In its new report, ‘Abandoned in agony: cancer and the struggle for pain treatment in Senegal‘, Human Rights Watch have highlighted the severe lack of pain relief in the country.
Senegal only imports around one kilogram of morphine each year – enough to treat about 200 cancer patients. Belgium, a similarly sized country to Senegal, uses 81kg of morphine per year, and has a quota of 5,000kg.
While there are often shortages and limited access to morphine in Dakar, Senegal’s capital, it is completely unavailable in the rest of the country. As morphine can only be prescribed for one week at a time, patients or their relatives must travel to Dakar once a week to get their medications. This is practically impossible for most patients from rural areas.
The government does not import morphine, so hospitals can only obtain morphine by importing it themselves, a highly complex process that most hospitals are unable or unwilling to undertake. Morphine syrup, essential for paediatric palliative care, is not on Senegal’s essential medicines list at all.
However, the Senegalese government has added oral morphine pills to its 2013 list of essential medicines, and the National Pharmacy estimates that it will begin importing morphine at the end of 2013.
Human Rights Watch say that there is still much more work to be done to ensure broader public access to oral morphine in pill and liquid form.
In addition to restrictive drug regulations and poor drug supply, a lack of training and lack of integration of pain treatment into health services also prevent universal pain treatment and palliative care.
Human Rights Watch is urging the Senegalese government, in consultation with healthcare providers, international donors, WHO, non-governmental organizations and other stakeholders, to urgently develop action plans to ensure access to palliative care and pain management nationwide. Its report makes ten recommendations for improving access to palliative care and pain relief.
Angela Chung from Human Rights Watch said: “Many thousands of cancer patients and other Senegalese suffer unnecessary agony because they can’t get morphine to treat their pain. Senegalese officials should ask themselves whether they would want their own parents or children – or themselves – to suffer such pain when there is a cheap and effective way to relieve it.”
The unnecessarily restrictive government regulations and the other obstacles faced in Senegal are not unique to this country – thousands of people in many other countries in Africa and worldwide suffer due to a lack of available pain relief. According to the International Narcotics Control Board, 80% of the world’s population has no, or overly restricted, access to the opioid medications essential for pain management at the end of life.
Human Rights Watch have made a 5-minute film about the lack of pain relief in Senegal which is available on YouTube. Alongside the full report, which can be downloaded from the Human Rights Watch website, Angela Chung, who worked on the report, has written about the experience.