Determination through Setbacks
The Making of PCN-e's July 2008 Session - Palliative Care in Nigeria

I was indeed very happy and felt honored to have been invited to participate and contribute to a Palliative Care Network-e (PCN-e) session. The requirement was very simple considering the level of development and advancement in Information Technology (IT), but unfortunately may be elusive in some disadvantaged parts of the world.

I was advised to download and watch the first video session of the project to get an idea of what the session entailed.  This in itself took an eternity and was almost impossible with the low bandwidth. Thank God, the PCN-e team was considerate enough to suspend video transmission and switched to the audio format. 

There was a technical hitch during my pre-testing and I was advised to wait and prepare ahead for another month. Then came my turn (July session) and unfortunately my hospital broadband facility failed due to the ISP provider.

Trial sessions were practiced using the near by so called broadband cybercafés, which are usually in a market place with noise and clients playing loud music on the computer systems. Intermittent power outages occurred often (causing a pause for the electrical generating set to be switched on, the server to be re-booted and assigning me an address) while the PCN-e team waited on the other side.

The audio clarity was poor and as expected ceased intermittently and the PCN-e team often times had to continue the communication on my mobile line or finish our discussions with e-mails. It was decided that the conference should take place on my mobile phone, a test run revealed the usual problem of dropped calls, faint network, etc.  A landline was suggested; I used to have one but because of its inefficiency had recently decided to discontinue it. Its reactivation took 96 hours and another trial was done with my wife at home since the trial call coincided with the Hospice and Palliative Care Association of Nigeria (HPCAN) Scientific Meeting and the first annual general meeting of the association where I held the National Secretary portfolio and also saddled with the responsibility of presenting two papers.

The July audio session was scheduled for the day following the HPCAN program. I was not ready to call it off this time despite my tight schedule. Fortunately enough my hospital internet facility became functional and I rushed back from Ibadan venue of the National association meeting to Abeokuta, about an hour drive with the hope of joining the team. The internet speed was found to be very slow and suddenly a big dark cloud appeared signifying a heavy downpour of rain a few hours to the conference.

It was obvious that the weather would disrupt both the telephone and internet services.  The only option for me, so as not to be a big disappointment, was to jump inside my car and drive back to Ibadan hoping for better weather.

Dr. Folaju O. Oyebola
Head, Pain and Palliative Medicine Department
Federal Medical Centre, Abeokuta, Nigeria