Oral liquid morphine for children to be accessible across KZN, South Africa

It is exciting times for palliative care in South Africa, but particularly in our province of KwaZulu-Natal (KZN). The end of September saw the Hospice and Palliative Care Association’s annual conference held in Durban, and co-hosted by the KZN Department of Health.

Both the provincial MEC for Health and National Health Minister addressed the delegates with passion and conviction, affirming the right for all patients to access high quality palliative care.

But we have had another triumph in KZN.

Morphine availability has not been consistent across the province, particularly in the more rural district hospitals.

A few weeks ago a 2-year-old boy, with a nasty brain tumour, was discharged from the specialist hospital back to the family’s local district hospital as no further curative options were available. The child was then sent home with only paracetamol for pain as the hospital didn’t have oral liquid morphine in stock. In desperation his parents contacted Umduduzi – Hospice Care for Children for assistance. Supporting the local hospital doctor telephonically, we were able to ensure the child’s comfort by using the intravenous preparation of morphine buccally, as a temporary measure.

Through our national networking and advocacy group, The National Palliative Care alliance, we acquired the email address of the head of pharmaceutical services for the province, Mr Dlamini. His response was rapid and beyond expectation. Within a few days the child had the necessary oral liquid morphine, ensuring comfortable discharge and home care.

But more than that, Mr Dlamini issued a letter of instruction to all Hospital CEOs and managers, pharmacy managers and heads of departments stating that oral liquid morphine must be kept in stock and available whenever and wherever needed.

The best part? The letter started with “Palliative care is an approach designed to control the quality of life for a patient who is diagnosed with a terminal condition. It focuses on the needs of the patient, as well as those of the family and carers and it can begin as soon as you are diagnosed. Managing pain is an important part of Palliative Care.”

The time for palliative care is now!