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The journey of Kenyatta National Hospital Palliative Care Unit

Author: Aquinas Nyakundi
08 July 2014
  • Kenyatta National Hospital palliative care team

Established in 1901, Kenyatta National Hospital has grown to become the National Referral Hospital and establishment of a palliative care unit was inevitable to address concerns of patients with life threatening illnesses.

Kenyatta National Hospital (KNH) is the largest referral hospital in Kenya handling major health care cases affecting the public at relatively affordable rates.

Being a center of last hope for most patients with little financial ability, there was need to have a palliative care unit to take care of patients with life limiting illnesses.

Dr Esther Munyoro is the pioneer of Kenyatta National Hospital Palliative Care Unit (KNHPCU) incepted in March 2007.

She is the PCU coordinator and a qualified anesthetist, currently undertaking a Masters Degree in Palliative care.

The urge to begin a palliative care unit was as a result of the loss that Dr Munyoro suffered. Her father died of Oesophageal cancer back in February 2001.

She saw her father undergo suffering during the course of his illness and she had a feeling that something needed to be done. The quality of dying was very poor and regardless of expected outcome patients should be comfortable.

Dr Munyoro realized that there was a gap in the health care system and purposed to see the Chief Executive Officer at KNH to express her concern.

Following the meeting, a steering committee comprising of a multidisciplinary team was formed to work towards starting a palliative care unit at the largest referral hospital in Kenya.

This steering committee’s subsequent engagement with the administration yielded positive results what saw the unit commence its operation in March 2007 with one doctor and three nurses.

At that time, the palliative care team of four had at least a certificate in palliative care and is currently at different levels of advancing their palliative care education to diploma, degree and masters.

Majority of the patients have cancer but those with other conditions requiring pain management are also seen by the team. The team manages total pain which means the psychosocial and spiritual issues are addressed.

The team has since expanded to six nurses and a doctor with two nurses qualified as stoma specialists who, in addition to seeing other palliative care patients, attend to stoma patients and those with malignant wounds.

The unit has seen over 3000 patients since it was incepted with a monthly referral average standing at about 80 patients.

“We see patients both in the wards as well as at our unit. We have nurses visiting the private wing, medical wing and the pediatric wards and additionally seeing the other patients as referred,” says Ann Mwangi, palliative care nurse at KNHPCU.

She says that in these visits, their aim is to make their life as comfortable as possible adding that most clinicians have little time to discuss pain.

“With the unit in place, we can attend to these patients, have a discussion and handle their physical and psychosocial suffering,” she says.

She adds that the hospital staff has accepted the palliative care concept with time after seeing the result of what we do.

The unit hosts both local and international scholars some who have done research on various issues affecting patients at the end of life. The unit supports Doctors and Nurse at various stages of palliative care education.

The unit also advocates for cancer education to other healthcare workers as well as the community.

KNH has 50 wards, 22 out-patient clinics, 24 theatres (16 specialised) and Accident & Emergency Department. Out of the total bed capacity of 1800, 209 beds are for the Private Wing.

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