Palliative care in cancer treatment
Regrettably, most cancer patients in Uganda are diagnosed when cancers are in advanced stages. Trends observed at the Uganda Cancer Institute indicate that almost 80 per cent of patients present the disease in advanced stages.
The bitter meaning of this is limited interventions to prolong survival leading to premature cancer mortalities.
Data at UCI shows more than 60,000 cases of cancer per year in the country, of which 25,000 are incident cases and about 22,000 deaths occur in the country due to cancer.
However, this sad reality should not, whatsoever, mean that advanced cancer patients, who are at the end of their life are left to die in excruciating pain. This is against the right to freedom of pain for anyone.
As we tailor strategies to increase early detection prevalence so as to spur survivor rates, we need to take good care of those waiting to breathe their last.
The magic bullet that ably insulates or relives thousands of advanced cancer patients from emotional pain, roofing them (patients) and their caregivers is Palliative Care.
As defined by the World Health Organisation, Palliative Care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual. It is fundamental to health and human dignity and is a basic human right.
According to Mark Donald Mwesiga, the country director of the Palliative Care Association of Uganda, palliative care is highly effective in managing pain and physical symptoms and can improve adherence to medications. “It can and should be delivered with curative treatment that begins at the time of diagnosis.”
Mr Moses Muwulya, the communications manager, Kitovu Mobile, a venerable medical and community empowerment organisation, which offers palliative care to cancer, and other people living with life threatening chronic illnesses, among other medical services, notes that he has realised the noble importance of palliative care to advanced cancer patients.
“I have seen clients benefiting from our holistic palliative care services getting relieved of the intense pain. I have seen caretakers, who had abandoned patients coming back to look after them. I have seen caretakers, who had got weary become energised through counselling to continue taking care of loved ones..,” the former Daily Monitor health reporter and cancer fight activist, notes.
Paul Lukyamuzi, one of the many palliative care clients for Kitovu Mobile would not manage advanced prostate cancer pain and age-related pains; but because of palliative care, the eighty-five-year-old resident of Kyotera District bravely manages.
“I have just been enrolled in palliative care but there is a sharp difference regarding my emotional and physical well-being,’’ he says. His remarks are synonymous with those made by hundreds of patients on palliative care. Caretakers, too, who need emotional support, attest to this!
But beneath this great impact made by palliative care, there is still need to have it widespread. While the Greater Masaka Communities may be served, many areas are underserved, leaving patients sink in unimaginable pain.
Mwesiga says by December 2019, there were about 225 health facilities offering palliative care in 105 districts of Uganda. There were 30 districts without any form of palliative care being provided to those in need. Of these, 148 were public while 77 were private.
According to him, the most suitable model for the provision of palliative care, especially at the end of life is home care. This is a type of care where health workers visit the home of the sick.
In Uganda, only private health facilities with a palliative care programme offer home care. Only 17 palliative care home programmes are available and they are all by private hospices and organisations. The government health facilities do not offer home care for palliative care patients.
“This has left a gap in access to care. Reports indicate that only slightly more than 11 per cent of all in need of this important service access it in Uganda,” he notes.
But as coverage is ensured, Muwulya says there is also need for the public to know the availability and need of such services.
“Kitovu Mobile has been offering palliative care in great Masaka; but as we grappled with emotional pain, we hardly knew such services were available..,” Muwulya recalls of his daughter’s sickness.