Together, let’s join forces to make a difference in the lives of people at the end of their lives!!!
I- CONTEXT
In Cameroon, palliative care is not integrated either in the minimum package of activities, nor in the complementary package of activities delivered by Health Training (FOSA).
For 4 years, the Ministry of Public Health (MINSANTÉ) has supported and subsidized the Cameroonian palliative care conference, an exchange platform for palliative care stakeholders in Cameroon. Very few public health facilities have a palliative care unit and the uninterrupted supply of opioids is a recurring problem, making management of severe pain difficult.
Holistic cancer care integrating the management of patients’ physical, psychological, social and spiritual problems is not effective in the majority of health facilities. A large number of patients die in suffering and without assistance due to the lack of knowledge among nursing staff on the overall care of people suffering from chronic pathologies; the home care system, “home based ” model visit “, recommended for countries with limited resources is almost non-existent.
Although civil society organizations (CSOs) and faith-based organizations contribute to the delivery of palliative care in Cameroon, this activity should be coordinated by MINSANTÉ to ensure its implementation throughout the national territory.
While waiting for a coordinated response led by the country’s health authorities, it was necessary to use more simplified language to promote the popularization and practice of palliative care in Cameroon in general and in the Central region in particular.
To do this, a model of assistance and collaboration was designed: the creation of compassionate communities around patients in palliative situations. Made up of a group of relatives and acquaintances of the patient (family, neighbors, friends and others), these will serve as the first intervention in the circuit of improving the quality of life of patients. In addition, they will also have a community relay role between the patient, the Home Care Team (ESAD) and the health facilities.
For more than 2 years already, the Care of Life Association (whose aim is to promote the culture of palliative care and anti-cancer treatments in Cameroon) has been working on the implementation of this model.
This document presents what is being done or has been done in a traditional way, formalizing it around specific tasks (micro project) and subsequently duplicating it in each large community.
II – PROJECT DESCRIPTION
1° The objectives of the project
➢ Overall Objective:
Establish a community palliative care network in the Mbankolo district.
➢ Specific objectives ASSOCIATION SOIGNER LA VIE 3
Association subject to article 7 of law n°90/053 of December 19, 1990 relating to freedom of association
SO 1 : Raise awareness among at least 200 people about palliative care in the MBANKOLO district by October 29, 2023;
SO 2 : Identify, enlist and train 10 to 15 community volunteers in palliative care before the end of November (11/19/2023);
SO 3: Create the community palliative care network in the MBANKOLO neighborhood and ensure its monitoring.
2° The project stakeholders
These are Persons or organizations involved, directly or indirectly, in the project, or likely to be affected by its completion.
➢ The beneficiaries of the project : volunteers, social and religious leaders of the city of Yaoundé.
➢ Project team: Association to care for life.
➢ Partners, sponsors or other natural or legal persons who will contribute directly or indirectly to the implementation of this project (Hospital Institutions, local and/or international NGOs, Town Halls, businesses, etc.).
III – REVIEWS OF ACTIVITIES CARRIED OUT IN CONNECTION WITH THE SET
OBJECTIVES
SO 1 : Raise awareness among at least 200 people about palliative care in the Mbankolo district by October 29, 2023
As part of achieving this objective, the following activities were carried out:
1 A preparation phase for different communications and awareness
2 First public awareness on 1/10/2023 within the parish
Association subject to article 7 of law n°90/053 of December 19, 1990 relating to freedom of association
More than 1450 people affected by the communication.
On this day, we recorded the following statistics:
| DAYS | Stand 1 (large gate) | Stand 2 (gate) | TOTAL |
| Wednesday | 12 | 19 | 31 |
| SATURDAY | 16 | 16 | 32 |
| TOTAL | 28 | 35 | 63 |
Breast cancer cases recorded: 4; cases of sickle cell anemia + severe anemia: 1; lump in the right breast: 1 case.
Dr Mireille Djuidje visiting the sickkel cell disease yong girl.jpg
3 The first awareness and screening campaign (Wednesday October 4, 2023)
• Expected people: 31 people
• People actually received: 15 people
• Number of patients already registered and waiting for VAD: 11 people
• Consultation and examinations paid: 3 people (3000 FCFA)
Activities carried out:
• Educational talk on breast cancer and palliative care
• Taking parameters
• General consultations
• Sharing experience on volunteering in palliative care
• Communication on home care and the project of 500 free VADs during the month of October 2023
Activities Not carried out:
• Oncological Consultation
4 The Second Awareness and Screening Campaign (Saturday, October 4, 2023)
Expected people: 32 people
People actually received: 19 people consulted
consultation and examinations paid: 5 consultations (5,000 FCFA)
consultation and examinations Unresolved: 14 consultations
Activities carried out:
Educational talk on breast cancer and palliative care
taking parameters
general consultations
Oncological Consultation
sharing experience on volunteering in palliative care
communication on home care and the project of 500 free VADs during the month of October 2023
Staff present:
Dr Kennedy, Dr Christelle, Raïssa T, Michel T, Cyrille, Willy, Patrick, Louis Marie BODO
Volunteer-Raissa-JOUSSE-at-the-bed-of-end-of-life-patient
SO 2 : Identify, enroll and train 10 to 15 community volunteers in palliative care before the end of November (11/19/2023)
To achieve this objective, the association previously thought about sub-activities (descent for communication in living ecclesial communities and home care visits in the community of MBANKOLO) with the aim of identifying potential volunteers who have already started the action of assisting sick people and who will then be enrolled and then trained for an effective response to the expectations of sick people in communities. A total of 13 volunteers were trained.
IV – DIFFICULTIES ENCOUNTERED AND MEASURES TAKEN
| Activities | Encountered difficulties | Impact on activity | Correction measure |
| General execution of the project | Financing (feedback from potential donors) | Delay in project start | Slv endorsed the implementation of the project, reframing the project and centering it on a single community |
| Preparation of various communications | Schedule a meeting with religious and social leaders | Delay in project start | Descent carried out with project supports within the parish of Mbankolo |
| Awareness raising and information during masses | Availability of teams during the first and last hours of the day | Only one person who communicated in the early hours and only one person in the late hours | Teams should arrive early (7:00-7:30 a.m.) and at least 2 or 3 people during the later hours of the day. |
| Conduct of awareness and screening campaigns | Start of the activity 1h30 after the scheduled time | Impact on other tasks of the activity and late closing of the latter | Despite the late arrival of participants, follow the program as planned at the base |
| Participants did not anticipate the costs required for screening | Unable to recover funds from consumables used during the campaign | Insist on the financial participation of participants during the awareness and information phases | |
| Identify, enlist and train volunteers from this community | Visits to the communities were delayed due to concerns about the availability of human resources, but also the time provided for communications. | Delay in descent times which also causes a delay in the continuation of activities | Schedule in advance all resources to be allocated to activities |
V – SUMMARY AND PERSPECTIVES
Ultimately, the compassionate community of Mbankolo was officially created in early January 2024. It has 13 members brought together within a platform for exchange and information around supporting people in palliative situations in their locality.
This being said, and with the correction of the small shortcomings observed, the Care la Vie association intends to duplicate this initiative in other communities during the year 2024.
Thanks for sharing your approach.
David Henderson. Strathcarron Hospice in scotland.
Together to face sufferings