When you are healthy you belong to yourself - when you are sick you belong to your family.
Reflections on an Evening With Dr Christian Ntizimira and the African Framework of Community at the End of Life
Last night I spent my Friday evening in the company of the wonderful Bec Lyons and the Australian Home Funeral Alliance, listening to a Zoom session that I’m still thinking about this morning. It was one of those talks that gently rearranges something inside you.
Our speaker was Dr Christian Ntizimira, a physician, author, and global advocate for integrating palliative care into oncology. He is the founder and executive director of ACREOL, and the author of The Safari Concept: An African Framework on End-of-Life Care. His work focuses on expanding access to compassionate, holistic care in low‑resource settings and advancing culturally grounded models that honour suffering in all its dimensions.
Dr Ntizimira’s book describes The Safari Concept as “a groundbreaking approach to palliative care that transcends cultural and linguistic barriers. By recognizing the importance of family and community in African cultures, the concept invites them to participate with medical caregivers in decision‑making and care, as they have for millennia.”
After hearing him speak, I understand exactly what that means.
The session explored what we might, from a Western lens, call the African way of end‑of‑life care — except, as we learnt, that phrase doesn’t exist in many African languages. There is no “end‑of‑life care” as a category. There is simply community, right up until your last breath.
Dr Ntizimira spoke about the history of African beliefs around dying — before colonisation, before Christianity, before the medicalisation of death. He described how dying was once considered an honour, a celebration of a life lived well, not something to fear or fight. A “good death” was measured by whether children were present. To have children witness your death was considered a blessing, a sign that your life had been lived in such a way that the next generation could safely be present for your final moments.
“What a beautiful, ancient way to measure success.”
It made me think about how, as children in the West, we’re taught — directly or indirectly — to avoid death. Even when the words aren’t spoken, the tone is clear: death is something to fear, to hide from. Last night’s session gently poked at unravelling that conditioning.
Throughout the talk, the chat was full of little heart emojis and comments from people who were just as captivated as I was. The photos, the stories, the cultural wisdom — it all felt like a privilege to witness.
One moment that stayed with me was when Dr Ntizimira shared a faux pas from early in his career. He described walking into a palliative care room in Boston, holding the hand of a woman nearing the end of her life. Seeing photos all around the room, he tried to comfort her by saying, “Don’t worry, you’ll be with your loved ones soon.” But the photos weren’t of people who had died — they were of people who were very much alive.
He was confused. If they’re alive, why aren’t they here?
In Rwanda, he explained, the whole village would be present. There would be no need for photos on the wall — the people themselves would be gathered around the bed.
That contrast struck me deeply. Not as a criticism of Western ways, but as a reminder that there are other ways — ways rooted in presence, connection, and community.
And this wasn’t a romanticised “old ways are best” session. Dr Ntizimira spoke honestly about the real challenges: navigating family conflict, balancing cultural traditions with individual wishes, and the tension between personalised care and medical intervention. These are themes I hear echoed here in Australia, thousands of kilometres from Africa.
“Our cultures differ, but our humanity is familiar.”
One line that I can’t stop thinking about is his explanation of the word palliative. In Rwanda, it translates to “to be present.”
How beautiful is that.
I think I’ll quietly adopt that meaning from now on — to be present care.
Before the session ended, I ordered Dr Ntizimira’s book. I’m not affiliated in any way, and I won’t earn a cent from recommending it, but if you’re looking for a new read — or if you ever get the chance to listen to him speak — I highly recommend it. Listening is such a powerful tool for knowledge, and last night I felt genuinely privileged to listen.
One last thought -Dr Ntizimira spoke of how his book is most often purchased in the UK & Australia, a sign that perhaps that western culture is looking for a different way of caring for our dead - a way to reclaim knowledge, take away fear and fully embrace the only one experience we all will share.