Born: May 13th, 1935
Died: May 18th, 2025
Dr Anne Merriman, a visionary humanitarian who introduced palliative care to Uganda and much of Africa, has died at the age of 90. Widely regarded as the “mother of palliative care in Africa”, she founded Hospice Africa Uganda (HAU) in 1993 to bring affordable, holistic, compassionate care to people suffering from critical and life-limiting illnesses.
Central to Dr Merriman’s mission was a model of palliative care with pain control which was affordable and accessible to some of Africa’s poorest communities. Over her long and distinguished career, she oversaw the care of more than 40,000 patients in Uganda, and facilitated the training of thousands of healthcare workers across Africa in palliative care.
She wrote several papers on pain management, and two memoirs – Audacity to Love (2010) and This is How the Light Got In (2023), both which capture the personal and professional journeys of a woman devoted to easing suffering.
Born in Liverpool on May 13th, 1935, to Irish parents Josephine (Josie) and Thomas (Toddy), Anne was the third of three children (Joseph, Oonagh and Bernard) raised in a Catholic household. She was educated at St Matthews Primary School and Broughton Hall High School. A defining moment came at the age of four when her mother showed her images of sick children in an African missionary magazine, Echo. Anne declared that she wanted to become a nurse and work in Africa. Her calling deepened at the age of 10 after seeing a film about the Irish Medical Missionaries of Mary (MMM) order of nuns, The Visitation.
At 18, she entered the MMM order in Drogheda, Co Louth, and was sent to study medicine at University College Dublin. She graduated in 1963 and began working as a general physician. She was sent to Nigeria by the order, where she cared for patients who were dying in pain and often alone. This experience impacted her deeply and sowed the seeds for her life’s mission.
Even though she left the MMM after two decades, Dr Merriman’s faith remained unwavering, and she retained a close connection to women she met in the order, many of whom were lifelong friends. Returning to the UK, she broadened her medical expertise as a consultant and associate professor in geriatrics and public health, and what was then the emerging field of palliative care. She was inspired by the founder of the modern palliative care movement, Dame Cicely Saunders.
In the 1980s, she moved to Singapore and became a specialist in geriatric and internal medicine at Tan Tock Seng Hospital. In 1985, she founded Singapore’s first palliative care service and cofounded what would become HCA Hospice Care, now the country’s largest home hospice provider. While in Singapore Dr Merriman developed an affordable oral liquid morphine formula to manage patients’ pain, made at a sink using water, preservatives and morphine powder. The integrated model of care – attending to physical, emotional, social and spiritual needs – became a hallmark of her work and would later be adapted for Africa.
[ A vision of a better world — medical missionaries who made a differenceOpens in new window ]
After a brief return to the UK, Dr Merriman focused again on Africa. In 1993, at the age of 57, she founded Hospice Africa Uganda in Kampala following feasibility studies she carried out in two African countries. With a small team and very little money, and a vision that palliative care should be available to all in need in Africa, she began what would become her most impactful work, using her determination and passion to succeed and overcome the many obstacles that stood in her way.
Merriman marked her 90th birthday on May 13th with a celebration Mass at her home where she perfectly expressed her life’s ethos, saying: ‘Compassion is such an important thing… not... only in work, but also with each other’
Her arrival in Uganda came at a critical time. The country had just emerged from war and was at the height of the HIV/Aids epidemic. Almost 60 per cent of the rural population had no access to healthcare, or cancer-related pain control, and the average life expectancy was just 38 years. She used her famous powers of persuasion to advocate for legislation to allow for the importation of morphine to Uganda to allow for the production of cost-effective oral liquid morphine for pain control.
She followed this up by successfully lobbying for the introduction of regulations to allow nurses and clinical officers, and not just doctors, to prescribe morphine, a vital step in expanding access in a country where physicians were then scarce. Her community-based palliative care approach, using nurse-led clinical teams to deliver care in people’s homes, was always respectful of the local culture, integrating all aspects of the patient’s and family’s wellbeing. It has become the widely accepted palliative care model throughout Africa.
From the first clinic in Kampala, two additional clinics followed: Mobile Hospice Mbarara and Little Hospice Hoima. She also founded the Institute of Hospice and Palliative Care in Africa, which has trained thousands of healthcare professionals in palliative care. Under her leadership, HAU’s International Programmes Department has supported the increased reach of palliative care services in dozens of African countries. When she began, only three African nations had such services. Today that number is 37 – a lasting tribute to her vision.
Dr Merriman received numerous honours for her humanitarian service. She was awarded the Most Excellent Order of the British Empire (MBE) in 2003 for her transformative contribution to healthcare in Uganda. In 2013, she received the Presidential Distinguished Service Award from President Michael D Higgins. She also received honorary doctorates from several institutions, including the National University of Ireland and Makerere University.
[ Dr Anne Merriman’s hospice brings dignity to the dying in UgandaOpens in new window ]
Until recent years, Dr Merriman was an annual visitor to Liverpool and Ireland, where she had huge support from Hospice Africa Ireland and Hospice Africa UK, two boards which fundraise for and champion her work. Hospice Africa France and Hospice Africa USA also support the work of HAU.
A rebel with a cause, Dr Merriman, or “Jajja” (the local word for grandmother) as she was fondly called by patients, staff and friends, was dogged and focused, with a wicked sense of humour. She was known for her huge interest in people and her ability to mentor. In recent years, Tuesday nights in her home, where she hosted volunteers, medics, students, religious and friends for dinners, were legendary.
In her downtime, she drew inspiration from the writings of Irish poet John O’Donohue. An animal lover, she kept rescue dogs and cats in her home in Kampala, where she was cared for by her devoted household team – Anne, Margaret, and Alice – whom, along with their children, she loved fiercely and regarded as her Ugandan family.
Dr Merriman remained active well into her final year. Just weeks before her death, she gave an inspiring online talk at Harvard Medical School’s Global Health and Social Medicine Department. She marked her 90th birthday on May 13th with a celebration Mass at her home where, in what were to be her last public words, she perfectly expressed her life’s ethos saying: “Compassion is such an important thing… not... only in work, but also with each other.”
Dr Merriman was predeceased by her parents, brothers and sister. She is survived by her nieces, cousins and second cousins, including Chris Merriman, chair of Hospice Africa UK, and extended family, and her extended Hospice Africa family.
