Dame Cicely Saunders

 

Cicely Mary Strode Saunders, was the founder of the modern conception of hospice and, also established the discipline and rigor associated with palliative care – a type of care with the primary goal of relieving pain and distress in patients with severe and often terminal illnesses. By definition, a hospice is a home for the severely or terminally ill patient.

Cicely Mary Strode Saunders was born in Barnet, Hertfordshire, England in 1918. She was the eldest of three children. Saunders’ family was financially well-situated; however, the household environment was deeply affected by a controlling father and a remote and withdrawn mother. The family lived in in a large house with spacious grounds.

When Saunders was just one years old, she was cared for by her Aunt Daisy. This arrangement was soon abruptly ended and she was subsequently returned to her home and sent to Roedean School when she was 10 years-old. At school, Saunders was taller than the other girls. This difference made her feel awkward and separate from her peers. she felt that this aspect of her growing up made her come to appreciate those who were considered different. As a child Saunders suffered from scoliosis – defined as a sideways curvature of the spine - severe enough that she was made to lie flat on the floor for 40 minutes a day.

These experiences as a child may have contributed to her desire to be of service to others and become a nurse. Her father did not approve of this choice of possible careers. As a result, she went to St. Anne’s College in Oxford where she pursued the study of politics, philosophy, and economics with the goal of eventually working in government.

However, the outbreak of World War II that began when Germany - under the aegis of Adolph Hitler - invaded Poland (1939), disrupted this career path, and, defying her father’s wishes, she enrolled as a student at The Nightingale Training School to become a Red Cross war nurse. During her training, she had rotations at several mental hospitals and worked at the Park Prewett Hospital in London. Physically, the work was very stressful, and placed an additional burden on her back. As a result, she returned to Oxford for a year and gained a "war degree." She was trained at the Royal Cancer Hospital that qualified her as a social worker (almoner), in 1947.

It was in the following year that a life-changing experience altered the course of her professional career. While working at Archway hospital in London, she cared for a Polish émigré, David Tasma, who was dying. In the course of her caregiving, Saunders and Tasma became intensely involved with each other. In their conversations, the idea occurred to them of founding a home in which people who were dying could find some solace and peace in their final days. On his death, he left her 500 pounds as seed money to realize this dream.

Saunders was advised by professional colleagues that if she truly wished to realize her dream, she should obtain a degree in medicine as a doctor. It was reasoned that with this credential she would be more readily listened to. In 1957, she became a physician graduating from St. Thomas’ Medical School in London. She broadened her knowledge in pharmacology so that she could better understand how to alleviate pain in terminally ill patients. With this knew knowledge, she became a powerful advocate for the regular administration of pain medications to such patients rather than supplying them on demand.

In 1958, shortly after she qualified, she wrote an article concerning a new approach to the end of life. In it she stated that, "It appears that many patients feel deserted by their doctors at the end. Ideally the doctor should remain the centre of a team who work together to relieve where they cannot heal, to keep the patient’s own struggle within his compass and to bring hope and consolation to the end."

During this time, Saunders began to formulate her vision for a facility devoted to the care of terminally-ill patents. She envisioned a facility that would provide emotional and spiritual support in addition to the traditional focus on medicine. She also appreciated the value of providing a comforting and homelike environment to those at the end of life. Saunders also kept in mind the need to offer support to the families of patients as well, recognizing the stressful aspects of end-of-life issues.

By 1959, she had drawn up a detailed proposal for the hospice she had in mind. After an intense period of negotiation, construction began in 1965 – it was to be called St. Christopher’s Hospice located in South London. It was opened in 1967. It has since become a prime model for hospice care to this date, that is emulated throughout the world.

Saunders spent her final days at St. Christopher’s along with her husband, Marian Bohusz-Szyszko. He passed away in 1995 and she continued working until the end of her life in 2005.

The extent of the contribution Saunder’s has made to the caring of the terminally ill might best be expressed in her own words taken as an excerpt from her acceptance address of the Templeton Prize given on May 12, 1981.

“For over 1,000 years hospice was a resting place for pilgrims, giving them a welcome that lasted till they were ready to go on. For a few, the sick and wounded, it would have been the last stage. For the past 100 years or so hospice has also meant a foundation, still religious, admitting those with incurable illness when the hospitals would no longer care for them. Founded on both sides of the Atlantic and in Australia around the turn of the century, they were for patients dying of cancer and of tuberculosis and with long term illness when the only alternatives were the Poor Law and similar Institutions. Among this group it was the Irish Sisters of Charity who chose the name Hospice, first in Dublin, later in Hackney and applied it especially to those who were dying.

“Over the past decade the word has been filled up with new meanings and has come to stand for a world-wide movement identified by attitudes and expertise rather than by bricks and mortar, for many hospice teams have no beds of their own. I would define the modern hospice as a skilled community working to improve the quality of life remaining for patients and their families struggling with mortal and long-term illness. Some also include the frail elderly. Hospice is about a special kind of living and in a sense is still concerned with travelling: patients, families, elderly residents and the staff and volunteers who meet them, find they are drawn into a journey of the spirit.

