Contribution from an IAHPC Board Member
New Palliative Care Initiatives in Kenya.
Like many other developing countries, Kenya faces challenges when it comes to supporting people with life limiting illnesses such as cancer and HIV/AIDS. WHO estimates that in Kenya there are over 80,000 new cases of cancer diagnosed every year, but only about 4500 (5.6%) of these are recorded. Of these 4500 cases, only a small percentage have access to palliative care and appropriate pain medication. One can only imagine the terrible conditions that exist for the majority of those who do not have appropriate palliative care and pain medication during their illnesses and when dying.
Over 1.2 million people are living with HIV/AIDS and approximately 300 die from this disease each day. Most of these people suffer uncontrolled pain and other distressing symptoms that could be relieved with appropriate palliative care. Barriers to palliative care in Kenya include:
- a lack of national polices on palliative and pain management;
- a lack of awareness of what is possible with appropriate care;
- a lack of trained health care professionals;
- an unfriendly regulation of the opioid supply and use; and finally
- a lack of integration of palliative care into an essential health care package.
Palliative care in Kenya, until recently, was predominantly provided by free-standing hospices and a few mission hospitals. However, this is now changing due to the intense advocacy work that has taken place in the last three years with the support of the Open Society Institute (OSI) and others. Also, the combined effort of the Kenya Hospices and Palliative Care Association (KEHPCA) and its member organizations has resulted in positive actions by the Ministry of Medical Services and the Ministry of Public Health and Sanitation to integrate palliative care into government health facilities. This project started with ten government hospitals at the provincial level including high volume (level five) hospitals in seven provinces. This will bring much needed palliative care closer to patients and their families, some travel long distances to access care.
However, every new initiative comes with its challenges, such as a:
- lack of palliative care guidelines for hospitals;
- lack of enough trained health care professionals;
- lack of space;
- lack of opioids;
- lack of reading materials and other teaching resources and
- lack of adequate funds.
With respect to developing a long term solution for the lack of knowledge and skills of health care professionals, KEHPCA is working closely with the relevant institutions to ensure that palliative care education is integrated into the curricula of health care professionals. This project is currently supported by the Diana Princess of Wales Memorial Fund and the African Palliative Care Association (APCA).
Kenya is a country awakening to the needs of those living with life threatening illnesses. Health care professionals are constantly requesting education; the government is working on a national cancer control strategy that has a very strong component of palliative care; there is an awareness of pediatric palliative care; and in the forefront, the public is more aware of their right to healthcare and quality palliative care. The journey of a thousand miles has begun, and will continue until all those who need palliative care gain access to it.
Dr. Zipporah Ali
National Coordinator
Kenya Hospices and Palliative Care Association (KEHPCA)
PO Box 20854-00202 Nairobi, Kenya
Website: www.kehpca.org
Dr. Ali is a member of the IAHPC Board of Directors and her biography may be viewed at
http://www.hospicecare.com/Bio/ali.htm
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