforts have meant and why she is so determined that they will carry on. 'But,' as she adds, 'the oil to keep it going is the funding and without your help, it cannot continue.'

To contribute, write to Pat Linnell, Honorary Treasurer Hospice Africa, 41 Harrison Hey, Liverpool L36 5YR, or visit: https://mydonate.bt.com/charities/hospiceafrica