What you need to know:
Caregiving: Several medics and social workers have been trained as structures have started recognising the need for palliative care.
Institute of Hospice and Palliative Care in Africa (IHPCA) is the education arm of Hospice Africa Uganda. The specialty institute offers certificates, diplomas, degrees and masters in palliative care and is accredited by the National Council for Higher Education.
In Uganda, palliative care services started in 1993 but the institute started in 2003 as an institution of higher learning, offering certificates and diplomas in palliative care. In 2010, the institution was awarding degrees in the same discipline in affiliation with Makerere University.
IHPCA being a centre of excellence in Africa, the discipline of palliative care, according to Dr Nasur Buyinza, the academic registrar of the institute, attracts a high number of international students because so many other countries have now embraced the policy of palliative care as part of their minimum healthcare packages in most of their hospitals.
In Uganda, several nurses, doctors, and social workers have been trained in about 85 percent of all the districts in the country. Several structures have started recognising the need for palliative care and there is a growing demand for the package. All regional referral hospitals as well as health centre IVs should be able to offer this service.
However, Dr Buyinza remarks that the country still lacks a palliative care policy. “Without the policy, many trainees may not be able to practice the skill and with time, they become deskilled. Also, the government will not be able to commit resources towards this cause and the country will lag behind,” he says.
The palliative caregivers manage patients not only with life limiting conditions but also those with physical pain. Students who come to study palliative care receive not only a qualification but also a calling to care for patients beyond their physical pain management and move the journey to the end of life together, supporting and preparing their families.
The discipline targets health professionals such as nurses, midwives, clinical officers, doctors, pharmacists and dispensers, physiotherapists, social workers and people in the allied health professional courses. There are also training sessions for institutions and organisations that are interested in incorporating palliative care in their programmes.
The programmes offered by the institute include; Diploma in Clinical Palliative Care, Diploma in Palliative Care, Bachelor of Science in Palliative Care, Master of Science In Palliative Care and Post Graduate Diploma in Palliative Care.
“During the programmes, participants are equipped with modern methods of caring for sick people, pain assessment, management of cancer, and HIV patients at any stage, train them on the prescription of morphine while adhering to the legal requirements (successful candidates are registered prescribers in Uganda), a holistic assessment and management of pain, symptoms, psychosocial and creating awareness of the spiritual needs of the patients,” he says.
They are able to offer support to patients and anyone affected by the illness with spiritual, economic and bereavement counselling. All these depend on the type of course you have applied for and your qualification.
The institute also extends training for international students. Although the clinical centre is in Uganda, they work with partner organisations in many African countries to help them bring palliative care programmes to their countries. At the inception of Hospice Africa Uganda, only three African countries had palliative care programmes but through training, several international students, more than 37 countries now have the programme.
This was achieved through the Palliative Care Initiators Course that is held every year. More than 245 healthcare workers from anglophone countries and 137 from Francophone countries have so far been trained.
“We are small enough to mentor and give personal attention to each student and yet big enough to offer palliative care training across Uganda and sub-Saharan Africa either physically or virtually,” Dr Buyinza says.
Palliative care is person and family-centred care provided for a person with an active, progressive, advanced disease, who has little or no prospect of cure and who is expected to die, and for whom the primary goal is to optimise the quality of life.
End-of-life care is the last few weeks of life in which a patient with a life-limiting illness is rapidly approaching death. The needs of patients and their carers is higher at this time. This phase of palliative care is recognised as one in which increased services and support are essential to ensure quality, coordinated care from the healthcare team. This takes into account the terminal phase or when the patient is recognised as imminently dying.
Palliative care helps people live their life as fully and as comfortably as possible when living with a life-limiting or terminal illness identifies and treats symptoms which may be physical, emotional, spiritual or social.