The Hospice Africa Uganda (HAU) model is now in place and can be adapted to the economy and culture of any African country. Thus the founding vision in 1993 and “third objective” of HAU was to extend hospice care across the continent of Africa. Our International Programmes commenced with training for Tanzania in 2000. Since then we have we have been visiting other countries, training, introducing affordable oral morphine and helping to start new initiatives on the ground. To date there have been eleven of these initiatives in eight countries and two in Francophone countries.
The countries we are presently working with include Nigeria, Cameroon, Sierra Leone, Congo Kinshasa, Cote d’Ivoire, Senegal (through Hospice Africa France), Malawi, Sudan, Rwanda, Togo and Ethiopia. Training programmes have been initiated in some countries and others come to initiators training in Uganda to see how palliative care can work in African countries, within the cultural and economic conditions of today.
Other countries send their palliative care leaders for the degree programme and are followed up in country by HAU’s International Programmes, the Institute of Hospice and Palliative Care in Africa (IHPCA) at HAU and APCA (African Palliative Care Association).
The 5 week Initiators Training Programme, which prepares initiators and those just gaining skills in palliative care, has had 168 participants to date (128 from Anglophone countries and 60 from Francophone countries). The courses bring in people from across Africa to learn patient centred holistic palliative care, the importance of a supportive multidisciplinary team and the skills for effective training and advocating for palliative care with various public and private stakeholders. Teams from Uganda have visited, and worked alongside new teams while learning their cultural and economic needs and assisting in setting standards and training on site.
We have 15 residential rooms in our Kampala campus for those in training from other African countries. Other health professionals from Uganda and overseas students on electives with hospice also use this facility. However because of limited space, many of our course participants have to be accommodated in local affordable hotels.
Another key area that IP focuses on is advocacy through meeting with governmental officials discussing the reality of the need for palliative care and the means to introduce oral liquid morphine into a country. In 2013, IP representatives travelled to Togo and the Democratic Republic of the Congo to support this type of advocacy. This included offering assessments and helping to support planning for the way forward and working to get commitments to support students to undertake the initiators course.
A successful trip in early 2014 to Malawi included support for the establishment of clinical standards for palliative care and an assessment into the feasibility of conducting an initiators course there next year.
There is still a lot of advocacy work to be done in Francophone Africa to ensure governmental support, especially to ensure liquid oral morphine is at the needed level.
We are grateful to the many donors who supported the work of our international programmes. These new services show us of the importance of hospice care in the lives of patients we see and remind us of patients who are missed. These reminders are what keep our team going, confident that each person provided with dignity at end of life, makes the efforts of all worthwhile.