Standing on The Shoulders of Giants

Sixty-eight years ago, two women met for the first time when they both joined the Medical Missionaries of Mary in Drogheda as novices.

One of them, Anne Merriman, was a 19-year-old, who had been born to Irish parents in Liverpool. Anne’s arrival to the Medical Missionaries of Mary  was delayed by a year as she didn’t have the hundred-pound dowry that she needed to be accepted by the order. She made it up by working in the Jacobs biscuit factory in Liverpool, saving every penny she earned.

The other was a 56-year-old woman, Dr Sybil Magan, who had for the previous 25 years been a GP in Granard, County Longford. Now widowed, Sybil had decided to join the MMMs with a view to using her medical skills in Africa. This intrepid and courageous woman was my grandmother – my mother’s mother.

They both had a vision of a better world. Sybil went to Tanzania, where she spent almost 20 years working in small hospitals. She was a formidable healthcare professional. I remember her describing a patient coming into the bush hospital she was running. The woman was going to die if she didn’t have an operation. The nearest hospital with an operating theatre was 100 miles away, they had no way to get the woman there, and even if they had, she would probably not survive the journey. Granny described saying a prayer, taking down a surgery textbook which had belonged to her surgeon brother-in-law – by then deceased – and asking him to guide her through the operation. The patient lived and went on to have a full life.


Later her sister, Molly, widow of the surgeon whom Sybil had called down, took grave exception to her sister calling on her husband to help. It was never to happen again, she insisted! I think granny hoped it would never happen again either, but it did more than once – on these occasions she was talked through the operations by a living doctor, remotely, via a radio.

Anne Merriman went on to study and became a doctor. 30 years ago, having left the MMMs, she started Hospice Africa Uganda and set about revolutionizing palliative care with a view to creating a model that would be applicable right across Africa. At the time oral liquid morphine – the most effective painkiller – was illegal in Uganda. Doctor Anne persuaded the government to legalize it, to allow nurses to prescribe it, and then set about manufacturing it to her own recipe in a kitchen sink. Hospice Africa Uganda now has a small liquid morphine production unit in their grounds in Kampala. Dr Anne has created a blueprint for access to oral liquid morphine for palliative care in Africa. When she started, only three African countries allowed liquid morphine to be prescribed to patients at the end of life – now some thirty-seven do.

Jean Callanan, Chair of IHF with Dr Anne Merriman MBChB, MBE, MCommH, FRCPI, FRCP

Visiting Kampala this summer, to get to know my grandmother’s friend and to learn more about palliative care in Africa, I got to see first-hand the impact of Dr Anne’s work. She and her team care for some 2,000 people who are terminally ill each year and the difference they make to the lives of their patients is phenomenal. There is very limited access to curative treatment for terminal diseases in Uganda, so palliative care is in most cases the only treatment – and is vital for alleviating pain. The Hospice Africa Uganda home care teams deal not just with the physical aspects of the disease, their approach is truly holistic.

When I accompanied them on home visits in the Katanga slums, the home care team brought food as well as liquid morphine. The cares of the family, as well as the patient, were addressed, and in many cases following the visit an envelope with some money was handed over, to help keep patient and family afloat. The dignity and love this team brought to their patients was humbling and inspiring.

Throughout my time in Uganda, I kept hearing about phenomenal Irish women. The word ‘Kevina’, used in Uganda to mean a hospital or Hospice, is derived from Mother Kevin Kearney, born in Wicklow in 1875 and founder among other things of the biggest hospital in Uganda.  Mother Kevin, I was delighted to hear, has been declared by the Vatican to be a  ‘Servant of God’, the first step to being canonised.

Truly we stand on the shoulders of giants.


As published by the Irish Times on 3/12/23