Garissa Provincial General Hospital is leading the way forward on Paediatric Palliative Care in Kenya. Dr Patrick Mburugu, Palliative Care Clinic Coordinator had been a key player in driving the first Paediatric Palliative Care Unit in Kenya forward. Dr Mburugu recounts ‘in 2011, Kenya Hospices and Palliative Care Association (KEHPCA) through the Kenya Paediatric Association invited our staff to attend a training session on paediatric palliative care, before this, there was limited awareness of palliative care for children in the hospital. Throughout the training we started to generate ideas of how we could take this forward in Garissa PGH and one year on through focused implementation strategies we have been able to establish a fully functional Paediatric Palliative Care Clinic.’
On top of this Dr Mburugu has also established a comprehensive child friendly palliative care room, decorated in bright colours with a TV set, toys and a variety of childhood games and is in the process of creating a child friendly play room in the paediatric ward. As a paediatrician, Dr Mburugu understands the importance of a child’s surroundings in the development of their social, emotional and intellectual abilities through play, interaction and sensory stimulation, and that a child with a life limiting illness is no different in these needs from other children.
Setting up the Paediatric Palliative Care Unit, was not without its problems, there was inadequate infrastructure, insufficient human resource for health, lack of finances and staff burnout. In order to overcome this, Dr Mburugu worked in partnership with the support of the hospital administration and the Medical Superintendant to identify ways of overcoming these issues, and with the help of KEHPCA, APHIA PLUS and Hospice Care Kenya came up with a complete solution of utilizing the integrated model of service delivery which enabled staff to multi task to deliver a range of incorporated services, access grant funding and provided 25 staff members with additional training to enable them to become more fulfilled and involved with the work of the Paediatric Palliative Care Unit.
The unit is now fully operational and delivering services to 79 children living with HIV/AIDS and/or Cancer.
Part of the success of the unit is the adoption of specific admission, follow up and referral forms, along with training on palliative care to other medical professionals within the hospital which has built up trust and encouraged more hospital staff to refer for the specialist support the Paediatric Palliative Care Unit supplies. Dr Mburugu noted that ‘Some practitioners are afraid of palliative care. Practitioners naturally want to enable people to live. KEHPCA is playing an important role in supporting practitioners to be equipped to provide the best possible service to terminally ill patients.’ Because of increased awareness of palliative care and of the new unit, more and more children are being referred and are accessing holistic child friendly support for patient, parents and siblings.
On top of the success of the establishment of the new facilities, Dr Mburugu exhibited a poster presentation at the 13th Kenya Paediatric Association conference. The presentation generated much interest among paediatricians from East Africa who were in attendance and it was realised that the paediatric palliative care programme was implementable and can be duplicated in other centres all over the country.