Palliative care is “neglected” worldwide, report saysBMJ 2011; 342 doi: https://doi.org/10.1136/bmj.d3510 (Published 06 June 2011) Cite this as: BMJ 2011;342:d3510
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I have been working in palliative care in Tanzania for the past 10
years and must congratulate the BMJ on including the news item "Palliative
care is the 'neglected child of the health care family' too often".
However the report by Human Rights Watch contained some inaccuracies one
of which was quoted under the photograph at the head of the article.
Although the consumption of opioid pain medicines may have been very low
indeed in Tanzania between 2006 -2008 it was certainly not zero. The
hospice and hospital in Muheza, Tanzania, where I worked, were using oral
morphine solution at this time as were several other institutions. The
palliative care which was started in Muheza in 2001 has now been rolled
out into the whole of Tanga region from 2008 and oral morphine and
palliative care expertise are available in the regional and all district
hospitals as well as in the community. This has been made possible by
grants from the Diana Princess of Wales Memorial Fund.
Again, the news item quotes that there are "inadequate opportunities
for medical education..." and that in Tanzania " no such education is
available". I agree that the inclusion of palliative care and pain relief
is sadly still missing in undergraduate medical education but there have
been many programmes bringing palliative care, including the use of
morphine, to hospitals, home based care and right down to grass roots.
The excellent Palliative Care Toolkit, published by Help the hospices and
World Wide Palliative Care Alliance
in 2008, has now been translated into Kiswahili
and 5000 copies of this are being distributed throughout the country.
Tearfund has a pilot project running in the Lake Zone, The African
Palliative Care Association and Tanzania Palliative Care Association
have teaching programmes in palliative care, and the Evangelical Lutheran
Church of Tanzania had a grant from USAID to put palliative care into the
Lutheran church based hospitals.
There is still a huge need for more palliative care education and
better access to pain management world wide and I would like to thank
Human Rights Watch for highlighting this need so vividly in their report.
Dr Karilyn Collins
Former Medical Director Muheza Hospice Care
Co-founder of Palliative Care Works
Competing interests: No competing interests