The role of spiritual care in a holistic approach to paediatric palliative care in Cameroon

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When a terminal illness creeps into an African home, hope often becomes one of the vital ingredients in determining the final outcome. Hope is often found to be in direct proportion to the individual’s inner strength. Approximately 90% of Africans are very religious, so incorporating inner strength, psychological and spiritual elements is crucial in end-of-life care, especially in Cameroon.

Like in all countries across the world, the Cameroonian society place a very high value on children. Culturally, children are believed to be angels, divine gifts, innocent, a treasure, sin-free and a symbol of the future. In their old age, parents rely heavily on children as there is no public healthcare insurance in Cameroon.

Palliative Care is a specialised area of healthcare that focuses on relieving and preventing the suffering of patients. Palliative care is a very rare practice in Cameroon hence most support is provided through spiritual care provided by spiritualists, priests, witches and prophets. Spiritual healing, which is the core of spiritual care, is defined by the Advanced English Dictionary as ‘a form of alternative medicine (when modern medicine fails) in which spirits, normally of the dead, assist in curing the afflicted.’ Spiritual care is an alternative medicine provided in life-limiting or life-threatening conditions.

All African ethnic groups believe in a ‘superior-being’ or ‘superior-power’. God, Allah and ancestors are believed to inflict pain, plagues, epidemics and even death. Spiritual care is not only important in paediatric care but in geriatric care as well. Spiritual care is an important approach in holistic care in Cameroon, although there are no proven clinical benefits. It is common practice for the child’s family to request the presence of their spiritual leaders. Most times the parish priest would perform baptisms, communions, or visit regularly for prayer whilst a witch would summon the ancestor’s spirits, offer sacrifices and plea to the spirits responsible for the child’s ill-health. A large percentage of patients do feel a lot better after such rituals, however there is no scientific evidence explaining how it works. These religious rituals provide great support to the child and family and are even commonly practiced by the more affluent or educated Cameroonians.

Exploring the child’s mind to understand their spiritual needs and understanding of their condition often reveals a vast array of beliefs. This process if often lead by the child’s spiritual leader and can be incredibly beneficial to the child, family and multi-disciplinary team.

Unlike in many western communities, in Cameroon discussions around diagnosis are often shied away from or even unwelcomed by the family. The child and family place more focus on getting well rather than the diagnosis. 

Once the child has passed away, Cameroonian culture prohibits the men from wailing at the death of an adult, however when it comes to the death of a child, the men can freely join the women in wailing. In this final stage, spiritual care still continues. Spiritual leaders often come in to assist the family through the grieving process and offer guidance through their many unanswered questions.

There is some sense of uniformity in cultural practices across Africa, hence the importance of considering the Cameroon experience in global perspectives on health care, especially in achieving a universal and integrated paediatric palliative care approach.

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