Regional Reports
Kenya
KENYATTA NATIONAL HOSPITAL PALLIATIVE CARE UNIT
Nairobi, Kenya
Kenyatta National Hospital in Nairobi, Kenya, has recently opened a palliative care unit.
Kenyatta National Hospital is Kenya’s tertiary referral Hospital, with a capacity of 1800 beds and caring for over 80,000 inpatients and 500,000 out patients annually. On average the hospital attends to 2,000 patients daily, a large percentage of them with advanced cancer.
Kenyatta hospital aspires to be a regional centre of excellence in the provision of innovative and specialized healthcare. Our mission statement gives the hospital identity and unique purpose,” to provide specialized quality health care, facilitate medical training, research and participate in national health planning and policy”. The hospital houses many medical specialties and a new one has been added, palliative care.
The concept of palliative care was first introduced to the hospital’s acting director Dr. Kibosia in July of 2006 by Dr. Esther Munyoro, an anesthetist and palliative care specialist. Dr. Kibosia also trained in palliative care and having taken an active role in establishing Eldoret Hospice, fully supported the idea of establishing a unit in Kenyatta National Hospital. This support was even greater when Dr Micheni took over as hospital director. While trying to determine the way forward, a request to the International Association of Hospice and Palliative Care (IAHPC) got us the ‘Getting started Pack’ which has helped a great deal. We have also received a donation of books through the IAHPC Clearing House Program, which has helped us prepare educational materials.
A task force for the palliative care unit was formed and is composed of personnel from various disciplines. The nutrition department, physiotherapy, social work, pharmacy, hospital chaplain, psychology, oncology and the Nairobi hospice were represented.
Finally, on March 1st 2007, the palliative care unit at Kenyatta National Hospital was opened, with one part time physician, two nurses and one administration officer.
The goals for this unit are to:
- improve pain and symptom control
- increase patient and family satisfaction with care
- improve communication techniques among the hospital health care workers
- increase clinical knowledge of pain and symptom control
- respect and support patient’s preferences
- prevent inappropriate emergency department and inpatients admissions
- increase enrollment of patients who will benefit from hospice care
The Challenges ahead are to:
- change the perception of our fellow health workers about palliative care so that it is acknowledged as a profession.
- encourage doctors and nurses to support patients even through terminal care.
- obtain funding, which will be the greatest challenge, for education material, drugs and other items useful to our patients.
Dr. Esther Munyoro
Nairobi, Kenya
Lucy Kimanthi, Catherine Awour, Ann Mwangi and Esther Munyoro
Skopelos, Greece
A new Charity is created to support patients with advanced cancer and other conditions in Skopelos, Greece
‘Faros Skopelou’
We are situated on the island of Skopelos the second largest of the 4 islands that constitute the Northern Sporades. Faros means ‘lighthouse’ and we felt that this name with its connotations of light and security would be an appropriate one. Cancer is still a taboo word for many people in Greece and people diagnosed as having cancer often feel isolated from the community and as a result unable to talk about their experiences.
The Charity was established and developed to meet the special needs of patients with advanced conditions and illnesses. Due to the isolation in the islands and the fact that they are far from the main treatment centres on the mainland, patients with cancer and other conditions have to take long journeys
by hydrofoil and bus in order to reach Athens or Thessaloniki. This can be exhausting both physically and financially. The system for refunding these traveling costs is complex, and as a result, many patients decide to remain in the island and not seek treatment in the mainland.
One of the challenges for Faros Skopelos will be to facilitate and simplify these procedures so that patients can travel when they can benefit from treatment.
Our aims are:
1) Give practical and psychological support to people with cancer and to their families, wherever needed.
2) Ensure that any person or child on this island, suffering from a terminal condition, can receive palliative care, through the existing health services.
3) Expand these services to the other islands of the group
Initially we are planning to fund and send a group of health professionals to the Princess Diana Centre for Palliative Medicine at Hospice Casa Sperantei in Brasov, Romania for a short course in Palliative Care/Medicine. We are very fortunate that we have the support of the Health Centre, the Priests and the Mayor at the Town Hall to support this initiative.
Anne Cragoe
President Faros Skopolou
Island of Skopelos
Greece
Serbian Association of Pain Research and Treatment
(SAPRT)
On the behalf of SAPRT (Serbian Association of Pain Research and Treatment) I am delighted to inform you that this year our small association has become the IASP and the EFIC chapter. In observance of the IASP 2006-2007 Global Year Against Pain in Older Persons, on April 20, 2007, SAPRT held an annual meeting for physicians - 150 participants. The title of the meeting was Therapy of Pain in Older Age. Topics covered were cancer pain, chronic non-cancer pain (low back pain, osteoarthritis), acute postoperative pain and use of pharmacotherapy (NSAIDs, opioids, co-analgesics); physical therapy; interventional pain procedures in the elderly.
Prof. Serdar Erdine, EFIC President, presented our guest lecture: EFIC; a Leading Force in Pain Medicine in Europe. SAPRT also held press conferences on topics of pain management in older age and on chronic pain as a global health problem and a “disease” per se. Pain relief is a human right. A high proportion of Serbia’s population is over 65 years old and will increase from 16.5% to 30% by 2050. In spite of this increase in age distribution, pain is a common symptom of an underlying health problem in older persons. Serbia may and must learn how to treat it. No older person should suffer in pain. Our new book “Pharmacotherapy of Cancer Pain“, edited by Snezana Bosnjak was disseminated to all participants.
Prof. Miroslava Pjevic
SAPRT President
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