This facility provides palliative care for cancer and HIV/AIDS patients who are without home care or medicine and are too poor to provide the basic nourishment requirements to sustain their comfort and dignity. Also the volunteers go out into the community to assist in the breaking down of the social stigmas that the local community has regarding patients with HIV/AIDS.
The idea of setting up a comprehensive palliative care programme at AIC Litein hospital was mooted in 2004. The need for palliative care had been recognized and could not be wished away. A proposal was then prepared and submitted to HoldMe Africa, a group of volunteers from The Salvation Army Agape Hospice of Canada and the Mary Tidlund Foundation. Later on, a former employee of the hospital who had had a first hand experience on the need for a hospice, Michael Kirui, gave a presentation on behalf of the hospital on “Hospice Africa Project: Agape Africa” to the Canadian Hospice Palliative Care Association Board of Directors, the programme and steering committee for the 2005 National Hospice Palliative Care Conference. Mr Kirui had witnessed his father undergo intense pain and suffering as he battled cancer which eventually ended his life in 2000. He went to Canada determined to push for the establishment of a hospice in the neighbourhood of Litein to help manage pain of terminally ill patients.
Following positive response to the appeal for support, the hospital board and management decided to begin with a small hospice care programme which was a more affordable option and the programme kicked off in earnest.
In October 2005, 30 volunters were trained in palliative care and HIV/AIDS related illnesses. Cathy Garratt, a Canadian volunteer nurse then working at the hospital, was encouraged by the leadership of Africa Palliative Care Association (APCA) to develop a comprehensive palliative programme for the hospital. A six- day on-site training was organised in collaboration with APCA, HoldMe Africa and the HAART clinic in March 2006 and was attended by hospital staff as well as staff from neighbouring hospitals and health facilities.
Since then, Morphine has been compounded and prescribed to patients. The department has grown and is now staffed by one Clinical Officer who has attained a diploma in palliative care, three registered nurses who have undergone and qualified in palliative care training and a Chaplain who oversees spiritual counselling. Some 650 clients are on our follow up programme to date while 2000 others (both on care and ARV treatment) receive palliative care at the HAART clinic.
ACTIVITIES
- New clients are seen and treated in outpatient or admitted as necessary
- Further assessment, treatment, counselling and follow up is provided
- Families receive intensive support in the wards
- Pain and symptom management with Morphine solution and other medications, physiotherapy, chemotherapy and palliative surgery
- Clients are referred for further diagnostics, chemotherapy and radiotherapy as appropriate
- Sensitization and awareness through health talks is given in CMEs and collaboration with neighbouring hospitals
- Home visits to improve continuity of care
ACHIEVEMENTS
- Availability of Morphine
- Follow-up of more than 650 clients
- Home based care groups, other hospitals are referring clients to the department and vice versa
- Palliative services are integrated into HIV/AIDS activities
- Opportunities for Staff to train others through presentations in CMEs
- Capacity building of staff through trainings on palliative care – one has just attained a diploma in palliative care
CHALLENGES
- Lack of adequate resources for medical care for the terminally ill
- The increasing number of patients – more resources are required
- HIV/AIDS is generally underserved and hidden away
- Education and training of nurses
- Home visits and nourishment needs.
- Adequate Medicines
- Increasing the number of volunteers through community involvement
- Social work – reducing emotional stress and the fear of dying alone.
- Clients delay in seeking treatment resulting in late diagnosis when the disease is in advance stages.
- Stigma and cultural barriers is a hindrance to disclosure and treatment
- Financial constraints that hinder clients from seeking treatment