As health professionals took their seats in the tent pitched in front of Thika Palliative Care Unit in Kiambu County, one could see on their faces the enthusiasm they have for the well being of their patients. They are making efforts to go by the saying that, “a good physician treats the disease; the greatest physician treats the patient who has the disease”. Supported by Treat the Pain, a program of the American Cancer Society, Kenya Hospices and Palliative Care Association (KEHPCA), holds training on pain management in different facilities. 27th February 2018 was the second day of a four days training on pain assessment in Thika level 5 Hospital. Twenty-two members made of doctors, clinical officers and nurses formed this tenth group to be trained in Pain-Free Hospital Initiative program. Dr. Muinga who is in charge of the program and Dr. Asaph both from (KEHPCA) were present to oversee the training.
Thika level 5 is a government hospital that has integrated palliative care in its services since September 2012. According to Edith Mwihaki a Kenya Registered Palliative Care nurse, the palliative care unit attends to an average of five patients daily. Since May 2017 KEHPCA has facilitated the training on pain management for more than 200 health professionals in Thika level 5 Hospital. The training is conducted by health care workers at the hospital. Rewarding with palliative care certificates at the end of the training motivates health professionals to enroll in the training.
Through a power point presentation by Edith Mwihaki, she first elaborated on the various types of pain which are physical, psychological, spiritual and social. Secondly, she explained the different techniques of measuring pain. The participants were given a Slap bracelet that has the visual analog pain scale as well as the Wong-Baker Faces scale for children which helps in pain assessment. On this, she insisted that the patient should be given the first priority to describe their pain. “Most of the time, health practitioners ignore a child who can speak and concentrate on finding out how the child is feeling from the parent or caretaker”. Thirdly she described various non-pharmacological (treatment that does not involve medicine) therapies. These include dance, music, acupuncture, herbs, and massage therapies among others.
A visit by KEHPCA representatives to the office of Medical Superintendent was graced by the deputy Dr. Jackline Wangeci who cheerfully stated that the hospital is becoming a pain-free facility. KEHPCA appreciated her for the opportunities and support given by the facility to carry out various activities like research and training. Catherine Mwihia the Nursing Service Manager was also happy with KEHPCA’s visit and appreciated them for their advocacy of pain-free facilities.
The hospital shares monthly reports with KEHPCA and Ministry of Health that includes opioid consumption. According to Dr. Bevin, one of the pharmacists, there has been a noticeable positive change in the prescription of oral morphine for patients accessing healthcare at Thika Level Five hospital.
As the palliative care unit continues with the Pain-Free Hospital Initiative in Thika, it is evident that this training has been of benefit to both healthcare workers and patients. “Hawa madaktari wamenisaidia sana hapa Thika-uchungu umeisha,” said one of the patients at the facility. (These doctors have helped me in Thika-the pain is gone).