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Palliative care project starts in Mauritania, West Africa

Author: Dr David Fearon, Cairdeas Sahara and Dr Alhousseynou Sall, ASSIDE
20 May 2015

Cairdeas Sahara, a new palliative care project in Mauritania, West Africa, has recently completed the country’s first training of health care workers in palliative care.

16 nurses and four health related workers attended the training in February 2015.

Cairdeas Sahara is an affiliation of several organisations; a local Non Governmental Organisation (NGO) Action Sahara pour la Santé, l’Innovation, le Développement et l’Education (ASSIDE); the Scottish charity, Cairdeas International Palliative Care Trust; and a Swiss NGO, Consulting, Training and Support (CTS).

The training, in French, was held over five days and based on the toolkit: Palliative Care Toolkit: Improving care from the roots up in resource-limited settings produced by the WHPCA and Hospice UK.

Novel, "excellent" training

Most of the participants had never heard of palliative care during their professional training or careers and everyone rated the week as being either ‘excellent’ or ‘very good’.

The sessions on communication skills were regarded as a highlight and the organising committee gained some crucial cultural insights from an enlightening discussion on what ‘a good death’ means in Mauritania.

“It was a great pleasure for me to be a part of this training. We are working hard to make sure that this project grows and will touch those who need it most, as there is much need here,” commented Dr Alhouseynou Sall, director of ASSIDE.

There is an appetite for ongoing regular training in palliative care and further sessions are already planned for the coming months, covering advanced communication skills, bereavement and physiotherapy in palliative care.

The medical director of Cairdeas Sahara, Dr David Fearon, explained that the training of local health care professionals in palliative care is one of four areas in which the charity is involved. The other areas are research, care provision and advocacy.

Research

The African Palliative Care Association’s African Palliative Outcome Scale (APCA African POS) is currently being translated and validated in several local languages: French (Mauritanian), Arabic, Hassaniya (a local dialect of Arabic) and Pulaar (Fulani).

This work follows the translation and validation guidelines provided by the POS team at King’s College London, and has involved numerous translators and health care providers across Mauritania, Senegal, Tunisia, Morocco and Sudan.

These are at different stages of development, with the Hassaniya version now ready for psychometric testing after completing cultural adaptation and validation. This process will involve 100 palliative patients, each being interviewed on four separate occasions.

Care Provision

Dr Fearon currently leads an informal home based palliative care service, however the project will soon be moving into a small new office and recruiting two full time nurses, allowing more patients to be visited at home and during their hospital stays.

The project has an established relationship with the National Oncology Centre, from where the majority of referrals are initially expected.

Advocacy

There is no current formal provision of palliative care in Mauritania, with limited access to injectable morphine and an intermittent supply of long duration morphine tablets (which are relatively expensive).

Liquid morphine or short-acting formulations are not yet available, and this is currently a priority for Cairdeas Sahara.

To find out more about this work, visit the Cairdeas Sahara Facebook page or the organisation’s website.

Read this article in Arabic, French and Pulaar on ehospice. 

Dr Alhousseynou Sall is director of ASSIDE, Mauritania.

Dr Fearon is medical director of Cairdeas Sahara and PhD student in palliative care at the University of Lancaster, United Kingdom. If you would like further information please contact him at d.fearon@lancaster.ac.uk

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