Hospice Africa Uganda

Anne Merriman describes the major achievements of HAU in the following terms:

I could never have envisaged that the thing would have grown so rapidly. We started, but I never thought of the future - you just saw what was on your doorstep and what needed to be done. But I think one of the achievements is: although we had a struggle getting into the curriculum for undergraduates, we were teaching in the university here since ’93 and every doctor that’s come out since then knows what we’re talking about and is converted. So we’ve got a group of these doctors who want to prescribe [morphine] and their senior doctors are telling them not to, but that will all change. We’ve Dr Jagwe you see who is trying to change them and he’s doing a good job with advocacy, but, you know, it’s taking a long time. So I think that’s one of the major achievements.

The other achievement is the fact that we’ve demonstrated that palliative care works and people who’ve come on our training programmes are really committed to it. When patients come here, not only do they have the medicines - they’re in their case with them – the doctors start them the minute they see them. They see the patient’s pain relieved within an hour - before they leave. If they find a patient or a patient comes in here with severe pain which they’ve had for months, within an hour they’re relieved of their pain and when you can see that, and see it as a reality, you get a deep joy, you know? And so people are really uplifted in their vocation as health workers because they’re seeing things happen which they never saw before.⁵⁷

A hospice patient confirms the discovery of a better quality of life:

Hospice helped me a lot; they helped me in so many ways. My father really praises God for hospice. I was going to hospital every day and feeling bad. But when I start with these people [hospice] they brought everything here; and I’m feeling well, and I’ve put on weight.⁵⁸

Little Hospice Hoima

During 2003-2004, the hospice’s achievements include:⁵⁹

• Acquisition of land for a new headquarters of LHH in Hoima town
• Establishment of a community volunteers programme
• Sensitisation of the community regarding the work of LHH
• Increase in pain control for patients
• Improved report-writing due to staff development activities
• Founding of a journal club

Mobile Hospice Mbarara

Program manager Martha Rabwoni writes:

Mobile Hospice has continued to expand in both the infrastructure and the personnel. We are very grateful to God who has given us the grace to care for our patients. We have seen many patients in their homes, in hospitals, and at roadside clinics. Patients are also examined in the back of our vehicle if the roadside clinic does not provide adequate privacy. The patients in turn have cared for us with a lot of prayers, appreciation and support which have helped us to keep working and sharing our knowledge and skills.⁶⁰

Regarding HAU training, Fatia Kiyange comments:

We’ve got the Distance Learning Diploma Course affiliated to Makerere University off the ground; it’s running very well. We are having students from different countries in Africa, that’s really an achievement for training. We’ve got the Clinical Palliative Care Course off the ground, it’s running - and we do that with the Ministry of Health, so that is also an achievement. We’ve trained and introduced oral morphine and pain control in 14 districts of Uganda and the morphine is there, they are dispensing it, the Ministry has purchased it and it’s free of charge. So that is as a result of our training here, so that’s also a major success. And even our major referral hospital: for years they have continued to refer patients, but we have active people now who have been trained to give the service, and they are giving the service there.⁶¹

Successes at the Mildmay Centre are seen in terms of:

• communicating the goals and services of the Centre to the people of Uganda (and beyond) such that over 7000 patients have come forward to be registered; around 5000 are actively involved with the service at any particular moment
• changing attitudes – with the assistance of antiretroviral drugs - regarding the value of a family’s investment in a child’s recovery, previously seen to be futile⁶²
• the range of education/training courses being taken up from people both within and outside of Uganda⁶³
• the delivery of education/training courses in country districts by innovative mobile teams⁶⁴
• public awareness-raising of the inclusive nature of the service which, due to the quality of the premises, could be misinterpreted as being exclusively for the privileged
• management of a service that has grown rapidly in a short space of time⁶⁵

Among these many successes, 23 July 2003 was a particular cause for celebration when 85 trainees from 8 districts of Uganda graduated from the HIV/AIDS palliative care and rehabilitation course. Joy Edith Angulo, mobile training team co-ordinator, writes:

The trainees at the end of the course designed and presented project proposals to potential donors. It is hoped that these projects will be implemented within the next six months and thus help to develop HIV/AIDS care services in the districts. Some of the districts have also formed palliative care teams within their districts and initiated HIV/AIDS clinics in various health centres and hospitals. The palliative care teams within the districts are also working together to strengthen the services provided.⁶⁶