Dear Sir/Madame - International Association for Hospice & Palliative ...

INTERNATIONAL ASSOCIATION FOR HOSPICE & PALLIATIVE CARE
Promoting Hospice & Palliative Care Worldwide
IAHPC Board of Directors
NOMINATION FORM 2011
Thank you for your interest in nominating a candidate to the IAHPC Board of Directors.
Before you complete this nomination, please make sure that the nominee fulfills the
criteria below and that the rules are met.
Criteria for nominees:
Nominees may be located in any country, have academic backgrounds and must fulfill
the following criteria:
1. Have been active members of IAHPC for at least three consecutive years prior to
the nomination.
2. Have demonstrated work and commitment in palliative/hospice care in his/her
field.
3. Currently holding or having held a position within a teaching hospital, university
or palliative care organization.
4. Have demonstrated willingness to participate and work in the board activities
including working groups and task forces.
5. Have demonstrated interest in international palliative and hospice care issues
6. Be able to communicate effectively in English.
7. Candidates must have access to the Internet and hold an active e-mail account.
Criteria for nominators:
1. Be an active member of IAHPC at the time of nomination
Nomination rules:
1. Nominators may nominate one candidate only.
2. Nominations have to be done by submitting a nomination form.
3. Please submit a copy of a current CV of the nominee
4. Deadline for nominations is December 15, 2011.
Please complete this form and return as an attachment via email. Only electronic forms
will be accepted.
1. Nominator’s Contact Information:
a. Name of Nominator: Dr Alick Kayange MD, MPH candidate
b. IAHPC membership number: 2684
c. Title: Medical officer, Head pediatric section
d. Organization: PASADA
e. Address P.O.Box 70225
5535 Memorial Drive Suite F –
PH (936) 321-9846 FAX (713) 589-3657
Toll Free (866) 374-2472
www.hospicecare.com

INTERNATIONAL ASSOCIATION FOR HOSPICE & PALLIATIVE CARE
Promoting Hospice & Palliative Care Worldwide
f. City: Dar es salaam
g. Country: Tanzania
h. Telephone (include country and city codes):+255 714841324
i. Email address: kayangealick@yahoo.com
2. Nominee’s Contact Information
a. Name of Nominee: Dr Frank Anamo Manase.
b. IAHPC membership number: 1919
c. Title: Medical director PASADA / student, Masters of Public Health
d. Organization: PASADA
e. Address P.O.Box 70225
f. City: Dar es salaam
g. Country: Tanzania
h. Telephone (include country and city codes):________________________
i. Email address: fmanase@yahoo.com
3. In a separate document, please send an updated copy of the Nominee’s CV in
English.
(Find it attached to this email: admin@iahpc.com )
4. State other information relevant to the criteria for selection (ie past regional and
international palliative care work, experience at managerial levels or as member
of board of directors, specialized knowledge, recognized leadership, etc).
Past regional and international palliative care work,
Dr Frank has managed to introduce the family centered palliative care mode of
service delivery at our organization. Initiation of cancer clinics such as Kaposi’s
sarcoma, cervical cancer to people living with HIV/AIDS. He is the pioneer of the
monthly Family centered care meetings where as different specialties such as
social workers, nurses and doctors meet together to discuss the progress of our
patient. He was key stakeholder during the development of the national training
curriculum on palliative care;
Experience at managerial levels or as member of board of directors,
Member of the board of directors of Dar es Salaam Community Health
Program (DACHEP), PASADA.
Specialized knowledge,
Well trained in Medicine, palliative care, research and management
5535 Memorial Drive Suite F –
PH (936) 321-9846 FAX (713) 589-3657
Toll Free (866) 374-2472
www.hospicecare.com

INTERNATIONAL ASSOCIATION FOR HOSPICE & PALLIATIVE CARE
Promoting Hospice & Palliative Care Worldwide
Recognized leadership
PASADA medical director 2007-to date;
PASADA assistant medical director 2006-2007;
Dar es Salaam Community Health Program (DACHEP), member of
advisory body;
5. Explain why you believe that your nominee is highly qualified to serve as a
director in terms of IAHPC’s needs for board members who have regional and
international credibility within the palliative care field, are experiences managers
and/or board members and are committed to IAHPC’s mission, values, and
programs.
He has been a team lead pioneer of palliative care at PASADA and making it the
Centre of excellence in East Africa. He has managed to introduce family centered
palliative care mode of service delivery in order to reduce the burden of HIV and
AIDS. He has adequate skills and experiences in management.
He has attended several courses within and outside the country in management
and palliative care. This includes TB/HIV program management-Alert Ethiopia
July, 2008; Fellowship in Palliative Medicine-University of California San Diego
Hospice and Center for palliative care Studies-2006; Medical Ethics Training for
Doctors in Africa-Harvard School of Public Health- 2008; Principles of Finance
and Management-2006; Training on Palliative care and practical experience on
the use of oral Morphine-Muheza Hospice Tanga Tanzania 2006 and Emergency
Medicine Education and Development Course-The center for International
Emergency, Disaster, and Refugees Studies at Johns Hopkins- 2003; He is a
person with passion of seeing the wellbeing of other people who are suffering is
well taken. He is a person with a good heart.
6. Provide a brief description of the nominee that will be used for distribution to
IAHPC board members as part of the voting process (max 200 words).
Dr Frank Anamo Manase is a well qualified leader in the health field. As the
medical director of PASADA, he has managed to pioneer palliative care
services/family centered care services which have made our organization as the
centre of excellence in palliative care. Through his initiative, many young
physicians and nurses has been trained as palliative care nurses or doctors. This
includes workers from the well known palliative care institution like Ocean road
cancer institute and Muhimbili national hospital. He is the man of integrity,
focused, hard worker with a strong team building capacity. He has been also a
member of advisory board of Dar es Salaam Community Health Program
(DACHEP)
5535 Memorial Drive Suite F –
PH (936) 321-9846 FAX (713) 589-3657
Toll Free (866) 374-2472
www.hospicecare.com

INTERNATIONAL ASSOCIATION FOR HOSPICE & PALLIATIVE CARE
Promoting Hospice & Palliative Care Worldwide
Thank you for completing this form. Please submit as an electronic file (word or pdf
format) to admin@iahpc.com
5535 Memorial Drive Suite F –
PH (936) 321-9846 FAX (713) 589-3657
Toll Free (866) 374-2472
www.hospicecare.com