The ministry of health has provided funding for the purchase of morphine to enhance palliative care among patients with life limiting illnesses.
Speaking after a three-day training for pharmacists on palliative care, the Senior Deputy Chief Pharmacist in the Ministry of Medical Services Dr Elizabeth Ominde Ogaja said great progress has been made with regard to availing finances through its supplies division to purchase the pain management drug among others.
“We are making a case to Kenya Medical Supplies Agency (KEMSA) to try and see if the supply of morphine could be made constant.” Dr Ominde said.
She said that to achieve this, an elaborate data recording system has to be instituted by all departments to enable the ministry procure as per the demand of the country.
Dr Ominde said the training of pharmacists in palliative care should have started long ago as they are the custodians of these drugs and leaving them out means creating a gap in pain management that is crucial in end of life care.
“My hope is that this training be institutionalized to enable pharmacists have knowledge in palliative care as they undertake their studies.” She said.
Following a recent study visit to Uganda to familiarize with how palliative care has taken root, Dr Ominde said they are looking for possibilities of having a central morphine reconstitution center to make morphine solution in accordance to international standards and for better control.
Currently, morphine powder is reconstituted at hospices and palliative care units with the help of qualified personnel.
“If we are to meet the Ugandan threshold, we have to sit at policy and service delivery level and agree on where to start and make changes to ease the access of palliative care to all.” Dr Ominde said.
The study visit was organized by Kenya Hospices and Palliative Care Association (KEHPCA), Africa Palliative Care Association (APCA) and Global Access to Pain Relief Initiative (GAPRI).
Officials from the Ministry of Health, Pharmacy and Poisons Board, Kenyatta National Hospital (KNH) and the Nursing Council of Kenya participated in the two-day study tour.
With regard to the new form of governance, Dr Ominde said there is need for a forum for governors to discuss matters of chronic pain as this requires extra funding besides the set budget for health in these counties.
“We have previously been focusing more on infectious diseases only to discover that non-communicable diseases have a higher cost in treatment and management and their preference is on the increase.” She said.
The senior deputy chief Pharmacist said that Kenya has a bright future and all we need is to focus.
She added that there is need to have regular forums with the trained group to share as such a team is the one to move the agenda forward with doctors and everyone in the system they work in.
Dr David Wata, a clinical pharmacist at the KNH said the training came at the right time as they have to be part of the palliative care agenda to make a good contribution in the management of patients with life limiting illnesses.
“If a pharmacist is not aware of what palliative care entails, there could be a barrier in provision of pain management to patients with life limiting illnesses. Palliative care involves team work and all parties must me involved.” Dr Wata said.
Since these pharmacists did not have such training while schooling, Dr Wata said such a forum was crucial to equip them with knowledge in palliative care.
The Executive Director of KEHPCA Dr Zipporah Ali thanked the participants for their dedication and willingness to attend the training.
“I am really encouraged to see that the future on health in Kenya is bright and we assure you of our support in your field. We are releasing you as champions and we urge you to take the fight against pain wherever you will be working.” Dr Ali told the pharmacists.
She said that once the palliative care policy is in place, KEHPCA will work together with them in its implementation to alleviate pain from patients with life limiting illnesses.
Dr Joe Kanja from Meru Level 5 took the pharmacists through documentation with regard to opioids saying that this is the only way to ascertain the demand in the country.
“Documentation helps in accountability besides being a legal requirement and can help us in research on opioid use in the country.” Dr Kanja said.
He said that if we can replicate the HIV/AIDS care model in cancer and home based care with regard to palliative care, we could be many steps ahead as a country.
Dr James Angima of Kisii Level 5 Hospital said he has learnt a lot in pain management especially from the WHO pain management ladder.
“The more people know about this, the more we could save our patients from pain and maximize pain management in the country.”
He said that it was until the training that he got an understanding that morphine can be administered through the rectal route if the patient is not able to swallow.
This was the first pharmacists training organized by KEHPCA and the Ministry of Medical Services and funded by GAPRI.
The Special Coordinator for Access to Pain Relief and Palliative Care at KEHPCA Dr. Esther Muinga said that the training aimed at empowering pharmacists as advocates of palliative care in the institutions they work in and improve team work amongst other health care workers.
“They are crucial members in palliative care in terms of ensuring availability of essential medicines and their appropriate use.” Dr Muinga said
25 pharmacists and pharmacy technicians were trained from KNH, 11 from level 5 hospitals, 9 from level 4 hospitals and 3 from private hospitals.