“However, this new development began with a building when you, Ma’am, opened St. Christopher’s in July 1967, when we took the word Hospice from St. Joseph’s, generous in this as in everything else. Not the first hospice, but the first planned not only to care for a mixed group of patients but also to develop research and teaching.”

It is for these reasons that the name and person of Dame Cicely Saunders has become synonymous with what is regarded as modern hospice care. Without her clear and compassionate vision, the pain and suffering endured by the terminally ill would not have been so effectively curtailed.

Raif Badawi - Saudi Activist & Political Prisoner

 

Raif bin Muhammad Badawi gained notoriety when he was arrested in 2012 at the age of twenty-eight for the following crimes: "setting up a website that undermines general security", "ridiculing Islamic religious figures", and "going beyond the realm of obedience.” He was sentenced to seven years in prison. This sentence was increased to 10 years in 2014.

Badawi is a is a Saudi writer actively engaged in advocating for a more liberal social and political environment in his native Saudi Arabia. To expand his audience, he created a website – Free Saudi Liberals.

Badawi's blog had many members. It quickly became a forum for vigorous debate regarding Saudi politics. For this reason, he was arrested in late 2007. Although he was eventually released, he became the victim of constant harassment that eventually led to his subsequent arrest in 2012.

Raif Badawi was born on January 13, 1984, in Khobar, Saudi Arabia. His parents are Najwa, a Lebanese Christian, and Muhammad Badawi, a Saudi Muslim. At a young age, his Saudi grandmother explained to him that, “Saudi society historically was not as strict and men and women used to work together in the fields.”

Badawi's mother died young at an unknown age. He was raised by his father and grandmother in a household beset by economic difficulties. Badawi attended school until the age of thirteen when his father reported him for parental disobedience, a crime in Saudi Arabia, and spent six months in a teenage detention center.

Saudi Arabia is a theocratic monarchy whose laws and regulations follow the rulings and teaching of Islamic law. The legal system is based on sharia as interpreted by Sunni Islamic jurisprudence. The government is under the leadership of a king and prime minister. Furthermore, the royal family rules by fiat, and there is no Constitution.

Wahhabism is an Islamic revisionist theology that exerts a powerful influence in Saudi Arabian politics. It derived its name from the teachings of Muhammad ibn Abd al-Wahhabi. Wahhabism is an extremely stringent and uncompromising from of Islam that insists on a purely literal interpretation of the Koran. Through this highly restrictive interpretation, those who do not practice this form of Islam are considered heathens and are dealt with harshly. In Saudi Arabia apostasy itself is considered a crime worthy of the death penalty.

Badawi was influenced by the writings of progressive Arab author, Abdullah al-Qasemi, and Turki al-Hamad, a noted journalist and thinker. He was particularly inspired by Mohammed Saeed Tayeb, a staunch believer in democracy who was also imprisoned.

Ultimately, he became so concerned about the oppressive and authoritarian nature of Saudi politics that he began to speak out openly in regard to these concerns. For this reason, Badawi’s activities were considered by the government as anathema and explains the severity of the punishment he has been forced to endure. Badawi’s courageous insistence on expressing his views has been regarded as a particular threat, for the government’s autocratic imposition of Islam on the lives of its people is especially vulnerable in the human world of the twenty-first century in which global communication is a predominant aspect of modern life.


He has been reported to be in poor health, and his general condition has noticeably worsened during his imprisonment and torture according to his wife, Ensaf Haidar, currently residing in Canada. She fled her native country convinced that her life would be endangered if she remained in Saudi Arabia.


The following interview with Ensaf Haidar was conducted by Jaafar Abdul Karim at Deutshe Welle (dw.com) in 2017.


Ensaf Haidar: The fact that my husband has been in jail for five years shows that there is no freedom of expression in Saudi Arabia.

Raif expressed his opinion in a friendly and peaceful manner, so there was no reason to be afraid. He had also written for Saudi newspapers, and that shows that he wasn't an enemy of the state. He even had the experience of traveling abroad.


So why are some states so afraid of these independent spirits?

Because of the different opinions. It's us they're afraid of, not the expression of opinion as such.


So they would prefer there to be only one opinion?

This is what their approach suggests. They want everyone to be of the same opinion. They're afraid of a wide range of opinions.


How is your husband doing at the moment?

After five years in captivity separated from his children and the outside world, he's naturally doing poorly physically and psychologically. He has been imprisoned for five years without having committed a crime.


Of course, the Saudi authorities see the situation differently. What do you tell your children? Do they understand what's going on?

They understand it and are proud of their father, though they miss him very much. They need him, especially at this age.


Do you stay in constant contact with Raif?

In the beginning he always called me for brief periods of time, but I haven't heard anything from him in over three weeks.

If we had press freedom, Raif would be free. He's been in jail for five years and he'll be there for five more. Along with that he's also been handed a 10-year travel ban, a fine of one million riyal ($266,654 USD) and 1,000 lashings by cane. Anyone who sees this sentence can decide if we have press freedom here or not.


