Recently the Kenya Hospice and Palliative Care Association (KEHPCA) staff visited a number of palliative care units in Kenya to follow up the progression of integration of palliative care.
Isiolo County Referral Hospital
Travelling 5km in pain can be a task that majority of us cannot handle and yet some patients travel over 100 km in severe pain to Isiolo County Referral Hospital just to be referred to Meru hospice, more than 50 Kms away. The Meru hospice provides out-patient care to patients and families faced by life threatening illnesses.
Isiolo Hospital has 4 trained nurses in the palliative care unit with Amina being the Head of the unit. They receive support from Meru hospice who is their mentor in palliative care. They also receive oral morphine from Meru, that is only administered to the patients they refer to Meru hospice, thus patients have to share the little morphine.
The trained nurses are providing Palliative Care services on their own initiative as they have other assigned duties, making it difficult to be consistent in care. The hospital is also facing numerous challenges especially staffing, limited awareness regarding palliative care, space to coordinate and provide palliative care services and lack of some essential medicines including morphine.
KEHPCA continues to support the palliative care unit in Isiolo by training, sensitization and advocating for integration of services and availability of essential medications including opioids especially morphine. The Hospital administration is willing to support this initiative. Despite the challenges faced, the hospital has been working closely with other partners to conduct free cancer screening due to statistics showing that 2 out of 10 women are likely to have symptoms suggesting they have cervical cancer. Whenever the suggestive cases are identified, they are counseled and referred for further investigations. Cancer cases have been on the rise in Isiolo County hence a fully functional palliative care unit will greatly improve the patients’ quality of life.
Meru Hospice has achieved a lot of their goals in terms of: Having their own compound, office block and an increased number of patients from Meru County and nearby counties. In addition to this, they also provide mentorship to upcoming palliative care providers including Consolata Nkubu Hospital and Isiolo County Referral Hospital.
In spite of them having achieved great heights, they are burdened by some challenges such as increased cost of administration including salaries, which leads to limited staff. Thus caring for majority of their patients who come in pain with distressing symptoms and in need of psychosocial support becomes a very big problem.
MAUA METHODIST HOSPITAL
Under the Pain Free Hospital Initiative a program of Treat The Pain, part of the KEHPCA team conducted the 1st sessions of 2 departments that included doctors, clinical officers and the community health department. The session was quite informative with the participants being interactive.
“This is a very good opportunity that we are able to learn on why, how and when to manage the pain that brings many patients to our hospital” said one of the participants.
The knowledge they are gaining is not only going to address Palliative care but also accident and assault cases that the hospital receives often.
The team met with the hospital ceo, Dr. J Salvador, who welcomed the idea of KEHPCA training and encouraged the partnership between the hospital and KEHPCA.
The Palliative care coordinator at Maua, Steve Gitonga, who also serves as a member of the KEHPCA board said, “This is a very important program coming at the perfect time. We are grateful for the support given by KEHPCA and other parties. The program will help scale up palliative care to cater for more patients within and out of the hospital. Thank you.”
Maua Hospital is one of the facilities that have rolled out the Pain Free Hospital Initiative after Kenyatta National Hospital, AIC Kijabe Hospital and Moi Teaching and Referral Hospital.
The aim of the visit was to follow up the progression of integration of palliative care in the sites visited. Plans for follow up and continued mentorship of the sites and other sites are still underway.