In August 2016, IAHPC members from Africa and South America received grants to travel to Kampala to attend the 5th African Palliative Care Conference hosted by the African Palliative Care Association and the Worldwide Hospice Palliative Care Alliance.
As a requirement of the scholarship, grantees deliver an oral presentation and/or a poster and are asked to give a glimpse of palliative care in their countries and how they hope to adapt some of the knowledge and experiences gained at the congress to their own settings. Here, Valerie Maasdorp explains some of the particular challenges that she and her colleagues face in Zimbabwe.
Zimbabwe has a population of 14 million with 40 percent below the age of 15 years. The economic situation in Zimbabwe is fragile. Cash shortages, import bans and debt all continue to build up. Compounding this, across the country, more than disease. Two years of erratic rainfall and drought is wreaking havoc on the lives, livelihoods and health of many vulnerable families.
In Zimbabwe, the right to health care is enshrined in its constitution. The public health system operates at primary, secondary, tertiary and quaternary levels. Once lauded as excellent, the system has become seriously constrained over the years as a result of economic and funding constraints, new and evolving disease and health patterns, as well as population distribution and settlement patterns. The country cannot attract and retain health professionals especially as public health spend is low – only 6.57 percent of the total budget was allocated to health in 2015. Before 2000, the government financed most of the healthcare expenditure. Although donors have supported the sector since its deterioration, Zimbabwean households have had to assume a larger share of the sector’s financial burden. In particular, user fees have a negative bearing on access to health service especially among poor and vulnerable groups.
A prevalence rate of 15 percent makes Zimbabwe one of the countries hardest hit by HIV/AIDS globally. There are more than 35,000 children in need of Anti-Retroviral Therapy (ART), with only 17,000 accessing the life prolonging drugs. Every fourth Zimbabwean child is orphaned, the second highest orphan rate in the world.
The maternal mortality rate (an indicator of a nation’s health) is 614 deaths per 100,000 live births versus a Millennium Development Goal target of 174 per 100, 000 live births. The under-five mortality rate is at 70.7 deaths versus a target of 43 per 1,000 live births.
Zimbabwe has urgent need for palliative care services. The World Health Organization global palliative care study identified one in 60 Zimbabweans in need of palliative care, and the recent study by UNICEF/ICPCN (United Nations Children’s Fund/International Children’s Palliative Care Network) identified a significant need for palliative care among children in all 10 provinces of Zimbabwe.
Island was founded in 1979 as Africa’s first hospice. It pioneered the development of expert palliative care services, including bereavement services for families of deceased hospice patients and for the general community suffering loss due to any cause. Island has played a major role in scaling up palliative care in Zimbabwe and regionally. The organization’s philosophy encompasses a skilled and sensitive way of caring for those suffering life-threatening illness and their families, whether in hospital, at the roadside or at home. Patient care is provided within a multidisciplinary approach that focuses on the prevention and relief of suffering by means of early identification, impeccable assessment, treatment of pain and other problems such as physical, psychosocial, cultural and spiritual.
Through multi-sectoral partnerships, such as with Ministry of Health practitioners, Island plans to continue to teach, capacity build, implement and strengthen palliative care knowledge and practice throughout Zimbabwe. It will also continue to develop palliative care services with collaborating agencies to address the needs of special population groups, including orphaned and vulnerable children, women survivors of gender-based violence, the disabled, prisoners, traditional leaders, gays and lesbians, displaced persons, and others.
At times we can feel somewhat isolated and a conference of this type in Africa enabled us to network with those in the same field sharing technical expertise, experiences and our resilience in the face of challenges and difficulties for staff and patients alike. It also helped us to initiate new partnerships and opportunities for research and funding to enable Island to provide the needed palliative care services in the severely resource-constrained landscape in which we operate.
To find out more about IAHPC’s Program Support Grants, and our Traveling Scholarships and Traveling Fellowships, please visit our website. Through these programs we support projects and individuals around the world, especially in developing countries in Africa, Eastern Europe, Asia and Latin America.
You can contribute to this program and help palliative care workers attend and participate in congresses and courses by donating the TS Campaign in the Global Giving website.
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