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Is Togo ready to integrate palliative care?

Author: Dr Kokou Happy Agoudavi, National NCD Programme Coordinator, Ministry of Health
06 March 2013

Why Togo's healthcare system needs palliative care to address the psychological and spiritual needs of patients.

There is a real gap in the health system of Togo in regards to in palliative care. From the fear among Togolese doctors to prescribe morphine to a lack of competence among paramedics in supporting patients living with a chronic disease such as cancer and their families, the gap is prevalent.

This simply means that in Togo, patients living with Non Communicable Diseases (NCDs) are often abandoned to their own fate. Initiatives and resources dedicated to healthcare are more oriented towards the fight against infectious diseases.

However, it is obvious that pain and the feeling of being abandoned, does not contribute to the recovery of the patient. This is the cross and banner for patients living with NCDs such as cancer. In addition to the psychological trauma caused by the knowledge of their prognosis, there is poor pain management in our health facilities.

Patients living with cancer still sometimes face the indifference of health workers, which often consider them as a ‘burden’. This is the sad reality; humanism seems to leave our facilities in the face of high workloads and insufficient training. This creates and reinforces patients’ use of care from traditional healers and pastors.

Indeed, some paramedics do not hesitate to affirm that their patient’s illness does not fall within the competence of modern medicine, and that they should go to “seek the causes of their disease elsewhere”, or turn toward spiritism or fetishism.

Thus, for lack of competence in palliative care in our health centres, many patients are now in the convent or in prayers centres to be “exorcised” or “unbewitched” from the “evil that is bothering them”.

Is not the patient’s use of traditional healers and pastors after a hospital stay, a manifestation of the lack of holistic care in our health facilities? Isn’t it evidence of the need for the integration of palliative care in the minimum primary health care package? How long are we going to beat around the bush?

Togo, more than ever, needs to be accompanied in this new practice of medicine. Our brothers and sisters living with a chronic disease such as cancer have also the right to be supported, to be accompanied. It is time to put a little "heart" in our health facilities! The time for palliative care in Togo is ripe, it is now!

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