Malindi palliative care
unit will live to remember the services of Dr Eleanor Foster who has fostered
the integration of palliative care into Malindi Sub County Hospital in Kilifi County.
When she came to Kenya in
October 2011, Malindi had plans to set up a palliative care unit but had not
succeeded with the absence of government support.
Being passionate about
palliative care, Dr Eleanor was determined to have the services within the
hospital despite having no unit of operation.
Speaking to ehospice during
a visit to Kenya Hospices and Palliative Care Association (KEHPCA), Dr Eleanor
said that without government support back then, it was difficult to achieve
this integration.
“By the time I came, the
government was getting behind palliative care. The hospital set aside a room
that was in a deplorable state and lack of funds hindered its renovation,” she
said.
Following the completion of
a new building, Dr Eleanor said they were allocated a new room from where the
current unit stands.
“My role was to help the District to start a
palliative care program. I helped in mentoring nurses, medical interns and
raising palliative care awareness with support from the hospital management,”
Dr Eleanor said.
She mentions beliefs among
locals including witchcraft which plays part in their illness as one of the
commonest challenges hindering palliative care services seeking behavior in the
region.
“When the doctor tells the
patient that this illness is incurable, some opt to visit witchdoctors who
often tell them that they have a solution to their illness. After failing to
get the promised results, some return to us especially when their pain in
unbearable and we are able to manage them accordingly,” she says.
She said that her
experience in Malindi has been very encouraging given that when people heard
about palliative care, they were interested to know more.
“There has been a change
within the hospital and the community for the better in regard to palliative
care,” she said.
Dr Eleanor recounts when
she was called to consult on a patient with Oesophagus Cancer within the
hospital and was able to help with her symptom of shortness of breath and pain.
Since she was discharged,
the husband often came to collect medicine and Dr Eleanor was glad that the two
Community Health Workers (CHWs) who attended to the husband were able to
identify additional needs for the family.
“The team asked the carer
how the children were coping with the condition of the mother and from the
discussion identified that one child needed psychological support. We gave
advice to the health care workers on how to approach to children and the CHWs
and a spiritual leader were able to visit and address their issues,” she said.
Dr Eleanor said that the
patient later reported to hospital with severe respiratory problems and the
CHWs offered to come and stay with her and offer support to the patient and the
family until she passed on the following day. They also offered bereavement
support.
“This is a good example of
how CHWs, the palliative care and spiritual leaders can team up to offer
holistic care in palliative care,” she said.
She said that there are two
nurses currently undertaking a higher diploma in palliative care and the
medical officers and interns are being mentored in palliative care at the
hospital.
Dr Eleanor adds that there
is a nutritionist and occupational therapist who have understood how to support
palliative care patients and the whole hospital in one way or another is
involved in palliative care delivery.
She hopes that the County
will support this noble service to enable palliative care at Malindi Hospital
to thrive and support more patients.
Dr Eleanor encourages
hospitals starting or yet to integrate palliative care to use locally available
resources especially the personnel.
“Make use of the community
health care workers, spiritual leaders and help them understand more about
palliative care and include them as part of the patient care team. Use their
strengths to offer comprehensive services,” she said.
KEHPCA’s Executive Director Dr Zipporah Ali said that Eleanor’s
contribution to palliative care in Kenya will forever be remembered.
“She leaves Malindi with a palliative care presence that will continue
her great work. We wish Eleanor all the best as she returns to Canada and hope
that she continues her good work in palliative care there as well,” said Dr
Ali.
Dr Eleanor thanked KEHPCA
for the support given to start up palliative care services at Malindi and
encourages the association to continue supporting other palliative care service
providers, both established and the new ones.
ehospice thanks Dr Eleanor
for the great work she has done and the great fruits of her labor that she has
left behind.
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