How to be a friend right to the very end

WHEN Linda Sakr was training as a counsellor, she went in search of voluntary work to the Job Centre where a charity called The Befriending Network caught her eye.

"They wanted volunteers to train to support people with life- threatening illnesses, in a relationship of equality," says Linda. "Its aims immediately appealed to me."

The Network was launched in 1994 as a project of the Natural Death Centre.

The idea might sound too grim for words, but it's not.

The Centre aims to break taboos surrounding death and dying, restore control to the dying person and their families - who frequently become submerged by doctors, hospitals and a raft of unfamiliar procedures - and campaigns for NHS resources to be used to support people wishing to die at home.

Nicholas Albery, a psychotherapist who co-founded the Centre and the Network, describes befrienders as "midwives for the dying".

That's exactly how Linda Sakr, who is now in her fourth befriending relationship, sees her role with current befriendee Mamdouh Abou-El-Seoud.

She has known Mamdouh for a year, after he found out about the Network from an informal contact at a hospice where he attended a day centre. Mamdouh is 54 and has Behet's Syndrome, a rare condition in which blood vessels become inflamed. It has left him partially sighted, unable to walk and in constant pain.

Mamdouh says that its complications are terminal. He has frequent medical emergencies, including last Christmas Day when his heart failed, and he has spent more time in hospital than at home over the past four years.

Linda explains that while she has counselling skills, they are not essential to befriending. "The Network trains people from all walks of life, employed or unemployed, from social workers to City businessmen," she says.

"After assessment and six weeks of part-time training, befriender and befriendee are matched up and agree to see each other for a year.

We reassess annually. I see Mamdouh once a week for about two hours. He's like a friend or relative, and we've a genuine warmth and rapport. He has help from social services, so I offer emotional rather than practical support, but it's totally flexible."

Mamdouh agrees. "Mainly we talk. I'm very sociable and outgoing, but now I'm virtually housebound," he says. "I only see the colour of the streets from the windows of the ambulance."

He is trapped, partly because the social services are unsure whether they can provide a "stair-climber", which would cost 4,000, to help him negotiate the three steps from the lift to the outside world.

"Linda is like a friend. We talk about everything - including death," says Mamdouh. "I'm not afraid of it. On the contrary, there are only two facts of everybody's life - birth and death. It happens to us all."

Mamdouh, a Moslem, says his faith helps. "We all have our own time to die.

The merciful thing is that no one knows when." He adds that being able to talk about death has helped him. "I'm a step ahead of other people who forget about it."

Linda and Mamdouh share Arabic as a first language and agree that switching between this and English adds richness to their conversations. Mamdouh says he cannot praise The Befriending Network highly enough. "I owe the fact that I am alive now firstly to my wife, and secondly to the Network."

Most of those for whom the Network provides befrienders have cancer, and many are grateful for someone who enables them to forget their illness.

Mary, who developed spine cancer in her forties, explains: "Befrienders help to prevent my illness from becoming the focus of my life. Despite my illness and disability, I enjoy many hobbies, which befriending helps me to pursue.

It's a valuable addition to my support network. I live alone, have busy friends, and don't wish to place too much strain on one person."

To date, the Network in London has trained 80 befrienders, and set up more than 60 befriending relationships.

Hugh Kelly, director of the Network, who himself trained and worked as a befriender, is keen to reach people for whom English is not their mother tongue.

"Our current befrienders include people who speak Ghanaian, Russian, Polish and Chinese. If they can use these skills to help us help more people, that's great," he says.

The Network is seeking both volunteers to train as befrienders, and people who would like to use its services. It is expanding rapidly, with active projects in north and west London, and plans to cover the whole of the capital within five years. The Network's west London project is supported by a National Lottery grant, and that in north London by the King's Fund, a charity focusing on changing health and social care for the benefit of Londoners.

According to Hugh Kelly, these grants have transformed the organisation, but it's never enough. "We need donations to cover our core costs, and ongoing development. This includes exploring ways of increasing awareness of our work among the public and those professionals who refer patients."

It's a difficult subject, the quality of death, and the value of befriending is hard to convey. However, says Kelly, "feedback on our service, from both befrienders and those they support, is universally positive".

He was encouraged by a speech the Prince of Wales gave recently to the British Medical Association. "He highlighted how relevant and critical are the issues of the way in which we die and deal with death. We want to place the Network at the forefront of this work."

* The Befriending Network is at 020 7689 2443 (www.befriending.net). The next course for volunteers in north and west London starts on 6 February.

There is an affiliated project in Oxfordshire, funded by Macmillan Cancer Relief.

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