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Clean Intermittent Catheterization (CIC) an approach to improving quality of life of children with urinary incontinence

Author: Beatrice Mang’anda; Team Leader for Umodzi Children's Palliative Care Unit
11 May 2017

Umodzi Children’s Palliative Care Unit was established in 2002 at the paediatric department of Queen Elizabeth Hospital (QECH) in Malawi by Professor Elizabeth Molyneux. ‘Umodzi’ means unity, and we express our unity through caring for a sick child.

The vision of Umodzi is: “Access to palliative care services to all children in need”. The mission is to provide quality palliative care services to children and their families challenged with illnesses that are life threatening/limiting in nature; from hospital to home and to train others to do so using a public health approach through service integration at all levels of health delivery. 

Umodzi Children’s Palliative Care Unit provides services, trains and advocates in palliative care. The Umodzi values are to believe and uphold compassionate team work and excellence

The team in Malawi has facilitated to transform lives of children and their families with urine retention or incontinence due to neuropathic or hypotonic bladder.  

Clean Intermittent Catheterization (CIC) entails insertion of catheter into the bladder emptying out all urine and then removes the catheter. This is performed daily by the care giver. 

The positive impact of this procedure has put the patient in control of emptying the bladder and enhances independence and self -esteem, in that way improving their quality of life. 

Children can go back to school. It prevents Urinary Tract Infections (UTI) due to residual urine, helps interaction with friends and reduces stigma. CIC is started at any age of a child before continence is an issue.

Nicholas* is a 13 year old boy diagnosed with spinal cord compression due to Burkitts Lymphoma. He developed urinary incontinence due to his condition. While getting chemotherapy in paediatric Oncology, his guardian was trained to insert the catheter to drain out urine every four hours. 

He remained dry all the time and was protected from developing pressure sores; hence improved his quality of life. Nicholas is one of the children who benefited from CIC.

*Not his real name

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