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Living with Cancer...

• An interview with Mary Dolding, one of the founders of the Gibraltar Society for Cancer Relief
  by Anne Mesilio.

A rather sobering statistic is that 1-3 of us will get one of the over 200 types of cancer that are known today. The organs and tissues of the body are made up of tiny building blocks called cells, and cancer is a disease of these cells. It is not a single disease with a single treatment and Dame Cicely Saunders, (1918-2005) founder of the Hospice movement recognised this, “We have to concern ourselves with the quality of life, as well as its length”. A nurse, social worker and doctor she founded the movement to provide compassionate care for the dying. She established new methods of pain control and a multi-faceted and holistic approach to care giving.

This approach is achieved in Gibraltar through the Gibraltar Society for Cancer Relief which concerns itself with the training of paliative care nurses, now known as Cancer Relief nurses, to provide hospice at home facilities for those in need. Mary Dolding, one such retired nurse, chatted to me and told me about the beginnings of this worthwhile work. “I came to Gibraltar in 1971 with my husband David who was involved in building Glacis Estate. I’d always wanted to be a nurse, so when St. Bernard’s Hospital advertised for nurses in 1976 I applied and did my three years training”. She worked there until 1983 when as the result of a back injury she was transferred to the health centre. “My youngest child was 12 years when I started, and during that time I was also Commissioner for Guides, working with the young and healthy balanced working with those who were sick”. In her gentle easy way Mary recounted the history of Cancer Relief in Gibraltar with which “I have always been associated in one capacity or another”.

I learned that in January 1981 Maureen Stansfield had come to Gibraltar with her husband and she had begun to work as a midwife. In that first year she became aware of quite a few young deaths from cancer, so thinking of her hospice background, she had trained at St. Anne’s in Cheadle, she decided to do something about care for those terminally ill in Gibraltar. Despite her enthusiasm and talks with various people, GP’s, clergy and friends she could not raise any specific interest at that time. Then in October 1982, at a Bible study session with an army Padre the subject of death arose and Maureen grasped the opportunity to put forward her hospice ideas again.

This time, a lot of interest was generated. It so happened that the then Governor's wife, Lady Williams, had asked a Naval Padre, Simon Stevens, in Gibraltar for only a short time, to undertake a survey on her behalf as she was interested in palliative care. This word comes from the Latin “palliere” to cloak, and it is any form of medical care or treatment that concentrates on reducing the severity of disease symptoms by preventing and relieving suffering and improving the quality of life in those facing serious illness. This was a timely interest as Simon undertook the survey which showed there was indeed a need.

A meeting was called to suss out the possibility of opening a Hospice on the Rock and Lady Williams agreed to support the scheme as long as it had the support of the hospital Administrator, Mr. Bromley. “Why did she need the administrator”? Mary explained, “He had to be involved because it is medical work and there was a need for him to take on payment of palliative care nurses, though Cancer Relief paid for a year, but could not meet the on going salaries”. However, at the first meeting at the hospital the proposed scheme was not thought viable, and when Lady Williams heard this she arranged another meeting at the Convent. Dame Cicely Saunders was invited to come and give a talk but this was not possible and Dr. Fisher came in her stead. He was the founder of hospice care within the NHS.

He came and gave a slide show and talk at the Convent which resulted in the setting up of the following committee. It consisted of; Lady Williams, President, Lillian Pitaluga, chairperson, a barrister as legal advisor, a banker as treasurer, Maureen, Secretary, Mr. Bromley as medical consultant, a Catholic priest, a Jewish businessman and two house wives. Meetings would be held at monthly intervals and the first one took place on April 26th 1983. What were its aims I wondered and Mary enumerated; (1) community care, (2) lending of equipment, (3) education and the possible addition of a day care centre and small two bedded unit. It was also decided to send a State Registered Nurse for training. The work of the Cancer Relief nurses is quite different from hospital nursing as their job is to support the family helping them nurse their relatives at home, and work with the doctors in helping to prescribe adequately for symptom control and pain relief.

This was certainly a new venture for Gibraltar and I asked Mary how it was received. “Negatively at first”, she conceded, “people would cry and say relatives could not possibly stay at home because of children etc, but”, and she smiled her sweet smile, “I was able to help them, it was quite easy really and gradually word spread and in my first year eight people died at home with their families caring for them”. “Men fear death as children fear darkness”, (Francis Bacon,) and to fear death is neither a sign of shame or weakness. Today, many people with help are willing to have relatives at home, and Mary believes; “the best gift you can give anyone is to let them die at home in their own bed, and” she continued, “as long as pain and symptoms are controlled”.

I asked about the setting up of the Day Care Centre. “That was in 1984”, she recalled, “ thanks to the TGWU, we started in Transport House having being told that all we needed were two chairs and a kettle. Well”, she chuckled, “we had one chair and the kettle so I asked Jose Netto, do you need that chair in the foyer and he replied, oh, take it Mary, and we were ready, we had all we needed to start”. It transpired the GBC social club was closing down so they donated all their equipment, microwave etc and the Forces sold them a rather large carpet for the princely sum of £1. “For that we needed a hoover”, and two ladies who had just raised some money donated it for that. “It was wonderful to have so much support”. From there, the centre graduated to the Lady Williams Day Care Centre in Devils Tower Road in 1990. At the beginning this building was shared with the guides of whom Mary was Commissioner. The centre opened three days a week and Mary would take along her patients. Lunch was provided, bathroom facilities were available and hair and nail care was also offered. Maureen Stansfield was the first leader, then Marisa Desoiza and presently Helen White. “This was much more congenial to our needs”, Mary enthused, “ we had a lovely garden and access to the centre was easy too. Also, our volunteers, 60 in all were outstanding in their commitment and care”, Mary spoke with real feeling. I could take all that on board but had to wonder if needs have changed. Mary explained that these days most people with cancer have changed from being terminally ill to those who have survived it, to those who are actually living with it now. The Cancer Relief nurse exists to help improve the lives of people living with cancer , as well as those of their families and carers. This is achieved by providing practical, medical and emotional support.

The emphasis is certainly on the living, and the present centre is beginning to reach its ‘sell by’ date after nineteen years as it needs to cater for ever increasing and new demands. Since the guides moved out a new gym and library has been incorporated and there are aromatherapy and reflexology therapies also being offered. “We need a purpose built building to accommodate all these new demands and fresh awareness has to be raised. To this end”, Mary explained, “we are holding a year of promotion with events to be announced, as we need the continued support of the public”. Mary spoke about her dreams of new facilities she would like to see in the future for those requiring palliative care, and went on to say that there are already specialised nurses in hospital who have undertaken the palliative care degree and a lot of work does take place in hospital under their excellent care. The Hospice is a wonderful movement, but extremely expensive to run so for Gibraltar a purpose built building is the ideal answer. Mary is optimistic for the future. “Selena Victory has been appointed Cancer Relief nurse, we have some volunteers who have been with us since the beginning and are over 80 years old, but we still need a large band of volunteers to cook three course lunches, drivers, therapists, and maintenance as the centre enters old age. The support of the whole community, who fund raise to an incredible degree, is highly valued. Mary; “We have come a long way and we want to carry on”. She does not doubt that this will be so.