Tuberculosis and Palliative Care

Josephine Ngina’s illness has drained the family especially her children financially to cater to her medical needs. At 51 years, she is a mother and a doting grandmother. In 2014, she discovered she had diabetes and high blood pressure. This means that Josephine requires routine medical checkups and adaptation to the circumstances or change in lifestyle.

“At first, I received treatment from Machakos hospital casualty department. I remember after receiving treatment, I went back and told them I was still in a lot of pain. I was in a lot of pain in my back and I couldn’t walk.” Said Josephine.

Between April to August 2020. She made visits to several hospitals without much success and an accurate diagnosis. Some doctors dismissed her as they assumed her condition was not serious. After a while, she was advised to take medical tests for cancer. Her muscles and bones were in excruciating pain the physicians thought she had osteosarcoma.

 

 

Her sputum sample was collected. “In the same week I was also advised to take an x-ray among other tests and the diagnosis was tuberculosis of the spine. The doctors also found out that the joint bones in my back had detached. That is why I was in a lot of pain.” Said Josephine.

 

 

 

Therapy included sleeping on a wooden bed to straighten her spine. This was in addition to the medication she was taking. It is common for tuberculosis arthritis or spinal TB to be misdiagnosed. TB unlike other diseases is highly infectious and those caring for such patients ought to be cautious.

 

 

“At first, we were fearful when we found out she was diagnosed with TB. We were advised by the doctors to make sure that the rooms are well ventilated. That will reduce the chances of us getting infected and once she starts on her medication, we were safe from contracting TB.” Said Purity Mueni, Josephine’s daughter.

 

 

 

“Palliative care has helped me a lot in my journey to recovery. I was admitted to the Machakos hospital palliative care unit (PCU). I get pain relief medicine from the PCU on a regular basis delivered at home since I was discharged from the facility. I feel so much better because of the help I get from the PCU. I would advise patients to adhere to the instructions and medications prescribed because they have been of great help to me.” Said Josephine.

“Initially, palliative care services were not covered by the National Hospital Insurance Fund (NHIF) but through advocacy by Kenya Hospices and Palliative Care Association (KEHPCA), patients are able to benefit partly in treatment through NHIF.” Said Elijah Musau – Palliative Care Specialist and Head of Machakos hospital PCU.

 

Elijah adds, “We support patients with various diagnoses including cancer, HIV/AIDS, cardiovascular, diabetes and many other non-communicable diseases (NCDs)  at the PCU. Palliative care takes care of patients holistically. Elderly patients used to be dumped at the hospital and abandoned by their community. They were not aware or advised about home-based care. Through the efforts of the staff at the PCU, many people in the community have been advised and trained on how to take care of their loved ones at home. This has reduced the financial load to the families and it also calms a patient when they are being looked after by a family member. This is a caregiver they are familiar with and they trust completely.”

 

“The PCU was established in 2010 and the facility and staff understood that the community needs hospice care. We also give counselling and advice to patients on other aspects of life. This can be in writing a will for patients who would like to have peace in the unlikely event they pass on, their loved ones will be taken care of.” Adds Elijah.

KEHPCA continues to partner with various institutions, the Ministry of Health (MOH), and the county governments to ensure that palliative care is integrated into health facilities countrywide. With advocacy efforts and support from our partners, KEHPCA has helped increase the number of facilities countrywide. We have over 70 facilities in Kenya that offer palliative care services. There is still much more that needs to be done but a lot has been accomplished over the years. To find out more about KEHPCA and what we do please click the following link: https://kehpca.org/

Palliative care cuts across many aspects of healthcare and it is important to note that it is available for all who need it. There have been many myths about palliative care and who should benefit from the care. To find out more about myths about palliative care please click on the following link: https://ehospice.com/kenya_posts/myths-about-palliative-care/

The community should not shy away from accessing palliative care. People need to be sensitized and advised to seek palliative care services as early as possible, from the diagnosis of a life-limiting condition. Palliative care is my business, your business and everyone’s business.