The Kenya Hospices and Palliative Care Association (KEHPCA) has been supporting the integration of palliative care into public health services in Kenya through a project aiming at establishing palliative care in eleven public level 5 and provincial hospitals in Kenya. The project, funded by the Waterloo Coalition has now completed the training sessions and is moving towards the next objective of supporting the implementation of palliative care within the hospitals through continued mentorship over the next six months.
A total of 226 health care professionals have undergone the 5 days training and more than 75% of those trained have undertaken three day placements at designated hospices. These hospices have worked with KEHPCA to facilitate the trainings, mentorship and support supervision for the health care workers in the 11 hospitals.
The following provincial and Level Five hospitals have been trained: Garissa; Nakuru; Kakamega; Nyeri; Embu; New Nyanza Kisumu; Coast; Kisii; Machakos; Thika and Meru
In order for the project to be successful, other activities to increase awareness on palliative care and pain management were conducted at the same time that the training were going on. These included, targeting doctors through the regional KMA (Kenya Medical Association) bodies for CMEs on palliative care and pain management and also sensitizing the hospital staff on palliative care and the need for them to support the palliative care units within their hospitals by appropriate patient referrals
The objectives of these trainings were to educate participants on the principals of palliative care; how to communicate with patients and family members; pain and symptom management; ethical issues in palliative care; how to support bereaved families deal with the loss of their loved ones, end of life care and how to have a monitoring and evaluation program that is successful. At the end of the five day training participants were given a chance to do placement in hospices close to them. The Clinical placements provided trainees an opportunity to conduct a full assessment of a patient; assess and manage their pain and other symptoms; counsel a patient / family members’; tell the patient their diagnosis; support bereaved family members and also get an opportunity to visit a patient at home.
The majority of those trained have expressed a lot of interest in palliative care and most hospitals have started to integrate the services. They have continued to express appreciation to KEHPCA and the supporters of the project for a rare opportunity offered to them, which has enabled them to become better carers in their areas of operation. Heavy workload and under staffing in most departments in the government hospitals was raised as a major challenge to integration of palliative care services. At KEHPCA, , the project took a lot of commitment, involvement, efforts and therefore all the needed mobilization needs to be done to ensure accessibility of palliative care services in all the government hospitals.
The successful training for health care professionals in 11 Government hospitals under this project has made a great milestone for Kenya, a step that is providing a bench mark to the efforts of integrating palliative care services in the Government hospitals.
A participant from one of hospitals felt remorseful and said the following words after the training, “Oh my God! How I have been insensitive to the needs of patients suffering from life threatening illnesses! Whenever I saw a treatment sheet written morphine, I took no concern because to me the patient was dying anyway! I will now go back to the hospital a converted carer.”