BMJ  2003;327:209-213 (26 July), doi:10.1136/bmj.327.7408.209

Education and debate

Quality care at the end of life in Africa

¹ Programme on Cancer Control, World Health Organization, Avenue Appia 20, CH-1211 Geneva 27, Switzerland, ² HIV/AIDS Care, World Health Organization, Geneva, Switzerland, ³ Ministry of Health, Kampala, Uganda, ⁴ Department of Medicine, University of Zimbabwe Medical School, Harare, Zimbabwe, ⁵ Hospice Africa Uganda, Kampala, Uganda, ⁶ AIDS/STD Unit, Community Based Care, Ministry of Health, Gaborone, Botswana, ⁷ Ocean Road Cancer Institute, Dar es Salaam, Tanzania, ⁸ Radiotherapy Centre, Addis Ababa University, Addis Ababa, Ethiopia

Each year about 0.5% of the total population in Botswana, Ethiopia, Tanzania, Uganda, and Zimbabwe die from HIV/AIDS or cancer. The members of a WHO project to improve palliative care in these countries discuss their work. The greatest needs of terminally ill patients were for adequate pain relief, accessible and affordable drugs, and financial support to counter the loss of income of both patient and family caregiver. Special emphasis should be given to home based palliative care provided by trained family and community caregivers to counteract the severe shortage of professional healthcare workers

The first 150 words of the full text of this article appear below.

Each year in Africa about 2.5 million people die from HIV/AIDS, and more than 0.5 million die from cancer.^{1 2} Many of these deaths are accompanied by suffering that could be avoided or relieved if adequate palliative care were provided. Quality care at the end of life is a global public health problem.^{3 4}

Palliative care, as defined by the World Health Organization (WHO), is an approach that improves the quality of life of patients and their families facing the problems associated with life threatening illness, through the prevention and relief of suffering by means of early identification and careful assessment and treatment of pain and other problems, physical, psychosocial, and spiritual.^{2 4 5} Palliative care regards dying as a normal process and offers support to help the patient and family cope during the patient's illness and in the bereavement period.

WHO has developed a relatively inexpensive yet effective method for relieving cancer pain . . . [Full text of this article]

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