My neuro-anesthesia post-qualification medical training at Liverpool's Aintree Hospital was a three-part rotation: in theatre, then pain clinics, and, finally, hospice. I had little interest in the pain clinic and hospice because the practice seemed inapplicable to Kenya.
After I returned home, my father was diagnosed with cancer. Once it was decided that his cancer was inoperable, I felt abandoned by the hospital and health care workers. Luckily, because of my experience in England, I knew that a hospice would help my father. I took him to a hospice in Nairobi and he got excellent care that truly eased his suffering in many ways.
The experience of caregiving to a cancer patient changed my outlook towards patients. I now understood the meaning of the word empathy. I began to look for health-related suffering, which I now understood we all go through in caregiving.
I complained to senior colleagues about the lack of support for cancer patients within the 3,000-bed national referral hospital, and was taken very seriously; I was allowed to start a palliative care unit within the hospital. The unit has done well and will soon be a full department. Last year, upon my retirement, I was awarded presidential recognition for my work in palliative care; it felt good knowing that people benefitted from our services.
Now, I’m running a home for older persons who have a lot of health-related suffering due to dementia, among other medical conditions.
I recently renewed my membership as a lifetime member of IAHPC because palliative care changed my career path and is the one service I have no intention of retiring from.
—Esther N. Munyoro, MD
Consultant Anaesthesiologist/Pain & Palliative Care Specialist, Kenya
Hospice Africa Uganda (HAU) was founded in Kampala in 1993 by Prof. Dr. Anne Merriman with the vision: palliative care for all in need in Africa. In 1998, HAU founded Mobile Hospice Mbarara, later setting up outreach and roadside clinics, to reach underserved rural residents. A second clinical branch, Little Hospice Hoima, also opened in 1998 for another area in need.
Currently, HAU has a 74-member team, and several volunteers, who service most of the country.
Throughout its existence, HAU has cared for more than 35,000 patients, both children and adults, regardless of their gender, ethnicity, religion, political, or socioeconomic status.
Since 2003, more than 500 health professionals from across Africa have graduated from HAU’s Institute of Hospice and Palliative Care in Africa. Furthermore, 37 African countries have established PC services through HAU’s Initiators’ courses, which are available in both French and English.
A breakthrough for HAU was persuading the government to allow nurses and clinical officers to prescribe morphine. By training these medical professionals, the work of HAU was significantly accelerated, resulting in pain relief for hundreds of new patients. Today, HAU is in a private-public partnership with the Ministry of Health Uganda to manufacture oral liquid morphine for Uganda.
HAU provides patients care at a very highly subsidized cost—equivalent to the price of a loaf of bread for 110 days' treatment—which allows them to "live until they die." We are grateful to all our donors and partners who make this possible because most of our patients spend nearly everything to diagnose and treat cancer and come to us when they are in dire financial need.
HAU's lifetime membership with the IAHPC reflects our mission to support palliative care advocacy globally. IAHPC’s policy to provide students with free memberships allows our students to participate and learn more.
—Agasha Doreen Birungi, MD
Chief Executive Director
Hospice Africa Uganda
Learn more about Hospice Africa Uganda (HAU) in the IAHPC Global Directory of Palliative Care Institutions and Organizations.