Palliative care at a crossroads?

Categories: Opinion.

In addressing access to palliative care under sustainable development goal (SDG) 3: “Good Health and Well-being: to ensure healthy lives and promote well-being for all at all ages,’” the Worldwide Hospice Palliative Care Alliance noted that:

“Palliative care is a vital component of the basic and essential services within Universal Health Coverage as defined by the World Health Organization. As such, universal access to palliative care is a fundamental requirement to achieve this global goal for those facing serious illness and potentially the end of life.”

This goal comes at one of the most difficult times for palliative care throughout the developing world. As the global recession touches the “big” donors, they have changed their priorities to suit their finances and new priorities, and palliative care may seem to be in danger of disappearing.

We are struggling with this at Hospice Africa in Uganda and Hospice Ethiopia, among others, who are in the same situation. As I see wonderful caring members of our team, who have been fully trained in palliative care, having to leave our teams for want of salaries, our heart bleeds for them and the many patients they have touched and are still in need of their services.

The number of patients in need does not reduce along with reductions in funding. Hospice Africa Uganda’s 2,100 patients (and counting), still need us and need most of all our time to be with them and their families during their suffering and at this special time of life.

This time is reduced with reducing the number of staff members to care for them.

Even so, our patients and our degree programmes and other students are still being served with dedication. Oral affordable morphine is still being made for the whole country. We are still reaching out to Anglophone and Francophone countries starting off. New ideas are taking root: so all is not lost!

Yet how do we console loving members of our team, who are now faced not only those without a job but also those with reduced salaries or downsized to locums or volunteers to sustain a flagging organisation?

HAU is commencing an alumni programme for those who have spent time with us so they can carry out the ethos spirit through to their new organisations and know they are valued with support from HAU.

For us who have faith, we realise that our compassionate care is a work of a caring God, no matter what religion or none we subscribe to. We see him here at work within the homes for those we care for and within our own teams.

Reflections on sustainability

As I look back and see how we commenced with enough funding for three team members for three months and a simple faith that it would work in 1993, and how it has moved forward since, we realise there is a loving and compassionate God caring for the suffering and supporting us to be instruments of compassion.

As angels of mercy, we bring hospitality and love to each one, relieving physical suffering while attending to the other aspects of suffering which accompany the journey to the end of life.

Again we must turn to our faith and beg for succour from other sources for our patients and families. It may be the private sector in each country or new ideas for income generation or other honest means, while still catering for the poor.

For me approaching the end of life, I want to ensure the sustainability of palliative care throughout Africa. And for this we still need Hospice Africa Uganda, as its success affects those in need throughout Africa. This may mean a change of direction in this ever changing world. But the future for our legacy appears bleak without faith.

Realising that this recession is hitting so many humanitarian NGOs today, I have asked particularly those palliative care communities both with posts and without, to come together in the wake of the theme of this year’s World Hospice and Palliative Care Day, “Hidden lives, hidden patients.”

Let us realise that our experiences are not just for patients and families, but we have something special in our compassionate approach, offering hospitality and choices to the end of life for patients, will change the face of medicine today if we persevere.

Those who have left for other posts, some within palliative care and some without, please remember that you have something special, encrypted in the ethos for Hospices in Africa[i], which you can bring to other organisations, and which will overcome the bureaucracy which so often prevents the caring in the our regulated world, from having this essential compassion.

God has gifted us. May we trust in our God, for the millions suffering in need of care and love, carried from our God to each of them, through each of us.