Ten years ago, Rwanda adopted a palliative care policy with a goal to provide all Rwandans with incurable illnesses access to high-quality and affordable palliative care to meet their physical, psychological and spiritual needs.  

There is very little doubt that palliative care provides a positive difference to the lives of people with terminal illnesses and their families as well. One can never underestimate the power of living as comfortably as possible until death. 

The set goal was to be achieved by the year 2020. Within that timeframe, a lot has been achieved. Nurses have been trained to provide home-based palliative care, some hospitals have facilities and personnel to provide specialised care in this field. And, an exclusive palliative care center has been set up in Kigali and is fully functional.

While Rwanda has made enormous strides to avail the service, it has turned that the demand for palliative care exceeds the available facilities.

Take for example the main facility, The Palliative Care Centre - Hospice John Paul II that is located in Rusororo Sector, Gasabo District, has just about 20 beds, which are mostly fully occupied, and patients have to get a waiting list with hope of being admitted later.

Another unit, located within Rwanda Military hospital, was launched early last year but is designated for only cancer patients.  

Rwanda is a country on the move. According to the World Bank data, in the year 2,000 life expectancy of Rwandans was at 48.6 percent. Today, Rwandans are expected to live up to 70 on average. 

The increase in life expectance coupled with changes in lifestyles also means that more Rwandans are contracting chronic diseases such as diabetes, cancer, heart conditions and respiratory illnesses. And with the Covid-19 pandemic, the after-effects on immunity will be felt for a long time. 

What this implies is that the country has to think about how to take care of those who develop incurable illnesses. The best time to plan is before the demand completely gets out of hand. 

While, culturally, some families prefer to take care of their patients at home, and Rwanda has an impressive pool of trained nurses who can provide home-based care, this trend will likely change due to trends in urbanisation and as homes become smaller, making it inconvenient for patients. 

With the growing lists of priorities for the government, public resources to invest in palliative care may be limited. However, with the right incentives, private financing will yield returns not only for the investors but those seeking end-of-life care and their families.