Need to Know
1. “What exactly is palliative care and when should it start?”
Palliative care is the active, total care of patients whose illness is no longer responsive to curative treatment. It focuses on pain and symptom control, psychosocial and spiritual support, and helps families cope. It should begin as soon as a life-limiting illness such as cancer, HIV/AIDS, heart-failure or advanced diabetes is diagnosed—alongside any other therapy.
2. “Is palliative care only for people who are about to die?”
No. Palliative care is for ANY stage of a serious illness. Early integration improves quality of life, reduces hospital admissions and, for some cancers, even prolongs survival.
3. “Why can’t I get morphine or strong pain-killers at my local clinic?”
Most African countries restrict opioid prescription to doctors in tertiary hospitals; many do not stock oral morphine at primary-care level. Uganda is the exception: specially trained nurses and clinical officers in 226 accredited sites can prescribe oral morphine, which is why pain-control coverage there is higher than anywhere else on the continent.
4. “Does palliative care mean the doctor has ‘given up’ on me?”
On the contrary, PC is an extra layer of support that keeps the patient as active as possible. It neither hastens nor postpones death; it makes the life you have more comfortable.
5. “How much will it cost me or my family?”
Hospice and home-based PC services in East Africa are normally free at the point of care, funded by charities, faith groups or corporate donors. Hospital-based PC is charged at the same rate as any other ward stay; oral morphine costs roughly the same as a bottle of antibiotics in countries that produce it locally.
6. “Can children receive palliative care?”
Yes. Paediatric PC is now available in 15 African countries—up from only six in 2017—although most services are still clustered in South Africa, Kenya and Uganda.
7. “Why aren’t there more PC services in rural areas?”
Shortage of trained staff, morphine supply restrictions and poor transport networks concentrate services in cities. Task-shifting to community health workers and tele-consult (m-Health) projects in Uganda are proving effective bridges.
8. “Will I become addicted if I take morphine for pain?”
Addiction in patients who take morphine for cancer or AIDS pain is extremely rare when the drug is used correctly. Fear of addiction should never be a reason to leave pain untreated.
9. “Is palliative care recognised in national health policies?”
Only about a dozen countries have stand-alone PC policies; Tanzania adopted one in 2016 but slow budget allocation means implementation is still patchy.
10. “How can my clinic start basic palliative care?”
Start with these four steps:
- Write simple pain- and symptom-control guidelines
- Train at least one nurse and one clinician in basic PC (3–5-day course)
- Stock paracetamol, ibuprofen, codeine and—if regulations allow—oral morphine
- Set up a referral link with the nearest hospice or hospital PC team
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