The quote “behind every successful man there is a woman” by Mark Twain is a common saying that has been used since time immemorial. Thus, we can say behind every good doctor are great nurses who are dedicated, hardworking, caring and supportive to patients. They make work easier for doctors as they keep tabs on all patient activities.
In this case, we will focus on the journey of a palliative care champion nurse. Peninah Sidi Mramba, a nurse by profession and a mother of three girls, is the palliative care focal coordinator at the Mbagathi District Hospital.
After finishing high school, Peninah, like all other young people, had a dream. She wanted to pursue a Bachelor of Arts in law at the University of Nairobi; however, she chose Nursing as an alternative due to parental influence. A decision she now believes was God-sent and destined. She studied smart, and at the age of 24 years, she became a practising certified nurse. Having a total of 24 years of work experience as a nurse, 16 years of those 24 years have been dedicated to palliative care provision.
As a student, her strengths were in midwifery and public health, areas she believed she could advance in, but what changed her mind is still a mystery to her. Her interest in Palliative care was her own initiative, having seen many cancer patients suffering in pain without much attention from the medical team.
A scene that touched her heart was that of an old lady at Msambweni District Hospital years ago. “When I started working at Msambweni, there were many patients with different types of cancer but I was touched by this particular old lady who had advanced cervical cancer and she was also a leper with no fingers, no toes. Her face totally disfigured because of leprosy. She used to cry in pain day in day out and the only pain killers we had were the NSAIDs and paracetamol which were not controlling her pain” she said, “once in a while, I could help by injecting her with pethidine which would relieve her pain and she was able to sleep. The lady viewed me as her saviour” she continued.
“In her file, the doctor had advised her to go to KNH for radiotherapy and Nairobi Hospice for pain management with strong pain killers. However, she succumbed to the disease”
Years passed on, and while working at Kiambu District Hospital as an acting District Public Health Nurse (DPHN), an interning student linked her up with a friend at Nairobi Hospice. “The mention of Nairobi Hospice triggered me to take the action. To me, this student was God sent to remind me the burden I used to have for the patients living with life-threatening illnesses.” She then found herself in Nairobi Hospice with zero training in palliative care. She, later on, got trained as a palliative care nurse
Fast forward to 2018, Peninah, a palliative care provider, became the coordinator at the Mbagathi District Hospital, a newly formed unit that offers palliative care services. Being the only trained palliative provider at the facility has however come with its’ challenges in her.
“The most disappointing thing is to see the people who should be on the frontline supporting the move being the greatest enemies of the change due to various reasons,” “It’s high time we as medical practitioners acknowledge, appreciate and support any good move to meet the needs of our patients. We are not in competition but complementing one another for the greater good of our patients”
“What keeps you going? I asked. “The smile and appreciation from the patients and their families I attend to make me look forward to another day helping them where I can.”
Peninah agrees that there is always something that each one can do to ease the burden of another in need. She is thankful that the hospital administration sees the need for palliative care and patients are able to access this care at Mbagathi.
She also thanked Kenya Hospices and Palliative Care Association (KEHPCA) for their support of personal protective equipment and oral morphine solution donation to the health facility in hope that better things are yet to come. Truly the journey of a thousand miles begins with one step. Thus, a Luta continua.