Bringing Hope Through Palliative Care in Uganda

Dear friends, 

Happy New Year greetings to you all and we hope and pray that you and your families are still keeping well and safe. 

Thank you for your continued support of our work, we are glad that our service has continued and that we are delighted to bring you some updates from the last few months. 

1. Patient and family care 

In this period (November - January) the team has provided care; pain relief, treating for symptoms as well as social, psychological, spiritual and practical support to a total of 236 patients and families. With 225 physical contacts within Mulago Hospital, Uganda Cancer Institute and Kiruddu Hospital and over 191 contacts over the telephone where we follow up and are also able to provide bereavement support to families of the deceased. While we have lost many of our patients, many of them on discharge are referred to a Palliative care centre nearest to them for continuity of care. 

Below we share with you some of the cases that we have care for; 

AO is a 35-year-old male security guard diagnosed with a myeloblastoma and admitted to the Cancer Institute Ward. He was referred to the palliative care team by the ward team due to his overwhelming pain which made him uncomfortable with sleepless nights. Our team provided pain control by giving him morphine. The volunteers visited him regularly and supported him by listening to his worries and concerns and helped with his practical needs such as; collecting medications from the pharmacies, giving information to the families on how he should take his drugs etc.

His main worries were the fungating and smelly tumor associated with overwhelming pain that was unbearable and uncomfortable and made it difficult for him to sleep at night, not being able to work and support his wife and his three children with basic needs such as food and school fees, as the main bread winner of the family. 

He always looked forward to the visits from the volunteers who had become his regular visitors, their gentle touch on his shoulders and at times handshakes to which he says he was surprised other people could not do because of his fungating tumour and often smiled back when we smiled at him even when he seemed weak. 

He was started on palliative chemotherapy which led to a reduction in the size of his Fungating tumour and his foul smell was no more and he had this to say as he was leaving. 

“Thank you for your great generosity love and care you where God sent and able to bring joy and make me smile again”. 

Smiling through my brokenness

“…My biggest consolation in grief and life is to have fulfilled the wishes of my child. As he approached death during the last three weeks after his terminal diagnosis, I do not have questions and I know, how lucky I was when my beloved son was on his death bed and I met this unique and special palliative care team.  It was a very trying moment for us as a family knowing that it was obvious our son was dying. My greatest assurance was that we were able to meet his needs which included emotional, physical, and spiritual and being available to say good bye to him when he breathed his last. Thanks to your team that was available to walk with us the difficult journey - you all become part of our family. I have met families who did not have this and they tell me they will never recover and, knowing what RF’s death means to me, I believe them. (A bereaved mother a month after the loss of a beloved son). 

2. Education and Training 

We have not had a lot of training since our last report as the students have been on vacation. However, institutions have now been allowed to start teaching again from 1^st March with online teaching starting on the 8^th February 2021, thus the next period will be busy for the team with several groups of students to teach including; 

1. Medical students from Makerere University: 8^th February -  23^rd March 2021 - 17 students each week.
2. Medical students from the Islamic University in Uganda for placement: 1^st February to end April 2021 - 7 students every week.
3. Research teaching for the BSc and complex pain – Institute of Hospice and Palliative Care at Hospice Africa Uganda: 25^th January, 22^nd and 23^rd February/
4. Paediatric training supported by Laura Case grant and the International Children’s Palliative Care Network (ICPCN): 22^nd -24^th February and 16^th-17^th March to be followed by mentoring for 6 months, we expect 40 participants.
5. Health Worker’s training for Obonyi district in conjunction with our partners Cairdeas IPCT and Peace Hospice Adjumani through a grant from DFID-UK during April-June and we expect 30 participants. 
6. Medical students from Makerere University: February 15^th -18^th, we expect 65 students.
7. MMed internal medicine lectures (start date to be announced) and clinical placement: 1^st March to end April 2021.
8. MMed family Medicine: 1^st -30^th March 2021  
9. We also expect to participate in the Masters in Palliative Care training at the Institute of Hospice and Palliative Care/Hospice Africa Uganda, this is scheduled for March.

It is therefore going to be a very busy but also very exciting period for the team for the opportunity to be able to support palliative care development so the services can reach those that need it. 

We thank you for reading our updates and for your continuing support and we wish everyone and your families good health.  

Thank you for reading and please look out for more in our next update report. 

God bless you