Palliative care in Kenya especially optimizing pain management in cancer care was made a topic of focus in one of the workshops held during The 3rd International Kenya Society of Haematology and Oncology Conference hosted by the Kenya Society of Haematology and Oncology (KESHO). According to the W.H.O (World Health Organization) Palliative care is an approach that improves the quality of life of the patients and the family facing life threatening illnesses. The discussion on the palliative care was chaired by Dr. Zipporah Ali, Executive Director Kenya Hospices and Palliative Care Association (KEHPCA).
Facilitators leading discussions on palliative care included Dr. Esther Munyoro (Coordinator, Pain and Palliative Care Unit, Kenyatta National Hospital -Nairobi, Kenya), Dr. Esther Muinga (Special Coordinator for Access to Pain Relief and Palliative Care) and Gladys Nduku (Palliative care Nurse Kenyatta National Hospital).
Dr. Muinga started the session by giving a brief overview on why it is important to talk or raise awareness of palliative care. She gave some of the reasons patients present late for palliative care these reasons being; Lack of knowledge (patients and healthcare workers), difficulty accessing services, wrong diagnosis, lack of finances and Self treatetment (over the counter drugs)
Dr. Muinga mentioned components of palliative care including;
· Pain treatment
· Spiritual and social care
· How to break bad news
· Education and research
The patient should be the centre “Palliative care is not given by one person we all need to work together, all of us play a role in the care of the patient.” She concluded.
Dr. Esther Munyoro and Gladys Nduku followed with a presentation on optimizing pain management in cancer treatment. Dr. Munyoro emphasized on attitude change if we want to optimize treatment of cancer “we need to change our attitude toward drugs whether it’s curative or palliative”, she encouraged talking about death to the patients as it has a lot of benefits in preparing the patient psychologically.
Gladys Nduku a palliative care nurse focused on the process of pain management. She based her discussion on the guidelines set by the W.H.O which include use of the WHO step ladder, using oral medications and giving medication by the clock. “Assess the pain by asking the patient to rate their pain rather than making assumption and treating based on your own judgment” she argued. Also talked about morphine its effectiveness, how to prescribe it and how easy it is to administer it. “The patients should remain pain free and not let to scream in pain” she added. Gladys thanked KESHO for the platform, and her colleague Dr. Munyoro. “We are not just talking about cancer rather we are acting on cancer!”
In most cases patients don’t understand the kind of treatment they are offered. Doctors just prescribe treatment without explaining to the patient what medicine plays what role and its relevance as part of the treatment. Palliative care practitioners are advised to create a personal relationship with their patients showing concern and explaining the treatment process to the patient making them understand their treatment. The 3rd International Kenya Society of Haematology and Oncology Conference provided a platform to inform those medical practitioners who had not gone through palliative care training before on how to deal with patients who need palliative care.