28 November 2012

Uganda: Health Partners for Wider Palliative Care Coverage

Photo: Patrick Jaramogi/New Vision
Florence Nansubuga 43 and Nakku Florence 45 have been living with HIV for 17 years.

Norah, 40, a mother of seven was diagnosed with rectal cancer at Case Clinic January 2011. She was put on radiotherapy and chemotherapy at Mulago National Referral but when she lost her husband this August, her condition worsened.

Not only is cancer painful, but desertion from her relatives and in-laws since her husband's demise have had a toll on her physical, social, and psychological health. Her in- laws want to throw her out of the marital home.

People suffering from cancer like Norah need both medical and palliative care. She narrated her ordeal to the press during a regular visit from Hospice Africa Uganda (HAU).

Due to inadequate funds for treatment, Norah sought help from HAU, one of the stakeholders in promoting palliative care.

The World Health Organisation (WHO) defines Palliative care as "an approach that improves the quality of life of patients and their families facing the problems associated with life threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems , physical, psychosocial and spiritual."

In Uganda, there are an estimated 1.2 million people living with HIV including 150, 000 children. An estimated 64,000 people died from AIDS in 2009 and an estimated 100,000 new infections per year.

HIV infection, cancer and the need for palliative care led to the establishment of the Palliative Care Association of Uganda (PCAU) that shares its headquarters with HAU in Makindye, Kampala.

PCAU, ministry of health, with support from The Open Society Initiative for Eastern Africa (OSIEA) will launch the Documentation of Palliative Care Development on Dec 3.

The book aims to provide a systematic step- by- step national picture of palliative care development in Uganda highlighting achievements challenges and lessons during the process of introducing, integrating, and implanting palliative care in the health care system in Uganda.

HAU, the African Palliative Care Association, Kitovu Mobile PC Programme, The AIDS Support Organisation (TASO) and Mildmay are some of the stakeholders in promoting the extension of palliative care coverage nationwide in Uganda.

The health ministry fostered the incorporation if the palliative care in training curricula for health workers, the National Health Sector Strategic Plan, and HIV/AIDS policies and guidelines. Nurses and clinical officers with specialist palliative care training are now allowed to prescribe oral morphine.

He added that morphine is one of the most effective painkillers for such severe medical conditions.

Zirimenya said,"Rectal cancer is caused by poor feeding such as high consumption of proteins and low starch and also family history of polyps."

Other risk factors include increasing age, smoking, family history of colon or rectal cancer, high-fat diet mostly from animal sources, are some of likely causes of rectal cancer.

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