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A rural hospital initiates a successful palliative care service – St Francis Naggalama hospital, Uganda

Author: Sr Jane Frances Nakafeero
09 March 2015
  • St Francis Naggalama Hospital in rural Uganda

“My father the late Joseph Mugerwa suffered a long illness. My mother Rosemary had long passed on. We had to leave the hospital and nursed him at home in Namugongo, He had earlier undergone a hip replacement which weakened him and was confined to bed for over 9 months. While in this condition, his hearing became poor, he suffered from hypertension, became diabetic, lost his sight completely and could not swallow. Despite the care given by the family, he developed bed sores and eventually died in February 2011. The family watched him die slowly each day and when he finally passed on, we had all died several deaths before him. He had one inspiring sentence on his failing breath till his death. He would say: “Thank you my children, may God bless you”. He said this over …. and over…..” Rest in peace.

Inspired by this personal encounter, Sr Jane Frances Nakafeero re-initiated palliative care services in May 2013 at St Francis Naggalama Hospital on her appointment as Hospital Administrator. This was done after a series of discussions with the team of The Palliative Care Association of Uganda and APCA.  The hospital manager believes that whether sickness or age, everybody has a right to palliative care; it is essential to ensure that these people can live; and ultimately die with dignity. 

Therefore, with a one year grant of £5,000, from True Colors Trust through APCA, the Hospital which was founded in 1906 by Mother Kevin Kearney as a general 100-bed Not-For-Profit facility, embarked on a successful Palliative Care program which is offered alongside other services.   The Hospital offers preventive, curative and rehabilitative services including HIV/AIDs care, Maternal and Child Health care.   The palliative care initiative has been fully supported by both staff and board members of Naggalama Hospital.

The palliative care core team including one Registered Nurse, one Nursing Assistant and one Pastoral care giver, started with 14 clients and have now built it up to 50. The program embraces both geriatrics as well as clients suffering from life threatening illnesses such as cancer, diabetics and HIV/AIDs.  Clients are identified at the Out Patients Department, on the inpatient Wards and from the community.  Training for staff, caregivers and healthcare teams in the community was carried out and some drugs were purchased and oral morphine is given to those who need it in the hospital and on outreaches in the community.

The persistent challenges include lack of adequate transportation for both patients and staff and need for social support for some clients who are neglected by their own relatives and end up living in dire need of basic necessities e.g. medication, food, sugar, soap, beddings and water. There is need to train more staff in palliative care in order to strengthen the existing activities and to strengthen the outreaches. 

We appreciate the support of PCAU, APCA and all their staff and their interest, simplicity and encouragement to our staff, hospital management. The hospital Board is greatly appreciated for accepting the Program and for their encouragement.  As we implemented the project we got extra support outside the grant and we would like to appreciate Dr Howard and Prof Randi from New York, USA who now come to our hospital annually to support the palliative care program

In conclusion, palliative care has helped the clients to realize that they are not cursed, that somebody else cares, that God loves them and that they are not abandoned. It gives them hope and love.  A “thank you” or “a smile” from the client is very encouraging to the palliative care giver and vice-versa. Therefore, let us continue to embrace not only the pain and symptom management but the practical problems as well including the emotional, social and spiritual needs of patients.

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