Anne Merriman: “forceful and stubborn” physician who introduced palliative to countries across Africa

When 4 year old Anne Merriman saw pictures of sick children in Africa she announced, “I’m going to Africa to care for the poorly children.” This brash, single mindedness never left her. She spent more than 40 years in Africa, founding the pioneering Hospice Africa Uganda (HAU) and revolutionising end of life care in many countries across the continent. HAU has since trained more than 10 000 healthcare professionals in palliative care

HAU provides traditional, holistic, wraparound care with a difference. The Merriman model evolved from a simple recipe for cheap oral morphine that she developed with the Singapore National University Hospital chief pharmacist. Merriman declared manufacture of morphine as “easier than baking a cake.”

Ingredients included food colouring, a preservative, and a pound of morphine powder. Initially, weaker doses were dyed green, stronger ones pink and blue. A bottle cost around $2 (£1.47; €1.75) to make. Successfully introduced in Singapore in 1985, it was originally concocted in a kitchen sink, but is now mixed in industrial vats.

Merriman moved from Singapore to become the first medical director of a hospice initiative in Kenya, but left after three years, worn down by bureaucracy. She was a lone white woman in a world dominated by powerful men and there was widespread concern about the potential misuse of prescribed opioid drugs, especially outside hospitals.

She …