Wednesday, February 25, 2009
Sharing the Burden
By George Ntonya, a correspondent
The Nation Newspaper, 23 February, 2009, page 25
Helen Mkupa from Mangochi has been sick since 2006 and is usually in severe pain. When she gets up in the morning, Mkupa is taken into a shed behind her house to while away the day away.
She can hardly walk. She does not enjoy meals because of the pain.
Consequently, she has lost weight.
Two-and-a-half years after falling sick, what remains of her now is a shadow of the once strong and plump mother from Mkope area.
“I have been to the hospital several times but my condition continues to deteriorate,” said the woman who is believed to be around 65 years old.
“They told me that I have cancer of the uterus and I lose a lot of blood because of this,” she explained in a low tone, sitting feebly on a reed mat in the shed.
She said when relatives saw her massive weight lost they suggested that she should take an HIV test.
“The results showed that I was HIV negative,” she said.
Besides, family members, Mkupa looks up to home-based care givers in the area for assistance.
Sometimes the care givers bring her soap and basic food stuffs.
They also provide her with drugs to ease the pain.
“They (care givers) are trying to help but their capacity is limited,” she lamented, adding that in some instances she goes to bed without a proper meal, even when she has the appetite.
Davis Mchengani is Chairperson of Chiwalo Home Based Care Group at Mkope and said there are many chronically ill people his group is helping.
“Most of our clients are HIV-positive and some of them are feeling better because they have started the [antiretroviral] treatment,” Mchengani said.
According to national coordinator of Palliative Care Association of Malawi (Pacam) Lameck Thambo, there are tens of thousands of patients who are in severe pain and cannot access strong pain killers called opioids.
“Many patients, particularly those with AIDS or cancer die in severe pain,” Thambo said in a separate interview.
Out of the estimated 13 million people, over one million are infected with HIV and some of them who are on ARVs – drugs that prolong life – develop different side effects that also bring about severe body pain.
Thambo said patients in severe pain require strong pain control medicines such as morphine but most of them do not access drugs because of medicine control regulations that aim at preventing abuse.
He said the Association is carrying out advocacy programmes to sensitize people on the importance of providing quality care to patients in severe pain.
Africa Palliative Care Association Advocacy Manager Dr. Henry Ddungu said the World Health Organization (WHO) defines palliative care as “active total care of patients whose disease is not responsive to curative treatment.”
He said nearly 58million people die annually in the world and almost 65 percent have prolonged illness which is characterized by severe pain. This justifies the need for palliative care.
According to Thambo, palliative Care Association of Malawi is working in collaboration with the Ministry of Health and other partners to sensitize people on the need for provision of quality care to the chronically ill people so that they die a pain-free death.
“I am happy to say there is palliative care desk officer at each government hospital,” Thambo said, adding that he is looking forward to some flexibility by government in the way strong pain control drugs are regulated, so that patients in severe pain can access them.
In February, 2008 Evangelical Association of Malawi (EAM) launched a K16 million mobile technology with a view to help home-based care groups and health workers improve the quality of service they provide to patients, particularly those infected with HIV.
The mobile technology project was piloted in Mangochi district with financial support from Tearfund – UK, a Christian organization which is supporting different organizations involved in initiatives such as food security, water and sanitation as well as HIV and AIDS.
According to EAM Head of Programmmes Bryer Mlowoka, the project’s main objectives are to improve the quality of care provided by the HBC volunteers, to help the volunteers generate income from the phones for their sustainability and to offer a technological solution that effectively supports information and communication technology related to health services.
The Association distributed free mobile phones to different community-based care givers whose volunteers provide home-based care to the chronically sick people in Mkope in Malindi areas in Mangochi district.
The Association also trained the home-based care givers how they can give effectively use the phones to use the phones to help the sick access medical assistance in good times.
They were also trained in new methods of community home-based care to enable them to improve on the quality of care services they provide to the chronically ill.
The Association also trained them how to use the phones to generate income to support their activities.
Probably, patients such as Helena Mkupa would receive quality palliative care if more community members get proper training to care for the chronically ill.