The Minister of Health Dr. Elioda Tumwesigye today (Friday May 20th2016) pledged to support the scaling up of palliative care training in Uganda in order to meet the need of the country’s seriously ill and dying people and their families.
Speaking at the graduation of 29 students conferred with a Diploma in Clinical Palliative Care from the Institute of Hospice and Palliative Care in Africa (IHPCA) at Hospice Africa Uganda, the Minister said a number of challenges need to be met in order to make palliative care accessible to all in need.
“Despite major achievements, especially the work of Hospice Africa Uganda over the last 23 years, a lot more needs to be done to meet all of the palliative care needs in the country,” he commented.
He spoke of his own personal experience with cancer, having lost both parents to the disease. He revealed his mother was on the Hospice Africa Uganda programme in Mbarara.
Dr. Elioda Tumwesigye giving a speech during the graduation at Hospice Africa Uganda
Minister Elioda said there is an “urgent need” to scale up training with the Diploma in Clinical Palliative Care Programme, which trains registered nurses and clinical officers to legally prescribe oral liquid morphine for pain relief. Uganda is the first country in the world to make crucial legislative changes to allow specially trained nurses and clinical officers to prescribe oral liquid morphine, a cornerstone medication used in Palliative Care. This is to supplement the limited numbers of doctors, who in most countries are the only registered prescribers of such medications.
He committed to offer support to widen the reach of palliative care and to see if the Government, through the Ministry of Health, will consider stepping in to offer scholarships to students to whom fees for palliative care courses are out of reach, or at least to subsidize student fees as is done in Public training Institutions.
He also said he would work to ensure that all the three academic programmes run at the IHPCA - the Bachelor of Science Degree, the Diploma in Palliative Care and the Diploma in Clinical Palliative Care - are included in the Ministry of Public Service scheme of service. This has been the most serious challenge faced by graduates from these courses because it means they have no channel for promotion or career progression in public service.
To date the IHPCA has trained 160 palliative care practitioners in prescribing liquid morphine. Whilst palliative care exists in 80% of the districts in Uganda the Minister said this is “a drop in the ocean” compared with the demand for palliative care in the country.
In attendance at today’s graduation was the founder of HAU, Professor Anne Merriman, senior IHPCA staff led by the Institute principal Prof. Stanley Acuda Wilson, members of the Board of HAU, members of the Governing Council of IHPCA, the Acting Chief Executive Director of HAU, Dr Eddie Mwebesa, graduands and their relatives.
The Minister said that graduation is a very important occasion not only for graduating students and their families, but also for the entire country as another group of highly trained specialists enter the pool of those trained in palliative care.
“All over the world, including Uganda, the need for palliative care is significant and growing because of the high prevalence of cancer, HIV/AIDS and increasing prevalence of non-communicable diseases. In Uganda most of the palliative care has been delivered by Hospice Africa Uganda which is the country’s pioneer Hospice. Uganda has so much to be than for from the work of HAU, which was founded by the visionary Prof. Anne Merriman in 1993. I am indeed honored to meet her face to face for the first time today.”
He told graduands: “Your graduation today means that you have demonstrated dedication, toughness, and perseverance to attain the academic standards set by the National Council for Higher Education,, for the award of the Diploma in Clinical Palliative Care.”
“You are now ready to go out to the communities where you live and work with confidence and prove that the qualification you have received today is not just a piece of paper, but testimony that you have acquired the necessary skills to deliver high quality and holistic palliative care to hundreds of our patients suffering from cancer, HIV/AIDS and other life limiting illnesses in Uganda with dedication and devotion.”
Dr. Eddie Mwebesa ( 2nd from left), Prof. Anne Merriman, Ms. Naome Nasasira, Joan Kelly and DCPC graduands cutting the cake during the ceremony
Acting Chief Executive Director of HAU, Dr Eddie Mwebesa reiterated the huge need for Palliative care in Africa and in Uganda and stated: “According to Worldwide Hospice and Palliative care Alliance in 2016, 40 million people worldwide need palliative care. 18 million die each year in severe pain and distress due to lack of access to palliative care and pain relieving medications. 78% of these live in middle and low income countries and 6% are children. 42% of countries in the world do not have any palliative care services.“
“Since its inception HAU has cared for over 26 000 people at its three sites in Uganda, (Kampala, Mbarara and Hoima), and it currently cares for over 4,600 patients annually. Through training and education we can deliver on the founding vision. But a lot more needs to be done to see that this happens.”
Prof. Stanley Acuda Wilson said the IHPCA is playing a vital role in training and educating doctors, nurses and healthcare workers in palliative care in Uganda and Sub Saharan Africa.
“The Institute was recognized by the National Council for Higher Education as a tertiary institution in 2009 and granted a provisional license to confer degrees and diplomas in affiliation with Makerere University. The Institute was granted the degree awarding Institution status in 2014 with a provisional license to award its own degrees and diplomas. This was a very important development and a great step forward to spreading the mission of palliative care.”
HAU founder Professor Anne Merriman said “despite the achievements by Hospice Africa Uganda in provision of palliative care services with meagre resources, there are a number of challenges which require government help in order to increase accessibility of palliative care in Uganda and fulfill HAU’s vision of palliative care reaching all in need in Uganda and Africa”.
Prof. Anne Merriman talking to the health minister as he was preparing to leave
This includes implementation of the 67th World Health Assembly Resolution of 2014 on strengthening palliative care as a component of comprehensive care throughout the life course and specifically development and implementation of a National policy to integrate palliative care across all levels of health care;.