Palliative care in Addis Ababa during COVID-19

As the COVID-19 pandemic progresses, health systems around the world are straining under the extra burden, and bracing for the storm still to come. According to the World Health Organization, as of 28 April 2020, there were over 2.8 million confirmed cases of COVID-19 globally and 198,842 people had died from the disease. In Ethiopia, there were 123 confirmed cases and 3 deaths.

Although Ethiopia has not been as hard hit by the disease as other countries around the world, the Ethiopian government has taken measures to stop the spread of disease.

On 8 April the Government of Ethiopia declared a State of Emergency for five months to help limit the spread of coronavirus. Meetings and events of more than four people have been banned. Masks are mandatory when visiting ‘service providing’ places such as shops. Schools, bars and nightclubs have also been closed.

Under the current measures, Hospice Ethiopia staff are still able to travel and to visit patients. However, the hospice has put protocols into place to make sure that patients, families and hospice staff are protected.

Older people, and people with pre-existing medical conditions are more likely to become severely ill with the virus. This means that people with palliative care needs are at greater risk from COVID-19.

Hospice Ethiopia has implemented a ‘traffic light system’ for assessing patients and to make sure that they get the care they need, while avoiding unnecessary and potentially risky travel for staff.

After a team meeting, the patients are assigned a colour. Green means that the patient does not need an intervention at this time, blue tells the team to conduct a telephone consultation, while red indicates that a home visit is needed.

Staff travel in separate taxis to the patient’s home, and at the time of writing, have sufficient personal protective equipment and hygiene items such as soap and sanitizer. They distribute packs with soap and hand sanitizer to the patients and families at home.

Hospice workers take measures to prevent transmission, using gloves, masks, hand sanitizer and practicing excellent respiratory and hand hygiene.

Hospice workers are key in communicating information about the prevention of virus transmission within the community. They conduct awareness raising with the patients and their families during home visits and over the telephone, and have created flyers in Amharic to distribute at health care centres. Information shared includes: prevention methods, hygiene and alternative greeting methods to stop the spread of the virus.

The importance of local community connections is being highlighted during this time. A social enterprise that was set up to enable women to produce textile items for sale, has turned its production to make face masks. The social enterprise has donated 1,000 masks to Hospice Ethiopia for staff safety.

Hospice Ethiopia has purchased further masks, and plans to donate these to patients admitted in to the palliative care units of Tikur Anbesa Hospital and  and Zewditu Memorial Hospital.

Ephrem Abathun, CEO of Hospice Ethiopia, said: “We are continuing our service at this time, and our priorities are making sure we can continue to serve our patients while protecting our staff, and also educating the community to stop the spread of the virus.”