Kenya: Eleven Hospitals to Introduce Palliative Care Services

By Henry Neondo

NAIROBI---The Kenya Hospice and Palliative Care Association (KEHPCA) announced a major programme in partnership with The Diana, Princess of Wales Memorial Fund and the True Colours Trust to support the integration of palliative care into public health services in Kenya.

The partnership is through the Waterloo Coalition – a collaboration of donors and palliative care organisations working in Kenya and Malawi.

The Ministry of Health has identified eleven public level 5 and provincial hospitals across the country in which to establish palliative care services for the care of patients with life-limiting illnesses.

The Government of Kenya’s commitment to establish palliative care services in these hospitals will guarantee a more effective, efficient, and equitable health system.

The move comes only few months after the Human Rights Watch released a report critical of the government’s reluctance to provide palliative care to the terminally ill.

The report which mainly focused on the Kenyan children with diseases such as cancer, HIV/AIDS, and sickle-cell anaemia, pointed out the inability of the patients to get palliative care and pain treatment. The problem according to the report is that Kenya does not consider morphine an essential medicine and subsequently patients are living and dying in uncontrollable agony.

WHO reccomends the drug to treat moderate-to-severe pain. It is cheap, safe, and effective, yet the report states that the Kenyan Government does not procure morphine for public health facilities because it maintains there is little demand for it.

Of the country's 250 public hospitals only seven stocked morphine. Furthermore, medicines to treat neuropathic pain common in patients living with AIDS and cancer are also largely unavailable. The report also criticises health donors for overlooking pain treatment and palliative care in their programmes.

Kenyan health-care professionals are rarely trained to treat pain and are unaware of the benefits of morphine. Fears of addiction, belief that the drug is dangerous in children, misconceptions about palliative care with importance placed on curative care, and absence of psychosocial support and services at hospitals and at home have resulted in a dismal lack of attention to children with life-limiting illnesses. Sadly, the situation is much the same in other parts of Africa.

A health system that includes palliative care services is vital to ensure widespread pain and symptom control and an improvement in the general care, support and quality of life for patients and families facing life-threatening illnesses in Kenya.

This significant public-private partnership will focus on the development and implementation of a national training programme for the integration of palliative care into hospital services, the development and dissemination of comprehensive palliative care guidelines, provision of technical support and mentorship, and the measurement of the impact.

Over 220 health care professionals will be trained in palliative care throughout the programme, with eight established Kenyan hospices to mentor the newly emerging hospital palliative care units.

The  programme will ensure that local community healthcare professionals are aware of the new palliative care services at the hospital so that patients and families receive smooth and timely referrals.

KEHPCA  partnership will enable an additional 4,000 new adult cancer patients and 5,000 adult HIV / AIDS patients to receive high quality palliative care through the new hospital units in a period of one year. It is also projected that an additional 500 new paediatric cancer patients and 1,000 paediatric HIV / AIDS patients will receive palliative care through the new hospital units each year.

According to Dr. Zipporah Ali, National Coordinator, KEHPCA “effective palliative care results in patients spending more time at home and reduces the number of hospital inpatient days. It improves symptom management; provides patient, family and care giver satisfaction; reduces the overall cost of disease and improves quality of life of patients and family. This partnership will demonstrate and document these benefits and will highlight how palliative care can be used to strengthen the government health care system”.

Lucy Sainsbury, Chair, True Colours Trust, said the Government of Kenya’s commitment to integrate palliative care into eleven public level 5 and provincial hospitals is commendable. “We are delighted to be part of this partnership. It will help ensure that people with life-limiting illnesses across Kenya are able to access pain relief and symptom control,” she said.