World hospice and palliative care day is a unified day of action to celebrate and support hospice and palliative care around the world. The aim of this event is to share our vision to increase the availability of hospice and palliative care throughout the world by creating opportunities to speak out about the issues.
To raise awareness and understanding of the needs – medical, social, practical, spiritual – of people living with a life limiting illness and their families
To raise funds to support and develop hospice and palliative care services around the world. This year’s theme dwells much on three main objectives;
Equity for access to palliative care services, quality of health services and protection of people from finance risks related to access for health services.
AUDIENCE.
There were over 250 participants attended. Among participants were our valued palliative care patients, the district commissioner for Salima, members of Salima district council, all traditional authorities in Salima, local chiefs, councilors, education managers from Ministry of Education; zonal officers, district palliative care coordinators, district he alth management team members, palliative care partners such as College of Medicine; Lighthouse; Partners in Health, Catholic health commission, CHAM, Ministry of Health central level; PACAM board and staff members and Ministry of health director from Nursing and Administration Directorates and not forgetting the media.
PUBLICITY.
There was press briefing with the media prior to the event. Press release was done through the newspapers. Publicity was further carried out by health promotion band from Salima district health office prior to the event. Malawi is one of the six countries in Africa that has achieved all the necessary steps of the WHO public health model in integration of palliative care services into public health systems. Other countries that have integrated palliative care into public health systems include Kenya, Zambia, Namibia, Rwanda and Swaziland
The organizing committee chose Salima district for the event to allow participants to appreciate palliative care services offered at Ndimoyo Centre of Excellency.
ACTIVITIES.
The commemoration started with a tour at Ndimoyo one of the palliative care centres of Excellence, Ndimoyo, which means giving life}.
Stakeholders were impressed with the potential that palliative care has on the life of the patient and family. The stakeholders were taken to the clinic, the garden, the hall and the founder of Ndimoyo explained all that is available at the Ndimoyo. After the tour, the stakeholders travelled to the commemoration ground
Following the Ndimoyo tour, stakeholders went to view pavilions at the commemoration ground. Those who had displays included MOH – Nursing directorate, Ndimoyo palliative care site and Palliative Care Association of Malawi
After viewing the pavilions, then the program for the ground started with an opening prayer by Pastor Chirwa, of Partners in Hope, who was also a member of the organizing committee in Lilongwe.
Welcome remarks were made by the MC and PACAM Executive director. There after there was a poem by a local person, and testimonies by palliative care clients from Ndimoyo. Two of those who gave testimonies were patients while the third person was a family member
SPEECHES.
Speeches were made by a number of people such as PACAM executive director who welcome members briefed them on the background and importance of the event followed by PACAM board chair who informed members on the role of PACAM then the director of nursing who briefed members of the role of MoH and finally the guest of honour. There were speeches by patients as palliative care beneficiaries. Below are brief speeches by each speaker:
1. PACAM Executive Director (Mr. Lameck Thambo).
The director briefed participants on the background and the importance of World Hospice and Palliative care day with emphasis to the Theme. He explained that PACAM support the MoH to organize this international annual event. The director thanked the MoH for the commitment and support for palliative care in Malawi especially the fact that palliative care is integrated in Government health systems and allocation of full time staff in some Government health facilities. He also thanked all donors who offered support for the event. Linking to the theme “ Universal coverage for palliative care, the director expressed concern that palliative care is not yet scaled up to rural area where 85% of the population live and also lack of fulltime palliative care providers in some Government district hospitals. The director asked donors including the MoH to consider funding palliative care. He finally thanked all participants for attending the event.
2. PACAM Board Chair (Dr. Agnes Mosses)
The board chair started by sharing a scenario of a patient with advanced Cancer but through palliative care the patient is coping positively and able to do some work. The patient is pain and symptom free. She linked this to the mission and vision of PACAM that is to see people with life threatening illness pain and distress free. She further linked this to the theme of the event that this care it has to reach all needy people where ever they are regardless of their status. Agnes said that this year Theme is very important and if to have universal health and palliative care universal coverage there is need the Government, donors to provide adequate funding, human resource and improve infrastructure such as good roads and building. The board chaired also thanked donors who supported the event and thanked all participants for their attendance
3. The director of Nursing (Mrs.Tulipoka Soko)
The director started by thanking PACAM for the continuous support to the MoH more on the event. She recognized and thanked some palliative care pioneers in Malawi. She said that this year’s theme links well with the MoH sector strategic plan 11 of 2017 to 2 022 “Towards universal health coverage” The director explained MoH commitment on palliative care that it appointed and assigned a palliative care desk office in the MoH. She mentioned the development of national guideline and policy. However she was also concerned that Palliative care is not yet in the health centers and pointed this as a big gap that need a quick intervention. She finally thanked all participants.
4. The Guest of honour (Mrs. Beatrice Mbewe)
“This year’s theme “Universal Health Coverage and Palliative Care – Don’t leave those suffering behind!’ Focused on advocating for increasing availability of palliative care for all people in need which constitutes one percent of the total population according to WHO estimates. Available evidence established that Universal Health Coverage, including palliative care, is critical in improving the quality of life o f patients and their families as well as achieving Sustainable Development Goal number three which ensures “good health and wellbeing” including eradicating poverty. Therefore the key message for the day was to strengthen public private partnerships in extending palliative care coverage in order not to leave those suffering behind.
Currently 85 sites are providing palliative care services at all levels of care and Ministry of Health through the Directorate of Nursing and Midwifery services providing national leadership.
Availability of palliative care services is a worldwide problem. According to statistics from the World Health Organization; globally; 40-61 million people are in need of palliative care yet only 14% of this need is being met.
Likewise in Malawi; 174,000 people are in need of palliative care in Malawi; basing on WHO estimates of one % of the total population being in need of palliative care; (2017-2022) (Malawi Health Sector Strategic plan 11).
Strides have been made in integrating palliative care into public health systems and currently 32% of all people who need palliative care in Malawi; access palliative care an increase of 228% from global statistics. Out of all people who accessed palliative care adults accounting for 74% and children 24%
RECOMMENDATION.
The event was successfully carried out and our voice was heard to the majority and we are expecting to see change and improvement on Government funding for palliative care as well as allocating full time staff for palliative care. Since MoH has decentralized services to district councils and the event targeted the council then we are hoping that Council will prioritize and support palliative care.
CHALLENGES
The organizing committee experienced some challenges with transport reimbursement for some invited members due to inadequate funds.
ACKNOWLEDGEMENT
The management and staff of PACAM would like to acknowledge generous support by True Colours Trust for the support about 80% of the funds was from True Colours. PACAM also would like to thank Lighthouse Trust who support the event with 1000 bottles of water and again than K2 Taso who supported with MK 25,000.
The organizing committee would like to thank all people who participated more especially the guest of honour, director of nursing, PACAM board chair and traditional authorities.
APPENDICES:
PHOTOS OF THE EVENT
Invited guests visiting Ndimoyo palliative care
The district Commissioner for Salima District Council, The Deputy Chairperson of Salima District Council
The Director of Nursing Servises, Mrs Tulipoka Soka visiting Ndimoyo Palliative care with the Deputy Chaiperson of Salima District Council as well as the Founder of Ndimoyo Palliative Care Mrs Lucy Finch
Guests viewing pavilions mounted by PACAM
Guests viewing pavilions mounted by MOH Nursing directorate, PACAM and Ndimoyo
