Prof. Merriman rallies world leaders

World leaders must join the fight to end the pain and suffering of thousands of sick and dying in Africa, the doctor who pioneered palliative care in Uganda, with a vision to have it available for all in need in Africa, said Wednesday.

Nobel Peace Prize nominee Prof Anne Merriman appealed at the launch of the Anne Merriman Hospice Africa Foundation (AMHAF) in Kampala for support to ensure that the vision and ethos of the organisation she founded in 1993, Hospice Africa (HA) and the model for Africa, Hospice Africa Uganda (HAU), continues well into the future.

It is estimated that 50% of people in Africa will not access a health worker in their lifetime, and less than 5% reach chemotherapy or radiotherapy.

While in 1993 only three other African countries had palliative care now 35 have support care, while 20 have affordable oral morphine based on Dr. Merriman's formula, bringing hope that severe pain can now be controlled in Africa.

The affordable morphine formula was devised by Merriman in Singapore in the 1980's and HAU is now producing enough oral liquid morphine for all in need in Uganda, with the support of the Ugandan government.

Recognizing the shortage of doctor prescribers, Merriman's work was instrumental in having the law changed in Uganda to allow specially trained nurses to also prescribe morphine. Uganda is the only country in the world where this is the case. Uganda was thus applauded as the second country in Africa for the highest quality of death (Quality of death Index, the Economist, November 2015).

Speaking at the launch of the Foundation during the 5th International African Palliative Care Association Conference, Dr. Merriman said a good death is one of the most basic of human rights.

"Every human being on the planet no matter their colour, creed or social background should expect a pain free, peaceful, end of life. Unfortunately in Africa this is not the case for most. I have worked with dedicated teams for the last 23 years to change this and now that I am 81-years-of age, our loyal supporters and I, want to ensure that this work continues, until the vision is a reality. Together we have achieved a lot - but so much more needs to be done".

She appealed to world leaders and policy makers to take note and to do all in their power to ensure that people in Africa experience a good death.  "We need strong and powerful advocates to support this cause."

The founding vision of the Foundation is to carry forward the Hospice Africa vision and ethos. This will support those building services, training and education in palliative care, and to ensure a legacy is documented and preserved for the future of the Hospice Africa movement.

Since its founding, Hospice Africa Uganda has cared for more than 27,000 patients. It currently cares for up to 2,000 patients across its three centres in Kampala, Mbarara and Hoima. Those trained in Uganda, are providing services in 90% of the Districts. The care is family centred and is frequently provided in the patients' home, where most Ugandans wish to die.

Foundation founding advisor Shelley Enarson said: "We are here because we want to move the ethos of care: compassionate, team oriented, and patient centred, forward together. It's for this purpose that the Anne Merriman Hospice Africa Foundation will thrive in its vision."

Hospice Africa Uganda Chief Executive Director Dr. Eddie Mwebesa said: "An Africa where Palliative Care reaches whoever needs it is a very big vision.  This vision can only be achieved if impeccable clinical services, like the ones offered at Hospice Africa Uganda, are spread all over the continent and are integrated into the health service delivery system of every country. The AMHA Foundation will promote the spirit of keeping the patient at the center of our care, and ensuring that the ethos of organisational partnerships are encouraged".

 Dr. Anne has received many awards for her work. As well as being a Nobel Peace Prize nominee in 2014 other recognitions include an MBE (Member of British Empire) in 2003 for her contribution to health in Uganda. In Ireland, as an alumni of UCD, she received an honorary degree for her work with the suffering in Africa. 

In 2013 the Irish President conferred her with the Presidential Distinguished Service Award for Irish Abroad.

The Palliative Care Association of Uganda (1999) and the African Palliative care Association (2003) were formed as part of her vision.