How important then is freedom of expression?

There are people who say there is already too much division; there's terrorism and there's foreign interference, which undermine a country's sovereignty.

Those who speak peacefully and know the laws have the right to express themselves! That is a basic right of every person, whatever the subject.


Do you speak with your children about freedom of expression?

That is a social issue and not just a legal one. From society as well there is a partial rejection of freedom of expression…

Here in Canada it is, of course, completely different. It's a secular country, where you can express your opinion freely, directly in the press. When I tell my kids about their father, they don't understand what the problem is at all with someone having a blog. It's completely different here.


There is an international solidarity campaign for your husband. How does that make you feel?

I can only be thankful and hope that the initiators continue with it. However, so far it has had a psychological effect. It hasn't impacted the proceedings against Raif so far. But I hope that the solidarity continues nonetheless, because moral support is so important. That gives Raif and me hope and strength.


Do you personally hope that pressure from the campaign will help free Raif? It is now an international campaign.

I hope that the Saudi government one day recognizes that freedom of expression is every man's right. Raif always peacefully expressed himself and loved his country. In this way I hope that he soon comes free.


What is your appeal for World Press Freedom Day?

I hope that the whole world continues to stand by us. I call on the Saudi government to give every citizen a space for freedom of expression.


Badawi is currently represented by The Raoul Wallenberg Centre for Human Rights that acts as his international legal counsel. The mission statement of this organization is the following as presented on their website (raoulwallenbergcentre.org).


“The Raoul Wallenberg Centre for Human Rights is a unique international consortium of parliamentarians, scholars, jurists, human rights defenders, NGOs, and students united in the pursuit of justice, inspired by and anchored in Raoul Wallenberg’s humanitarian legacy – how

act can confront evil, prevail, and transform history.

“From mid-May to early July 1944, the Nazis deported 440,000 from Hungary to the Auschwitz Birkenau death camp – one of the most efficient, cruelest, and most horrific mass deportations in the Holocaust. Raoul Wallenberg arrived as a Swedish diplomat in the Swedish legation in Budapest in July 1944 and in six months saved 100,000 Jews.

“The Wallenberg Centre is organized around five pillars of pursuing justice, each of which reflects and represents Wallenberg’s humanitarian legacy. The Honorary Co-Chairs of the Raoul Wallenberg Centre for Human Rights are: Nobel Peace Laureate Elie Wiesel (U.S. – in memoriam); the Honorable Justice Rosalie Abella (Supreme Court of Canada); the Honourable Göran Persson (former Prime Minister of Sweden); and the Honourable Elyakim Rubinstein (Former Deputy President of the Israeli Supreme Court). The Centre’s Founder and International Chair is Professor Irwin Cotler and the Co-Chairs from countries of Wallenberg’s Honorary Citizenship include Jared Genser (US); Michael Danby (Australia); and Natan Sharansky (Israel).”


The goal of this organization is to use the global media as well as private diplomatic efforts to help secure Badawi's release from prison.

According to this organization, “Raif Badawi has been languishing in a Saudi prison since his arrest in 2012, and his subsequent sentencing in 2014 to 10 years imprisonment and 1000 lashes, itself constitutive of torture and a standing violation of International Human Rights Law. Badawi's "crime"? Establishing an online forum and exercising his right to freedom of expression. Despite Saudi Arabia expressing an interest in reforming and modernizing, Raif Badawi – an advocate of liberalism and tolerance, and the champion of these changes – remains imprisoned and separated from his wife and three children, now citizens of Canada.”


While his exact location is unknown, it has been reported that Badawi is currently imprisoned in Dhahban Central Prison.


Following the 2012 arrest, Amnesty International designated Badawi a prisoner of conscience. As reported on their website – amnestyusa.org,

“In May 2014, Raif Badawi was sentenced to 10 years behind bars, 1,000 lashes, a 10-year travel ban, and a lifetime ban from appearing in the media. He was convicted of violating Saudi Arabia's draconian information technology law and "insulting Islam." The conviction stems from number of articles Raif wrote and published on his site "Saudi Arabian Liberals," which he founded as a forum for social and political debate. Raif also refused to remove other Saudi writers' articles from the site.

"We want life for those who call for our death, and rationality for those who desire ignorance for us." -Raif Badawi


“The charges against Raif are related to articles he wrote criticizing religious authorities in Saudi Arabia, and pieces penned by others that Raif published on the Saudi Arabian Liberals' site. The prosecution had called for him to be tried for 'apostasy' or abandoning his religion, which carries the death penalty.

“Raif is one of many activists in Saudi Arabia persecuted for openly expressing their views online. Facebook and Twitter are incredibly popular in a country where people can't openly voice their opinions in public. The authorities have responded to this increase in online debate by monitoring social media sites and even trying to ban applications such as Skype and WhatsApp, further stifling free expression.”

Badawi’s unshakeable determination and remarkable courage as an advocate of human freedom and the right to express one’s views openly are of great value to us all, and a reminder of the inherent power of the human spirit.