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Promoting Hospice & Palliative Care Worldwide

International Association for Hospice & Palliative Care

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"Promoting Hospice and Palliative Care Worldwide"

 

2004; Volume 5, No 9, September

 

A day's work at Mobile Hospice Mbarara

by Dr Eunice Nyesigire, Medical Officer,
Mobile Hospice Mbarara

Index:

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Message from the Chair
& Executive Director:

Dr. Bruera
& Liliana De Lima


Article of the Month:
Dr. Ripamonti

Book Reviews:
Dr. Woodruff

Travelling Fellowship Reports:
Ghana

Regional News:
Africa
Uganda
UK

A Day's work:
Mobile Hospice Mbarara

Focus on IAHPC Board Member:
Dr Daniela Mosoiu

Hospice & Children:
Help the Hospices

Webmaster's Corner:
Anne Laidlaw

Editor's Notes:
Dr. Farr

Palliative Care in the Developing World: Principles and Practice

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A Day's Work at
Mobile Hospice Mbarara

My day starts as early as 6:00am when I wake up in preparation for the work ahead. It is usually not known where I will spend my day until about 8:30am when it's announced by way of writing in the diary; Dr. X, you are spending your day in hospital. By who? yes you guessed right, Ms. Martha Rabwoni.


The journey to the hospital from Mobile Hospice Mbarara is in most cases a luxurious ride in a comfortable Suzuki 'escudo' or 'Prado land cruiser' manned by our experienced driver Hassan Bukenya. However, when luck is not on your side, you take on an enjoyable ride on a boda boda (back of a motorbike) over the bumpy humps near Mbarara University gate on the way to Hospital.

In a flash of a bee's wing, we are at the hospital and straight away to the wards. On a fully packed ward with some patients on the floor, we are guided to a patient in a corner, with a huge mass on the lower limb. The notes of the referring doctors are saying "advanced osteogenic sarcoma". The patient is visibly in pain and is distressed. We greet the patient, who replies in a solemn tone that he is fine. One by one we pass our introductions and explain that we are from Hospice Mbarara and we have been directed to him by his doctors and that we are there to help him with his pain. The next question from the patient is whether really this pain can ever be relieved. Humbly by the patient's poor and sorry state, we reply that with God on whom we depend, everything is possible; trying to use the most empathetic tone and words that we can afford.

Ground rule:- If the patient seems to be in overwhelming and distressing pain, please score it and give a start dose of the "magic drug". Yes, I mean morphine, well, that is what I do.

Over the few months I have been in Mobile Hospice Mbarara, we have been able to attend to well above 100 patients in hospital, most of whom have been under our care and the hospital. I hope I am not confusing you; it is this easy, some patients are referred to us to take over management of pain and follow-up at home while others are managed jointly with the hospital, especially the AIDS patients.

Back to the point, after full assessment and dispensing our medication and after doing enough talking, we say bye to the patient who seems to be in a better mood now. On that particular day, we saw five more patients with considerable pain, some even more overwhelming.

It is now 13 00hrs, we are winding up with the fifth patient on gynecology ward, who is elderly unlike our fist patient who was young. We pack our bags and hit the road. At the university gate its like about 10 bodaboda riders were expecting us. Most of the bikes looked not to have seen water for decades. Ignoring most of them, we choose two that looked less dirty, and off we are on our bumpy road back to Hospice.

At Hospice Mbarara it is lunch time, and I breath a sigh of relief, the hospital visit for today is over and I get down to enjoying well cooked matooke for lunch.

by Dr Eunice Nyesigire, Medical Officer,
Mobile Hospice Mbarara