Located at Nyarugenge District in Kigali City, the Kigali University Teaching Hospital, CHUK (Centre Hospitalier et Universitaire de Kigali) is a public institution on 3rd level of referral health system of Rwanda. In 2012, the hospital saw 12,349 admissions and 111,844 OPD consultations. Complex medical cases are transferred on a daily basis.
Strengthening and integrating palliative care into national health systems through a public health primary care approach is a key goal of the THET funded project that is running from April 2012-March 2015. Lead partners for this project are the University of Edinburgh (UoE), the African Palliative Care Association (APCA) and the Makerere Palliative Care Unit (MPCU) which form the project steering group.
The goal is to work in partnership with the Ministry of Health in Rwanda and the Palliative Care Association for Rwanda (PCAR) and key hospital hubs. 3 hospitals have been selected (Kibagabaga Hospital, Rwamagana Hospital & University Teaching Hospital of Kigali, CHUK) by the MOH in conjunction with PCAR to develop as sites for training, capacity building, mentorship and community networks in order to integrate palliative care into systems, policies, practice and communities.
A key component in achieving the project goals is to build capacity through training staff. Mentors from the UK have had a key role in supporting capacity and embedding training in the clinical and management context.
The Aim of the training is to deliver introductory training in palliative care to a multi-disciplinary group of senior clinicians and nurses, supported by a team faculty from UK, Makerere University, CHUK, PCAR and Kibagabaga Hospital. The team includes palliative care specialists from across different disciplines and organizations:
- Dr Mhoira Leng, Palliative Medicine specialist, MPCU.
- Dr Michael Minton Palliative Medicine specialist, Edinburgh University.
- Dr Catherine D’Souza Palliative Medicine specialist, Edinburgh University.
- Ms Sue Hollingworth Palliative care nurse specialist.
- Dr Vincent Karamuka PC team CHUK.
- Dr Jean Luc Nkurikiyimfura, PC lead and Head of HIV Clinic/ CHUK.
- Dr Christian Ntizimira Palliative care Expert& Educator at Kibagabaga Hospital.
- Mrs Grace Mukakuranga, Project manager of PCAR.
- Mrs Diane Mukasahaha, Executive Director of PCAR.
20 senior health professionals registered for this 5 days-training ; 13 specialists and 7 matrons coming from Internal Medicine, Neurosurgery, Orthopedics, Neonatology, Infantile cancerology, ENT, Dermatology, Anesthesiology, Stomatology departments and sub departments.
At the end of the training, senior consultants and nurses were unanimous to acknowledge that the patients with palliative care issues are not currently being treated. For example, the concerns around the use of strong opioids was a myth that deterred them from using it as pain medication.
A small survey on mapping of morphine consumptions at CHUK showed that Anesthesiologist Departments used 32% of morphine compare to others wards where a lot of patients suffer from moderate and severe pain. This training has created a momentum on palliative care in CHUK as the trained health professionals have agreed on a pledge of commitment to advocate and improve their palliative care practices for the benefits of the patients.
Dr. Jean Luc Nkurikiyimfura is a consultant in Internal Medicine Department and Head of HIV Clinic/Kigali University Teaching Hospital
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