A workshop was held on children’s palliative care on the morning of Thursday 12th January 2023. Held in the Sunshine hostel at Korle Bu Teaching Hospital (KBTH), it was organised by World Child Cancer in conjunction with Prof Renner from KBTH for clinical staff from KBTH, Princess Marie Louis Hospital, and Greater Accra Regional Hospital, University of Ghana Medical Centre, and Holy Family Hospital, Techiman. 50 participants attended the workshop and included participants from the Child Health Departments, the paediatric oncology wards, palliative care practitioners, family medicine doctors and researchers. The energy in the room was exciting and participants were keen to learn and to share their experiences. Ensuring the workshop did not overrun too late was a challenge as participants wanted to ask more questions, get feedback, and share their experiences, and there was enthusiasm for more training on children’s palliative care and to ensure that it is available in the different health facilities.
Three key topics were discussed. The first was on the principles of children’s palliative care. Prof Julia Downing (International Children’s Palliative Care Network) took participants through the definition of children’s palliative care, which children need access to palliative care, and the different disease trajectories. She stressed the importance of the holistic nature of children’s palliative care and the fact that children’s palliative care is about living, that it should be provided across the continuum of care from diagnosis and is not just end-of-life care, that is included pain management, but that is only a small part of the care that we provide and is not just for children with cancer. Having discussed the philosophy of palliative care and the similarities and differences between providing palliative care for children and adults, she then went on to discuss some key principles of the provision of palliative care. She recognised some of the challenges that we experience in providing and developing children’s palliative care but encouraged participants that palliative care can and does make a difference in the lives of children and their families, that palliative care is not an optional extra care but should be integral to the care we provide, and that we all have a role to play in the provision of children’s palliative care and we can all make a difference.
Whilst acknowledging that managing pain is just one part of symptom control within palliative care, the assessment and management of pain had been highlighted as a key topic to cover. Thus, Dr Edwina Beryl Addo Opare-Lokko, a palliative care specialist physician from the Greater Accra Regional Hospital, the Ghana College of Physicians and Surgeons and the Ghana Palliative Care Association, led a session on pain assessment and management in children. She took participants through the basics of pain, assessing pain in children and then managing pain in children. Throughout the session participants were able to ask questions, to share their experiences and input into the discussion. Different methods and tools for assessing pain in children were discussed along with the challenges experienced in doing this, and how we assess pain in children who are nonverbal. Dr Edwina stressed the importance of a good assessment of pain in order then to manage it, as the type and source of the pain will impact how we manage it. The WHO analgesic ladder was discussed along with co-adjuvants and when we should and should not use certain medications. Several case studies were discussed as examples of how to assess and manage pain.