In 2002 Beris Bird RN Traveled to:
Baptist Convention North West province
of Cameroon

Beris Bird RN

Ms Bird's IAHPC Travelling Fellowship was made possible by an unrestricted donation by Mundipharma (Australia)

Highlights

I was invited by the Director of the Health Services of the Baptist Convention to visit Cameroon " to introduce palliative care throughout the Baptist health institutions starting with our two main hospitals. It is one of our goals to provide the highest quality of care with genuine compassion and it would be appropriate if you would put your undivided attention and energy into this service for us"

The Health services of the Baptist convention provide a considerable percentage of the health care available to the people in the North West province of Cameroon.

1 Margaret.

This 45 year old lady admitted with advanced cervical cancer. She came because of very severe pain. She was seen to be withdrawn and depressed and had said to a nurse " I think there is something you are not telling me" – she had not been told her diagnosis and was frightened of what was happening. Together with a nurse, I sat and gently spoke with her. It became apparent that her fear was of AIDS (most patients now fear AIDS more than cancer and so the diagnosis, even of terminal cancer, is better as there is no shame and no stigma attached). She accepted the diagnosis with some relief, then reached out to me, put her arms around me, and said ‘ thank you for telling me the truth’. Then the problem was her pain, severe, pelvic, back and neuropathic – all we had was codeine. A high dose together with diazepam at night did help her and the pain was relieved although she was not pain free. She needed the morphine that was not available. She was discharged home into the care of her family, and died three weeks later.

2. Quinta

This child had lower body paralysis resulting from an acute myelitis. She had been taken to a native healer and had spent a month on the floor of his hut being treated with herbal medicines. She was admitted with maggot infested and dirt encrusted pressure sores, which were cleaned in the ward, but did not heal. Her condition continued to deteriorate despite active treatment, and it was thought that home care was the best option, as the family could not afford the cost of continued treatment and hospitalization. Her mother was taught to care for Quinta and took her home confident in being able to do the dressing, care for the catheter, bowels, and to give medication as prescribed.

The plight of the paraplegic in developing countries is one that challenges the practice of palliative care. In some hospitals, there is a policy of non-admission, which means home and death. If admitted to hospital, the patient can deteriorate over months, always developing pressure sores, and dying slowly and painfully, with no hope of rehabilitation, no quality of life, and the family is left with a financial burden due to the medical costs incurred.

Submitted by: Beris Bird RN December 2002