Young children are assumed in our society not necessarily in terms of gender but children in general. Some are referred as ‘nuisance’ or ‘pretentious’. Why on earth would one assume a young and innocent child is not in pain and accuse him or her of being pretentious? This should stop! Jesus Christ himself was a great friend to children, he even put himself to relate with the young ones when he said to his disciples “Let the children come to me”.

Machakos Level 5 hospital has been in the fore-front in advocating for Paediatric Palliative Care. This great effort has helped in putting life in the days of the children living with life threatening illnesses. Mr. Elijah Musau(Physiotherapist) Machakos Level 5 hospital ensured that clinicians in the paediatric department availed themselves for the workshop held at the hospital recently on 24th March to learn on the various topics on paediatric palliative care.  “Let us ensure that we make the lives of our children in Machakos County comfortable by playing our roles diligently” said Dr. Ondere- a Paediatrician at the hospital.

Participants from the paediatric department fully participated in the interactive and enlightening session. “Taking care of a child needs one to behave like a child” said David (KEHPCA – Senior Programs officer) this statement seemed like a joke to many in the workshop but he meant it with a lot of seriousness. David stated the three languages of children being the body language, play language and spoken language. Understanding what an infant needs may take a long period of time for many and some may end up giving up or interpreting the communication wrongly. Same case would apply to school going children, teens and youths but the bottom line is one should learn to listen and take time to understand their communication.

Songs, facial expression and body language were also mentioned during the workshop as ways of communicating with children. Health care workers were asked to practice the art of living like children while taking care of these children as this will limit cases of living in distress for them. Dr. Ondere was asked to request for writing and reading materials from the hospital management for the children in the ward to assist them in education development. “Toys, child-like paintings for art work and kids television programmes are great distraction avenues for the sick children” said David. Pain management was among the key topics. Health care workers were taught how to identify the level of pain in children and how to manage the different levels of pain.

Spiritual aspects in care for children were discussed given that cases of children and families with different beliefs reject medication and care from the hospital on the basis of their religious beliefs.  Dr. Ondere reported that some believers from certain churches refuse palliative care services, chemotherapy and radiotherapy and even believe that morphine kills. This attitude has been one of the greatest challenges that most health care workers have to deal with everyday. Therefore health care workers have to educate patients to demystify these myths. “The spiritual leaders have a role in building hope in the patient’s life and thus having him or her in the hospital premises will ensure that such cases are solved” suggested one of the nurses.

Health care workers present at the workshop and the KEHPCA team looked into the way forward to improve Paediatric Palliative Care. The means discussed was through strengthening referral pathways from the wards to the palliative care unit to ensure there is early monitoring on the progress of the patient, improvement on pain management by having proper follow ups and change of attitude towards children for health care workers, facilitate sensitization on the availability of morphine in all wards to manage pain in patients, practice team work and better ways of communicating to patients and family on bad news. Additionally, KEHPCA was also requested to engage health care workers in frequent continuous medical education (CMEs) for continued learning.

Besides training health care workers, KEHPCA team was involved in reviewing some patients together with the hospital palliative care team. This was a great opportunity for the team to be part of the process where advice was given to a young mother and a grandmother who has been taking care of a young boy. The boy recently underwent a brain surgery and had come for review at the palliative care unit. Dr. Kinyanjui began practicing how to communicate with children based on David’s presentation earlier during the workshop.He asked the child in a soft child-like voice “unaitwa nani toto?” meaning “what is your name?” The child seemed dull initially but finally he gave a smile after the long conversation.

Put a smile on a child’s face and you light up the world around him or her!

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