Physicians in Kigali have come together to voluntarily offer the rare palliative care to patients with terminal illness, through Rwanda Palliative Care and Hospice Organization (RPCHO).

Dr Blaise Uhagaze, the founding head of RPCHO and the Executive Secretary of Rwanda Health Insurers Association, said that whenever a patient or caregivers/relatives learn that one a person has incurable disease, most times, it leads to psychological weakness leading to the premature end of the patient’s life—sooner than it would have been.

He says that with the increasing cases of such patients, there was need for people to know that high-quality palliative care services can actually "add a day or two or may be just a smile on such a patient and the people around them and which could help that person live his last days in dignity”.

Uhagaze was speaking to Sunday Times recently at the launch of RPCHO, a Non-Governmental Organization, which was established in September. Its care-givers have access to high-quality palliative services that are responsive to their needs, well-coordinated, affordable, culturally appropriate, and integrated into the healthcare system.

RPCHO offers voluntary palliative care, and works with hospitals around Kigali to give pain-reducing medication to patients with life-threatening illnesses.

"You all know how difficult it is for health providers to explain to families the reality of an incurable disease, but it’s necessary to help them by discussing the way forward. Therefore, In palliative care we are focusing on relieving pain and control symptoms, we are aiming to put the patient comfortable, not necessarily to cure but to give a quality of life focusing on all the aspects of humanity – of the patients and support families which need a very good psychological orientation during this difficult time,” Uhagaze says.

According to the World Health Organisation, palliative care 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 impeccable assessment and treatment of pain and other problems; physical, psychosocial and spiritual.

Life-threatening illnesses in numbers

RPCHO has worked with 76 patients and 53 of them have died; 57.7 percent of them died at home, 15.5 died at hospices and 26.5 percent at hospitals.

"This shows that a patient that who receives palliative care at home prefer to die at home instead of a hospital. Physical pain was managed and other symptoms controlled.” He said.

A study conducted by RPCHO shows that psychological support provided in dealing with depression, grief, anxiety, and other psychiatric disorders in palliative care, coping with loss have significantly reduced on the social, economic and spiritual burden and patients have faced death positively.

"RPCHO intervention made a significant change on the myth about dying at home. Since RPCHO started home-based care, the quality of life improved among patients. Families testified about the cost-effectiveness of the program but the most important impact is to bring the senses of humanity to those patients who already condemned by the society because of myths.” Uhagaze says.

RPCHO, has a Rwanda Mobile Palliative Care Unit (RMPCU) which conduct home visits to patients and provide Holistic support (Physical, Psychological, Social and Spiritual).

Magnus Udahemuka Gasana, a Clinical Psychologist and Palliative care coordinator in CHUK, said hospitals are "sometimes overburdened” by the increasing number of patients.

He said home-based palliative care was reducing hospitalization costs by giving care and necessary supplies and medications to the patients and their families at home, advice families to avoid unnecessary travel to hospital which is not beneficial to the patient, and focus on home care, and the pressure on district hospitals has decreased.

More palliative care volunteers needed 

The Ministry of Health’s Strategic Plan for Palliative Care for Incurable Diseases was introduced in 2010 but has suffered several setbacks mainly due to shortage of experienced palliative care practitioners.

"We cannot just relay on nurses and doctors to give this much needed care. We call upon churches and well-wishers to join and get trained on how to offer palliative care; It is one of the most easy yet high need service in our society,” Uhagaze explains.

"Patients with terminal illnesses also have psychological burdens such as depression, grief, anxiety, and other psychiatric disorders in palliative care to be treated using conventional standard. The organization needs more skills and knowledge to manage such complex cases,” the report reads in parts.

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