Providing Palliative Care in Kenya

by Indiana Institute for Global Health, Inc.
Providing Palliative Care in Kenya

JAMBO!

 I suspect most of us have been looking forward to 2021. Unfortunately, it appears we will still be dealing with COVID19 for a while. This also means the need to provide Palliative Care is even greater.

The AMPATH program, led by Dr. Hussein Elias in Eldoret, has continued to train Community Health Volunteers. To date, 80 individuals have participated in a 3 day training in Palliative Care, which has included information regarding COVID19. Since going back into their rural communities, the trainees have assessed over 1,000 individuals for physical and psychosocial distress. Seventy five of the individuals assessed required referral to a palliative care clinics for symptom management. Our budget for this program was 10 trainings. Given the positive impact we have been able to show, we hope to expand the program throughout Western Kenya. Any contribution you provide will assist us in this expansion.

We continue to hone our curriculum for training clinical officers and nurses as Palliative Care specialists. COVID19 has provided challenges for learners but have also used this opportunity to develop a Western Kenya Palliative Care Teleconference. This is a monthly online meeting that combines a sort didactic lecture on a specific topic, and then allows Palliative Care practitioners to present challenging cases for group discussion. The first teleconference was help in January of 2021 and was well attended with a great discussion.

The AMPATH program is grateful to the amazing Kenyan Clinicians who continue to provide clinical care during the pandemic. We also thank those who support their efforts. The program continues to grow and you are a key to our success! 

Please stay safe! - Ken

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JAMBO!

Hope everyone is staying safe in these challenging time.

Reports from our colleagues in Kenya tell us that things are starting to open up slowly. COVID is still a concern and folks are working hard to take appropriate precautions. Since our last report, we are excited to announce that our Kenyan colleague Dr. Hussein Elias was appointed Adjunct Professor of Family Medicine at Moi University. This was made possible by your financial support and we are deeply indebted to support of people like you.

I can share that Dr. Elias has been working diligently to promote palliative care. His efforts include clinical care and a number of educational efforts. In our last report, I mentioned he was organizing training sessions for Community Health Workers (CHW). These individuals are embedded in rural communities and are often the first contact patients have with medical professionals. The palliative care trainings were planned before COVID-19 but he was given permission from local health officials to proceed on the condition that he also provide training about COVID. He has conducted three sessions to date, each lasting 3 days. Numbers were limited to 10 so social distancing could be maintained. Additional trainings are planned in the upcoming months. The impact of this program is being assessed and if successful we will look to expand throughout Kenya. Part of the goal is to connect the CHW with palliative care specialists in an effort to ensure individuals in rural setting have access to pain and symptom management. We continue to work towards expanding the number of palliative care specialists and we'll update you in our next report. 

Thanks again for all your support. The program continues to grow and you are a key factor!

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Jambo!

Our last update was in February. I’m not sure where to begin. It seem like it was a lifetime ago in a world far, far away. I do hope all of you are safe and weathering the pandemic. For those in the US, I hope you are coping with the challenging events of the past week.

The pandemic has clearly changed our plans but not our agenda or determination. A number of palliative care physicians, including myself, were scheduled to be in Eldoret in April and May. Unfortunately, we are not able to go. That has left the heavy lifting to our Kenyan colleague Dr. Hussein Elias and the palliative care team at MTRH. Besides the clinical care they provide, Dr. Elias is organizing training sessions for Community Health Workers (CHW). These individuals are embedded in rural communities and are often the first, and sometimes only, contact patients have with medical professionals. The trainings were planned before COVID-19 and are focused on educating the CHW on palliative care and connecting them with palliative care providers. While the number of cases of COVID-19 remains low in Western Kenya, special safety precautions will be taken during the training. Moreover, the training will include education about COVID-19.

THE NEXT BIG THING. Currently, the medical school associated with our efforts does not have a faculty member to lead palliative care. With our financial support, a position is being developed, I feel this is the most important assistance we can give to improving pain and symptom management in Western Kenya. A palliative care faculty member will not only impact direct patient care but will also play a critical role in educating students at all level of medical training. The impact will be truly exponential. Any assistance you can provide in allowing helping us create this position will be greatly appreciated.

Thanks as always for your moral and financial support. Please, stay safe!

Ken

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Jambo! I send Greetings to all of you who share in our vision of improved Palliative Care in 2020!

Where to start, so much is happening!

Dr. Elias has been working hard to move our training program forward. As this will be a unique training program, it has undergone careful review by many Stakeholders and their input has been invaluable in improving the program design. The program is awaiting final accreditation by the national education board in Nairobi. Once obtained, we can enroll students and begin to meet the great need for Palliative Care trained health workers in Kenya. Will keep you posted!

In addition to the educational, we continue our research study evaluating an innovative use of telecommunication as a means of delivering end-of-life care in rural areas without hospice services. Our hope is to complete this pilot study by the end of 2020.

We continue to build a team of North American Physicians to assist in our tripartite mission of clinical care, education and research. I will be returning this spring as will Drs. Colleen Brown and Lindsay Dow. Dr. Clarissa Johnston will be making her first trip to Eldoret to work with the team this Spring. She is an Associate Professor at the Dell Medical School at The University of Texas in Austin. To add to the mix, Dr. Eric Shepard, a Palliative Care Fellow from Indiana University, will also join us.

Everyone in the program greatly appreciates your support and we are humbled by your generosity. Without you as part of the team, we would not have accomplished all that we have done (and will do!). As always, I must give the vast majority of the credit to the wonderful health care providers in Eldoret who are truly the agents of change. We remain inspired by their skill and dedication.

We’ll have even more to report in our Spring report, but for now I send a big Asante Sana (thank you very much) to you all!  

Ken

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Sunset In Eldoret
Sunset In Eldoret

Hi everyone! I just spent most of October in Eldoret and have lots to report. Much of my time was spent on finalizing the Palliative Care Curriculum for nurses and clinical offices. The work led up to a Stakeholders meeting with representatives from the Nursing Council of Kenya and Clinical Officers Council Kenya. We are working to have graduates recognized as specialists in Palliative Care on their respective licenses. The representatives provided important insights and we are working to meet their recommended changes. The administrators and educators at the College at Moi Teaching and Referral Hospital were also very helpful.

 

The Palliative Care team continues to work hard in providing care to patients in the hospital. I also had an opportunity to visit the new Living Room International Hospital. They will collaboration with us by providing our trainees with exposure to hospice and palliative care services at their hospital.

 

As I mentioned in the last report, We are very excited to have Dr. Hussein Elias join the efforts in Palliative Care. He was instrumental in the Stakeholder’s meeting and coordinating efforts with the training college. He will be spending 50% of his time with the Palliative Care program and will be the course director for the curriculum. Moreover, he is evaluating whether Community Health Workers, who are the major caregivers in rural Kenya, can be trained in identifying people who are in need of Palliative Care. He envisions them as being the eyes and ears of physicians providing symptom management in patients with severe chronic diseases. Your contributions are being applied to cover his salary and help him with these and other development projects.

 

It was also great to get to know Hussein better. While I was there he defended his research thesis to the faculty at Moi University. He did an outstanding job and I was very impressed in the design and results of his study of chronic back pain. He then took his final exam for the Family Medicine residency – and he just emailed that he passed! He is now a Family Medicine specialist and we are so lucky to have him helping us.

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Indiana Institute for Global Health, Inc.

Location: Indianapolis, IN - USA
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Twitter: @ampathkenya
Project Leader:
Ken Cornetta
Indianapolis, IN United States
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