(ይህንን ፖስት (ልጥፍ) በአማርኛ ማንበብ ትችላላችሁ፡፡)

In the day care centre for people receiving palliative care at the only hospice currently operating in Ethiopia, Flagot Tadele and Wengel Yared run music sessions. Flagot has been working as the Senior Palliative Nurse for around four years and Wengel, the Programme Manager, has been working for the hospice for about two years. Flagot’s responsibilities include seeing up to 6 patients every day based on the severity of their illness to provide palliative care, and social and spiritual support; Wengel is responsible for planning, organising and reporting on all Hospice Ethiopia’s projects and trainings.

Wengel and Flagot both say they did not have any formal music training background before learning the basic principles of using music in a therapeutic way from Music Therapists Emma and Erin (2022). However, they have been surrounded by music in their wider community – watching and participating in dancing and singing to Ethiopian traditional music during special occasions, which Flagot particularly enjoys. When Flagot joined the Hospice Ethiopia team and other nurses who learned from Music Therapist Hannah and her assistant Lily (2018) shared with Flagot their music skills,  bringing her own cultural music experiences to her work was an organic development. 

Flagot remembered seeing patients gathering to enjoy music together from the first music session she saw led by one of her colleagues. Flagot had never seen this type of musical activities in previous workplaces, but at the hospice she saw how the music sessions gave patients the opportunity for different interactions. 

The first music session Wengel ever saw was led by Flagot and involved cultural music playing in the day care centre with patients playing local instruments, like Keberos. Wengel was interested to see patients jumping up to dance and remembered the moment being very happy for everyone involved. 

The very first session Wengel observed being led by Erin and Emma was another significant moment for Wengel.

In that moment I could understand that even if you don’t communicate with the language then music kind of brings everyone together. So they don’t know the patients and cannot communicate in Amharic but they loved each other. They kind of communicated in a way that I don’t understand. But it was such a happy and vibrant moment. They taught us different techniques and we were practicing that techniques with the patients and it was easy to do and it was interesting, so we kind of see it has an impact.

Wengel

Flagot explained how before the training in 2022, music sessions largely included listening to recorded Ethiopian songs or using musical instruments to play traditional music.  Erin and Emma showed other ways of using music which was interesting and more interactive, especially as patients could also take the lead in some activities.  Wengel recalled after learning the different music techniques and seeing some sessions, leading her first session seemed difficult as it was something new for her to do, but it became easier after a while as the learning experience was interesting and fun. Now around 20 patients each year participate in the group music sessions offered as part of the day care centre’s activities.

Wengel and Flagot spoke about a current day care patient with various serious illnesses who appreciates accessing the day centre and loves the music sessions, particularly playing the Kebero. The patient was also very fond of the time with Emma and Erin and referred to the music therapists as ‘lije’, which is a polite and complimentary way of saying ‘my child’.

When Wengel and Flagot started leading sessions in the way they learnt from Emma and Erin, there was confusion at first for the patient as the sessions changed from only involving the use of cultural music to using music in a different way. However, the patient quickly became used to the new sessions as the way in which music was being used was not complicated. For example, the patient was shy to lead in a musical activity but once encouraged by everyone to lead, leading became one of the patient’s favourite things to do in a musical activity.

Wengel observed the patient becoming happier over the course of participating in the music sessions and less deep in thoughts. Flagot noticed how the sessions gave herself the chance to get to know the patient more, especially their interests and dislikes. The benefits of the music sessions for the patient have been enjoyment, social interaction with other people, and a mechanism to cope with stresses and personal issues.

Flagot and Wengel have noticed similar progress with other patients and have also seen music sessions helping other patients to open up, be present in the group sessions, and connect with others.

The music therapy helps them to interact with themselves. And we’re just using it as a pain distraction. It is one way of a distraction from their pain and psychological issues, social issues. It gives these benefits other than enjoyment.

Flagot

Another day care patient with serious illnesses who previously accessed the day centre, also enjoyed the music sessions. Initially this patient preferred the old way of music sessions that focused on listening and dancing to traditional music.  At first, she was not particularly interested in engaging with certain musical techniques, such as conducting, but she became open to music being used in the new ways introduced from Emma and Erin’s training. Flagot saw the patient connect with others and express herself more because of the music sessions. The patient seemed relieved of social and psychological issues when speaking about the issues with friends at the day centre and when entertained by music. 

It sounded like she began to feel a strong sense of belonging at the Hospice as she told the staff how she would proudly tell her neighbours that she was going to visit her family at Hospice Ethiopia whenever they asked her where she was going.

Observing patient’s happy emotions and hearing patient’s positive feedback of the sessions confirms to Flagot why she believes using music in a therapeutic way is important; and for Wengel, increased group communication is why the use of music is important.

Seeing them [patients] smile and then seeing them try to use the instruments is such a happy moment and it make us proud.           

Wengel

Hospice Ethiopia hopes to expand its services in the future by offering hospice care to children. Whilst Wengel and Flagot are not yet sure how the children would access sessions, they think the use of music would have a significant impact on children.  They can see music being an effective way to distract children from their physical pain. Flagot and Wengel imagine it being easier to adapt the techniques of musical activities for children and being able to have more varieties of musical activities for children compared to adults, particularly because they feel that adults can have more specific preference in the type of music they like to listen to than children.

There is also interest for Hospice Ethiopia to start using music when they provide home care, but Flagot is aware there will be social and cultural issues to consider carefully when using music in home-based care.