Palliative Care still a faraway cry in Africa

Palliative Care still a faraway cry in Africa

A 2015 worldwide survey by palliative care alliance released at the 5^th International African Palliative Care Conference at Speke Resort Munyonyo ranked Uganda second to South Africa in the quality of care given to patients who are critically ill. Uganda did wonders here.

But, overall, the country polled 37 — the usual suspects, Australia, Canada and the USA, coming in first, second and third positions respectively.

Much as the survey depicted Africa and indeed Uganda to be ‘progressively moving in a right direction' to provide pain relief and inclusive services to patients who it has been determined won't cure, it also showed the continent was still far off the ideal finish line.

The survey indicated that only about 10% of patients who have terminal illnesses and require palliative care in Uganda, receive the services. The majority 90% does not receive any care: they turn and writhe in their deathbeds, with no pain relievers and company to comfort them, waiting unto death to come to their rescue.

But Uganda is second in Africa (—largely because of Prof. Anne Merriman, who started Hospice Africa Uganda in 1993, which has taken care of over 28,000 patients). What about the rest African Countries?

Libyan health minister Reida el-Oakley said the plight of sick people who have been ‘written off' because of the gravity of their illnesses in his country was appalling.

"There are hardly any interventions going specifically for this bracket of (sick) people, who it has been determined won't cure," he said at the conference attended by health ministers from all of Africa.

"The hospitals can't keep treating a patient when they won't improve. The relatives can't keep bringing money to a health facility to support someone when they have been told there ‘isn't hope'," the minister said.

The deputy minister for Liberia Dr. Francis Kateh said health facilities were overstrained to provide services to patients, in addition to an increasing number that needed palliative care.

But, palliative care is the best for patients who have no other hope on life. Dr. Jonah Wefan, a consultant physician from Cameroon, said it (palliative care) makes the patients to "feel loved" in their last days on earth because it is "all round" and involves "physical, social, and spiritual" aspects.

Prof. Anne Merriman said "no one should die in pain. Everyone needs to be presented an opportunity to die a pain-free death. Dying in dignity and with respect is a human right."

Over 40 million people need palliative care in Africa.

The conference at Speke Resort Munyonyo, which was opened by the Ugandan Prime Minister Dr. Ruhakana Rugunda, sought to explore ways the ministers can improve the quality of care given to patients with terminal illness.

The Deputy Minister for Liberia said they need to know how to dispense ‘pain reliever' and main drug in the treatment of terminal illnesses morphine, without abusing it.

Dr. Ruhakana Rugunda called for more investment in the inclusive and all round pain relief services.

Woman MP for Kole District and chairperson of the HIV/AIDS committee in the Ugandan Parliament Judith Alyek called for more advocacy towards the plight of the "bed-ridden" who have no hope of recovery.

Dr. Eddie Mwebesa, the Hospice Africa Uganda executive director, said about 250,000 patients receive palliative care in Uganda. Hospice Africa Uganda cares for close to 1,800.

Health minister Dr. Jane Ruth Aceng said three quarters (66%) of the sick on palliative care, were cancer cases. The other majority fraction were also cancer-related, but co-infected with TB. A smaller percentage was patients living with HIV/AIDS and other terminal conditions.

She said Uganda consumes about 28kgs of oral morphine per year to treat the critically ill who need palliative care, it consumes about 0.73mg per capita.

Because of increasing cancer cases, some involving children and young people, Prof. Merriman said they were starting to register cases of young people who need palliative care.

Uganda registers about 35,000 new cancer cases per year. The country registers about 90,000 TB cases annually.   

Dr. Jane Ruth Aceng called for more training of clinical offices and specialists in palliative care, after state minister for health (general duties) Sarah Opendi said Uganda has only about 140 trained officers to offer the service.