Special Reports: Kenya conference

Volume 24, Number 12: December 2023

The 6th Kenya National Palliative Care Conference was held in Kisumu City November 15-17, 2023. Photo supplied by KEHPCA; used with permission.

Inclusivity Defined at Kenya Conference

By Josephine Muya
Administrative office, Kenya Hospices and Palliative Care Association (KEHPCA)

The theme of the 6th Kenya National Palliative Care Conference, “Palliative care through the inclusivity lens,” focused on access to palliative care for all by consolidating lessons through the pillars of equity and inclusivity. It encouraged access to palliative care by whoever may need it, provided whenever it is needed, wherever the patient is, and by whoever is able to provide the care.

The event attracted 300 delegates from Kenya and beyond, as well as keynote speakers from around the globe who addressed the rising triple burden of disease: diseases that are communicable, those that are noncommunicable, and emerging epidemics. 

Deputy Governor of Kisumu Country Dr. Mathew Owili spoke of the governor's unwavering dedication to ensuring quality health care for all. Photo supplied by KEHPCA; used with permission.

The focus on equity through inclusivity involved discussion about the beneficiaries of palliative care and their caregivers, the timing of palliative care, the setting of palliative care provision, and other stakeholders needed to achieve universal health coverage. Poster presentations were geared to one of two tracks: equitable access to palliative care through inclusivity, and equitable and inclusive health care systems for palliative care integration.

Messages to delegates

Mackuline Atieno, KEHPCA executive director, emphasized to delegates that every person receives the care they need without discrimination, as palliative care is a human right.

“We all have a role to play in ensuring enhanced, quality health care services for all in Kenya, regardless of your profession,” said panelist Susan Macharia.

“Even psychiatry is a form of palliative care,” noted Wilson Acurda, professor of psychiatry at the Institute of Hospice and Palliative Care Africa, “because psychiatric treatments are not frequently curative.”

Josephine Muya is the administrative officer at KEHPCA, which organized the conference. She was part of a team of employees and volunteers working at the event.

Forging New Paths: Former nursing students show leadership

By Stella Rithara
IAHPC Board Member

A group of palliative care nurses at the Kenya palliative care conference. All but four were taught by Stella. Photo used with permission.

At the Kenya National Palliative Care Conference, it was a great pleasure to speak with nurses I trained between 2013 and today. It was awesome listening to former and current students presenting new and innovative practices like these:

Several have established new PC units

Several palliative care nurses have launched palliative care units in their counties. They shared information about opportunities, such as becoming involved in hospital management activities, research, training, and presenting at conferences and symposiums. They also discussed challenges, including the lack of essential medicine such as morphine, lack of support in implementing palliative care, and conflict between oncology and palliative nurses. They talked about benefits to their choice of profession, such as freeing up hospital beds, enacting better management of both pain and distressing symptoms, and spreading awareness of palliative care services in hospitals.

Stella Rithara (right) with Julia Downing at the KEHPCA conference. Photo by Caroline Githae; used with permission.

Stelle Rithara is an active palliative care public health champion and leading nurse trainer in Kenya who, as an IAHPC board member, represented IAHPC at the conference. Read her bio.

The Right to Lifelong Health Care Is a Necessary Precursor to Palliative Care

Submitted by Monico Do Coutto Monni, IAHPC Focal Point for Canada; and
Executive Director, Near North Palliative Care Network, Ontario, Canada

Monica Do Coutto Monni at the CHPCA National Palliative Care Conference. Photo by Andrea Bird; used with permission.

The Canadian Hospice Palliative Care Association National Conference, held in October, included panel discussions on “Burning Issues.” I participated in one of them: “Reimagining Palliative Care: Examining the assumptions and asserting the importance of palliative care as a universal human right.”

“Throughout the CHPCA conference, we explored so many facets of the palliative care revolution we need in Canada. This Burning Issues panel shone a spotlight on the importance of challenging our basic assumptions at the foundation of what it means to provide high-quality palliative care to everyone who needs it in our communities.” 

—Laurel Gillespie
CEO, Canadian Hospice Palliative Care Association

We advocate that “palliative care is a human right,” but that statement is embedded in assumptions. The assumption of palliative care as a human right is mistaken for legal, theoretical, and historical reasons; human beings have the right to health. Palliative care should remain part of the right to the highest attainable standard of health. 

Why preventive care is a necessity

Societies should stress prevention, rehabilitation, and treatment. Properly done, this can reduce the need for palliative care. In lower- and middle-income countries, people routinely present too late for curative care, so palliative care is their only option. If there is no right to preventive care or treatment, it is absurd to promote a right to palliative care. It is important to recognize palliative care as a subsidiary right in the spectrum of services. Otherwise, to skimp on prevention and treatment, countries could theoretically offer palliative care after a whole life of poor health care, “to fulfill their human rights obligations.” Equity and inclusion are human rights principles, with no addition or qualification, and do not need to be stipulated separately.

The health care model generally is based on Westernized, Eurocentric knowledge, values, and beliefs of expansionist empires during the colonial period. When we talk about decolonization, this runs the risk of becoming one more buzzword. It is a decisive first step forward, but not enough, to decolonize the culture of Canadian indigenous peoples, for example. The palliative care revolution lies in advocating for the highest attainable standard of palliative care for all.

More than just decolonizing certain segments of society, Canada has been working to de-imperialize Canadian culture. As such, Canada is leading the way, in its sociopolitical progressive thinking, on how to overcome anachronistic practices and prejudices based on Western European aristocratic power, wealth, privileges, and class divisions that still resonate in the culture of former colonies around the world.

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