IAHPC Traveling Scholars' Reports

2015; Volume 16, No 9, September

IAHPC Traveling Scholars' Reports

Palliative Care Initiators’ Course for Francophone African Countries in Uganda

Health professionals from Benin and Mali received IAHPC Traveling Scholarships to attend this year’s Palliative Care Initiators’ course for Francophone African countries, an annual course delivered by Hospice Africa (Uganda) that enables health professionals to initiate affordable and culturally appropriate palliative care services in Francophone Africa. Timothé Vulin explains.

“Each year, an estimated 912,000 people, including 214,000 children, require palliative care in Francophone Africa”, says the report Ending Needless Suffering – Improving Palliative Care in Francophone Africa’, co-edited by the International Association for Hospice and Palliative Care.

“The need for this essential health service is likely to rise significantly in the coming years as the percentage of people over 65, the segment of the population most affected by chronic illnesses, is expected to more than double in Francophone Africa by 2050.”

“More than half the countries in the region for which data is available use so little morphine that it is not even sufficient to treat 5 percent of people dying in pain from cancer and AIDS each year,” recalls the same report quoting the International Narcotics Control Board, a United Nations agency.

Participants of the 4th Francophone Initiators' Course in May 2015
The Initiators' Course participants at the oral morphine production unit in Hospice Africa Uganda

“Most of the Anglophone African countries are much more advanced in palliative care than Francophone countries,” says Sylvia Dive, the focal person for Francophone Africa at Hospice Africa Uganda. “It is vital that Uganda, which is at the forefront of African palliative care, shares its successful story through quality education and advocacy.”

Hospice Africa Uganda (HAU), after 19 years of experience in Uganda and 12 years in Anglophone Africa, started its first Palliative Care Initiators’ Course for Francophone Africa, in 2012. Since then about 20 African Francophone health professionals are being trained annually in Uganda.

The intense five-week Initiators’ Course includes a two-week course on pain management and psycho-social support, a two-week clinical placement in the delocalized HAU’s sites and a one-week training of trainers’ course.

“I fully reached my objectives. (…) I now have the competence to deliver appropriate care to the people suffering from life-threatening illnesses, and to teach and advocate for palliative care,” says Dr Zakari Saye, surgeon oncologist from Mali who attended the last Francophone Initiators’ Course on 27 April-29 May.

Dr Saye received a travel grant funded by the IAHPC after his successful application. He is the very first health professional to be trained in palliative care from Mali. Now in Senegal to continue his studies, he has been mandated to carry out a national study on palliative care assessment in Senegal. “An excellent exercise that I will be using in my own country when I will be back in Mali next year.”

Three members of the delegation from Benin

The IAHPC also supported a high profile delegation from Benin with traveling scholarships. The delegation met the main palliative care stakeholders in the Ugandan health system, and visited the clinical and education services of HAU for one week. They experienced the quality integration of palliative care within the health and education systems.

“This week has given us the confidence to facilitate a fast development of palliative care in Benin,” stated M. Djossou, General Secretary of the National University of Sciences in Cotonou. The “vivid and living experience in palliative care from an African country” was so motivating that now back in Benin he and his colleagues are already writing a pilot project for two palliative care units: one at the Zinvié Hospital in southern Benin, to open in 2015, and the other in the St John of God’s Hospital in Tanguiéta in northern Benin, to open in 2016.

Dr. Fabien Houngbe, also from National University of Sciences in Cotonou, explained that for him the trip to Uganda was a rare opportunity to understand that it is possible to accompany patients at the end of life, to allow them to die with dignity and in less psychological and physical suffering, and to accompany families as well. He commented: “The new knowledge that I acquired during this trip will allow me, once back in Benin, to start more quickly – even if it is with few resources and a single patient – something that will grow slowly but surely. Over time, the experience will grow and this will extend the benefits inherent in palliative care to many patients.”

Palliative care is starting to become a reality in Francophone Africa. And the pioneers will therefore need support. “We’ll go back to challenging situations,” confided Dr. Lionel Kamgain from Cameroon on his last day in Uganda. And Dr. Bibiane Kubindana from the Democratic Republic of Congo (DRC) added: “We will need support to be able to do this, it is so important.”

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