Pediatric Palliative Care in Kisii
by Humphrey Odero and Zhuangchen (JJ) Zhou
The pediatric ward at Kisii Teaching and Referral Hospital, on Kenya's western border, is considered a model of integrated palliative care within the country.
Dr. Deborah Omeddo is the chair of the Pediatric Department. A couple of years ago, she was invited to a training workshop in palliative care run by the Kenyan Hospice and Palliative Care Association. Walking out of that workshop, she decided to implement what she had learned into the day-to-day activities of her unit. She said that her staff, who now have also received training by KEHPCA, welcomed the changes despite some initial resistance.
Kisii Hospital though, on Kenya’s western border, is poorly funded, low on medicine such as morphine, and chronically understaffed – a situation not uncommon throughout Kenya’s national hospital system.
Chair of the Pediatric Department Dr. Deborah Omeddo says that the emergency pediatric room usually has one doctor and several nurses crammed into a five by seven meter room with more than a dozen patients and their parents.
Although the palliative care unit provides morphine for children with acute pain, the hospital is frequently low in stocking the medicine, and it does not stock the medicines needed for treating the side effects of morphine, such as laxatives for constipation.
It is a system struggling to provide the care that children need with limited resources. The Occupational Therapy Center has four therapists dealing with more than three dozen patients daily. The Newborn Unit also faces similar challenges—two nurses on a given shift take care of dozens of premature or low weight infants sleeping shoulder to shoulder in incubators meant for one baby. The nurses eyes are ringed with fatigue.
The head nurse says, “I wish we could have more staff, so we could provide better care for babies here.” While the Ministry of Health recognizes the need, finding the money in a cash-strapped budget is not easy given the many needs throughout this developing country.
The palliative care unit concentrates on adults with cancer and registers very few children.The staff receive their training from seminars organised by KEHPCA.
Palliative care means offering holidtic care to your client.Children with HIV are treated in our hospital but those with cancer are referred to Kenyatta National hospital or Moi Teaching and referral hospital.Kisii hospital stull does not have the capacity to diagnose and treat cancer.
It would be great if we had more nursing staff in the hospital to offer quality care. It would be excellent if children with cancer can get diagnosed and be treated fully in Kisii.