Kenya, May 18, 2020. Published by the European Association of Palliative Care on its COVID-19 blog: reprinted with the kind permission of the EAPC.
By Dr. Zipporah Ali, Chief Executive Director of Kenya Hospices and Palliative Care Association
Countries across the world are all struggling with the COVID-19 pandemic. These are extremely challenging times for all, especially those in leadership and those working in health care. No doubt this is a situation that cuts across so many sectors within a country. Leaders are struggling to make the right decisions with very little knowledge of a new deadly pandemic. Health care workers and other frontline workers are doing the best they can with minimal or no supplies of personal protective equipment (PPE), inadequate knowledge of COVID-19, and poor infrastructure. This is felt even more in countries with weak/broken health care systems.
Amid all these challenges, the need for a holistic approach of care for those affected with the virus is important. Thus, those infected, their families, and people living with preexisting conditions and older people, will need comprehensive care that not only addresses physical symptoms of the disease for those with the virus, but also psychosocial and spiritual support to the sick, their families, the health care workers, and volunteers as well. In fact, since this is affecting everyone, there is a need for psychosocial, spiritual, and grief support for all humankind. We are all, in one way or other, affected.
Kenya Hospices and Palliative Care Association (KEHPCA) conducted a survey of 16 hospices and palliative care units in public, mission, and private hospitals across the country. From the survey, palliative care clinicians have genuine concerns both for themselves and for their clients. These are real fears and concerns that are hindering them from providing care for those in need. Fears include getting infected, infecting their clients because of lack of appropriate personal protective equipment, and not having enough information on COVID-19.
Patients too have fears and concerns for themselves and their loved ones. They are afraid that they may not receive the care they need for their preexisting conditions, may not have access to medications, may be affected with COVID-19, may spread it to their loved ones, and may die alone with no family member with them. Cancer patients on chemotherapy and/or radiotherapy are worried that they will not complete their treatment and that all funds will prioritize COVID-19.
They also have financial fears. These include: being unable to access or afford their medications, being a burden to their families, and breadwinners in the family being unable to earn due to isolation and curfews.
We have strongly advocated for palliative care to be integrated into the COVID-19 response by providing palliative care guidelines for COVID-19 management, and are working with our Ministry of Health/Mental Health Department to engage palliative care clinicians in providing psychosocial support to those affected (patients, families, and health care workers). This includes the rehabilitation of those who have recovered and helping them back into their community by addressing stigma-related issues.
We are also providing factual information on COVID-19 (in brochures, leaflets, posters, online training), and distributing PPE to enable palliative care workers to see patients and/or their family members through support from our international partners.
We are truly grateful to the True Colours Trust, Global Partners in Care, and Open Society Foundations, whose support enables us to support hospices and palliative care units in public and mission hospitals.
We encourage patients and families to use modern communications technologies, and are providing airtime and smart phones to hospices to enable communication, including video communication if need be. We are also working to build systems for psychosocial support to patients/families, as well as palliative care clinicians and volunteers, and developing bereavement support programs with our other partners, like Faraja Cancer Support.
This is a fight that requires we all join forces to mitigate the negative impact of COVID-19. Pamoja twaweza – together we can.
KEHPCA has been involved with the Ministry of Health of Kenya in developing the first National Cancer Control Strategy as well as the first National Guidelines for Cancer Management in Kenya.