In August 2017, Hospice Africa Uganda started programs to integrate Palliative Care into the refugee settings based on a report from a multi stakeholder consultations conducted in the refugee hosting districts that revealed a high need for Palliative Care among refugees due to life limiting illnesses including cancer, chronic hepatitis B, diabetes, heart diseases and Tuberculosis among others.
With support from the Open Society Initiatives for East Africa (OSIE) through the African Palliative Care Association (APCA), we were able to train 54 health workers from 5 major refugee settlements in Uganda including Bidibidi, Kyangwali, Kiyrandongo, Oruchinga and Nakivale. These health workers were selected from both government health facilities and that of UNHCR health Implementing Partners such as Medical Teams International (MTI), International Rescue Committee (IRC) and Real Medical Foundation (RMF). The training has greatly improved the quality of care for patients with chronic illnesses within the settlements and surrounding areas. HAU has also worked with these partners and the DHO’s offices in the different districts to improve on the morphine supply chain as well as the referral system of the patients.
We are currently working with Isingiro District where we are implementing a one year project of integrating Palliative Care into the humanitarian health interventions in the district with support from the Julia Taft Refugee Fund under the US Department for State. This project will see the establishment of 3 palliative Care units in government health facilities serving refugees (and host communities) namely; Nakivale Health Center III, Rwekubo Health Center IV and Nshongyezi Health Center III.
We have so far provided trainings to 25 Community Health Workers (CVWs), 12 traditional healers and 12 religious healers who will help with identification and follow up of patients from within the communities. We are also in the process of identification and facilitation of specialized training to 3 health workers in Palliative Care who will be the main providers of PC services at the units.
HAU has been conducting monthly outreaches to Isingiro to serve patients from both the local population and refugees from Nakivale and Oruchinga which has a huge population of over 134,000 people from different countries including DRC, Rwanda, Burundi and Ethiopia among others. Despite this outreach, several patients still have to be transported to our site in Mbarara, over 60 kilometers away but with the establishments of the 3 palliative care units, services will be made more available.
During a recent visit to Nakivale by our project team, one of the patients, a 48 year old Murekatete Domitile in Kashojwa “C” at the Base Camp, was delighted to learn that she will soon not have to travel the long journey to Mbarara for her medication and review for Palliative Care but simply walk for less than a kilometer to Nakivale Health Center III to get the care she needs. Domitile was enrolled in the HAU care program in October 2017 from Mbarara Regional Referral Hospital after a mastectomy (right breast removed) to treat breast cancer.
She has since then been returning to Mbarara for review and to get medication but once this unit is established, Domitile and other patients in the area will get all services without having to travel the long distance.
We thank all our donors and partners who have supported this initiative that is greatly improving access to palliative care for refugees as well as host communities across Uganda.