Affordable oral morphine for use in the home, is now possible for even the poorest countries, but is stopped reaching those in need by international and national laws, resulting in fear among health workers in its prescription.
During the IAHPC side event at the Commission on Narcotic Drugs (CND) in Vienna referenced in Dr Katherine Pettus’s article on 18 March, an African perspective was presented in regards to the importance of reaching the many countries that lack access to treatment for painful diseases such as cancer and without access to pain relief.
After describing the present situation in African countries through maps demonstrating countries reached with palliative care advocacy and those who have limited access to oral morphine, we went to the heart of the matter. Behind every decision made in the morphine regulations from INCB, stands a human being. Every human must be aware of the suffering of others and have the gift of compassion, if they are to make a just decision on their behalf.
The presentation depicted a series of three recent home visits to patients living in Hoima, a rural district in Northwest Uganda. Each patient had advanced cancer; their ages ranging from 6 to 72. These are three of the luckier ones who have been reached by the palliative care services of Little Hospice Hoima.
Without the control of physical pain, a patient cannot eat or sleep, or focus on the problems associated with leaving the world, while reaching peace with their family and their God. The pain of the patients presented had been controlled with oral affordable morphine. Without the funding necessary for them to access treatment for their cancers, they were previously lying in their homes, suffering and awaiting death while their families struggle to support them through their agonies.
The barriers to access morphine in African countries were further described. These barriers arise from someone who has not allowed compassion into their lives, without empathy for those in need. Medical professionals are not exempt from this pitfall, and the “caring” professions are losing their caring over many years, which needs to be renewed.
As we embark on using the inspirational model of ATOME for Africa as an ATOMA model to help us ensure pain control for all in need on the continent, we realise that the European Project of ATOME is not just needed as an “ATOMA” for Africa, but also as an “ATOMW” – with the “w” representing those suffering throughout the world. The relief of this suffering begins with ATO “ME” as we each spread the need for compassion to all involved.