Providing Palliative Care in Kenya

Jambo!

I just returned from my 7^th trip to Kenya and the Palliative Care Team and their patients never cease to amaze me. The team’s dedication and generosity is inspiring, and the love and care expressed by patients and their family is remarkable.

Many in the US are challenged by the cost of medical care, but legally care must be provided for life threatening illnesses. That is not the case in Kenya and families frequently must decline important therapies based on financial considerations. While struggling to pay for medical care remains a significant issue, I am glad to report I have seen progress since my first visit in 2014. More families are enrolling in the government’s National Health Insurance Fund which provides coverage for hospitalizations, inpatient medications, and some laboratory and x-ray procedures. This has made care significantly easier, both logistically and financially. About one year ago, the government program began paying for chemotherapy. This has brought therapy to patients who previously had little, if any option, for cancer treatment. Coverage coincided with the opening of the Chandaria Cancer and Chronic Diseases Building which now has a large room for chemotherapy administration and oncology clinics. Palliative Care’s offices and clinic room are smack in the middle of this space and the team is very active in addressing symptoms in the large number of oncology patients.

Our fledgling research program is up and going. The team conducted a survey of patient starting chemotherapy and found a high incidence of pain and other symptoms. They are now addressing how to manage symptoms closer to disease presentation. Our clinical protocol seeking to evaluate telecommunication as a means of delivering home hospice is now open and accruing. Research efforts have also funded the addition of a wonderful clinical officer, Silvanus Kibiwot, who joined the team in August. He is a dedicated, talented clinician and a great addition to the team.

I got to participate in a march to raise awareness of Palliative Care and Hospice which took place one Saturday Morning in Eldoret. Dr. Millicent Korir and Silvanus participated and Dr. Korir got to say some remarks at the conclusion of the walk. A Salvation Army band from Eldoret made sure everyone in town knew a walk was going on. I got to march next to the tuba and can assure you the marchers were sending a loud message about the importance of Palliative Care! I’ve included a photo from the walk as it passed by the hospital.

Your support has helped our efforts in obtaining pilot grant support. Research can help us understand the most pressing issues and help us focus our efforts. We also use donated funds to assist families in need. We see families struggle to raise just a few dollars to arrange transport of a patient home or to an inpatient hospice. Outpatient drug costs are usually not covered, so ensuring patients have bandages, colostomy supplies, and the basic medications needed to control pain and nausea are how your support can assist our patients.

Finally, I am writing this report the day before the October 26^th repeat presidential election. Everyone I met during my trip was anxious to move forward but quite apprehensive regarding the potential fallout. Please, keep the Palliative Care Team and the people of Kenya in your thoughts and prayers.  

As always, thanks for your support.

Ken