“Palliative care according to the World Health Organisation (WHO) is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.
Furthermore the WHO mentions that palliative care provides relief from pain and other distressing symptoms, affirms life and regards dying as a normal process and is applicable early in the course of illness, in conjunction with other therapies that are intended to prolong life, such as chemotherapy or radiation therapy, and includes those investigations needed to better understand and manage distressing clinical complications.
The major life-threatening diseases contributing to the palliative care burden in Africa are HIV and related infections and complications, cancers, other non-communicable diseases including heart diseases, diabetes, kidney diseases, chronic respiratory conditions and related complications as well as effects related to aging. With just 12% of the global population, Africa has 70% of the HIV burden as well as many preventable cancers such as cancers of the cervix, liver and other cancers related to an infectious agent. There is therefore a big number of people in Africa who need palliative care.
Many countries like Uganda, Kenya, South Africa and Tanzania have made good progress towards availability of palliative care but with coverage still limited within those countries especially as regards extending services to the rural areas. Despite considerable steps forward in palliative care provision across Africa there remains lingering and inaccurate myths which are inhibiting the role out of effective palliative care provision. These myths are held by many in the general public but also among health professionals and national and regional bodies that regulate the use of medicines especially narcotic pain medications. These myths hinder access to care so badly needed by many Africans. As such, I would like to take the opportunity of World Hospice and Palliative Care Day to tackle a few of these myths.
Too many people believe that if you accept palliative care you are accepting that you are close to death. This is simply not true. Palliative care is there to ensure people live a symptom free life given as early as possible at diagnosis of a life-threatening condition and for as long as possible to the fullest possible extent. Studies have shown that access to palliative actually prolongs life.
Equally, I know people worry about the use of opioids or narcotic pain medications and their potential to cause addiction. Again this is a myth. If morphine or other narcotic pain medication is used properly for pain control purposes, the risk of addiction is a pure myth as it does not arise at that stage. As medical professionals we look for what is best for the patient. Often this means prescribing pain control medications such as oral morphine to ensure a patient can continue living independently and happily without the distressing symptoms such as pain which in itself can cause untold suffering to the patient and his family.
Lastly, I wanted to comment on the myth that palliative care is just for old people. Again, this is simply not true. As we know that the conditions for which palliative care is needed affect all ages, palliative care should be provided to all persons irrespective of age, race, religion or gender. Palliative care therefore can and should benefit people, regardless of their age. Children with life-threatening diseases are just as much in need of palliative care as adults. The biggest challenge that children in need of palliative care face is the lack of advocates within the health system to push for their interest and ensure that their palliative care needs are met. It is essential that everyone, not just medical professionals, acknowledge this.
Palliative care has come a long way in Africa in recent years and I am delighted that more people than ever before are receiving basic palliative care. At the recent palliative care session for African Ministers of Health held in Johannesburg this September, and in line with the African Union declaration on palliative care and the African Union Common position on pain medications, a comprehensive consensus statement was passed about the way forward for palliative care development and integration into health systems in Africa.
However, we still have a long way to go before we can safely say everyone’s right to adequate health care, which must include palliative care, is fulfilled. Dispelling these lingering myths of palliative care is an essential step in moving towards a continent where no one suffers from unnecessary and preventable pain.”
Using the gains made on the continent so far we can make it possible for all Africans to have access to palliative care when they need it.”
This article was originally published on APCA’s website.
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