6 mins
‘Pray for our christian healthworkers’
Jackie Macadam learns how a Christian healthcare charity is supporting end of life care in Africa.
END of life care. It’s a scary thought – but in Scotland we can be reasonably confident that we will receive the best palliative care we can, and that there are specialist nurses who will care for us when we approach the end of our life.
Imagine then, being in a small village in Africa. You have cancer. Pain relief is occasional, at best.
That’s the situation a project headed by EMMS International is tackling.
The African Palliative Care Association, does its best, but drug supplies to Africa and then the outlying countryside, can be difficult to come by and supply chains can break down.
Cathy Ratcliff, Acting CEO and Director of International Programmes for EMMS said: “EMMS has worked on palliative care in Malawi since 2010, helping various partners to improve their care. From 2015 to 2018, we ran a three-year, DFID-funded project called METHOD, to help Mulanje Mission Hospital and Nkhoma Mission Hospital to reach the standards of the African Palliative Care Association, assisted by Palliative Care Support Trust and the Palliative Care Association of Malawi. (DFID is the UK’s Department for International Development.) As that project was ending, EMMS was running another project to improve healthcare along the lakeshore in north Malawi, especially reaching remote health centres which are inaccessible by road. And so our next DFID-funded project in Malawi combined these two ideas – palliative care through remote health centres, working with these same four partners plus David Gordon Memorial Hospital. We call this project Chifundo, which means “Compassion” in Chichewa, and it is helping all four central hospitals plus one health facility in each of Malawi’s districts to reach the standards of the African Palliative Care Association.”
The project aims to tackle the problem in a variety of ways.
“It includes training 95 health workers for five days and giving them a two-week clinical attachment, and training 62 spiritual, legal and social workers for two days. All the district health centres that we’re working through are Christian, of different denominations.” Cathy explains.
It’s not everyone who wants to work in palliative care, but the people who do are a special breed.
“Palliative care attracts people who are passionate about it,” says Mary Robertson Director of Fundraising for EMMS. “It is not for the faint-hearted or for the inexperienced. Many of the people we encounter in our partners who are working on palliative care started working in it because they nursed a close relative through an illness, and watched them die, usually in pain. Very often it is that experience that has made people work in palliative care, so that others don’t have to go through the pain that they saw their relative go through. Getting pain relief drugs in Malawi is a challenge, and quite often the whole country has no morphine supplies, for example, and so our project Chifundo works on that, holding regular meetings with government, and making sure that District Health Officers know that these drugs are needed. In our previous DFID-funded project, we also trained pharmacists, so that they knew when they should order drugs, and those pharmacists are still working in health facilities in Chifundo.”
But medical help is not the only aid provided by the project. The churches in the areas covered are able to take part as well.
Mary explained: “When dealing with life-limiting illnesses, of course spiritual support is very important, and each partner and each health facility has a chaplain, who makes home visits to families. We train spiritual workers to use a book called Inspiring Hope which EMMS published a few years ago, and we also train each of our four service provider partners (Palliative Care Support Trust, Mulanje Mission Hospital, Nkhoma Mission Hospital and David Gordon Memorial Hospital) to train 10 churches each, spreading messages of caring and love.”
Cathy explains that though not entirely new, the recognition of the need for palliative care has come on the back of the HIV levels in Africa.
“Palliative care is relatively new in Malawi, but has grown quickly through the efforts of EMMS and due to the needs caused by HIV. Many people with HIV in Malawi have cancer, and most of the patients in Chifundo have cancer. Cancer is common across all ages in Malawi, and so is very sad to see. Palliative care across Africa has been helped by the African Palliative Care Association and by generous donors such as the UK’s Department for International Development and another donor to our projects, The True Colours Trust. This is the stage that we’re at in the HIV epidemic in Africa – many deaths from cancer. Previously there were not so many deaths from cancer, and not so many painful deaths.
“We estimate that in Malawi 180,000 people need palliative care at any one time, in Nepal 120,000 people need palliative care at any one time, and in India over six million people need palliative care at any one time. These are real people, with stories of their own.
“There are people like young Jerimiah. He’s 14 and has cancer in his leg. His mother struggled to find enough food for the family and his only treatment was a grass mat that he could lie on, though the pain from his leg stopped him moving and he developed pressure sores as a result.
“But even though a cure is not available, there is still much that can be done to improve the quality of life of Jeremiah and his family.
“EMMS International’s partner, Palliative Care Support Trust, has been able to help renovate the family home so that they have safe and dry accommodation, especially in the rainy season. When needed, Jeremiah gets additional food support to help him stay strong and continue with his medication which he now gets regularly. Families like his are benefitting from support to set up kitchen gardens to help fight off hunger.
Jeremiah two years ago (left) and today (right) thanks to help from EMMS’ Chifundo project.
“Jeremiah receives regular visits from specialist healthcare workers to help him manage his pain and other symptoms. This eases the burden of care on his mother too.
“Jeremiah missed going to school and playing football with his friends. Thanks to a wheelchair provided by PCST he is able to sit up and be more mobile. He can spend time with his friends and enjoys the visits of a teacher who comes to his home for weekly lessons. Small ways to help a young lad, but crucial for his quality of life.”
And churches here can help too. Mary explains: “We need churches to pray for our Christian healthworkers trained on the Chifundo Project, many of whom are working with a shocking lack of resources and who are now more on the frontline than ever before. Please remember their patients and their families battling poverty, hunger, sickness and anxiety. Churches can support the work financially by giving to help change outcomes, to provide care, pain relief, comfort, and food. Their help is needed to extend palliative care to the next 10,000 families who have totally inadequate access to basic healthcare.
“We estimate that in Malawi 180,000 people need palliative care at any one time, in Nepal 120,000 people need palliative care at any one time, and in India over 6 million people need palliative care at any one time.
“At this stage, we are working hard to make sure that Chifundo improves the lives of nearly 10,000 more families in Malawi, mainly in hard-to-reach areas. We would love it if DFID and our other donors wanted to fund the next stage, perhaps taking palliative care to more Christian health centres in hard-to-reach areas, or to include more rehabilitation of patients, especially children.”
For more information, contact EMMS at www.emms.org
This article appears in the June 2020 Issue of Life and Work
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