Dr. Zipporah Ali
Dr. Ali is the Executive Director for the Kenyan Hospice and Palliative Cae Association (KEHPCA). She has been instrumental in fostering strong relationships with the Ministry of Health to integrate palliative care into government hospitals. She has also been instrumental in advocating for palliative care to be integrated in undergraduate medical and nursing schools in Kenya.
Let me tell you about a patient I met in 2002 who I was referred to by some nuns. He was a young man, 32 years old, and he had cancer of the lower limbs. He was seen at one of the hospitals, and the hospital kind of gave up on him and sent him back to his house. They told his family members to take back to his home village so he can die. When I saw this the patient he was really, really sick. He had a fever and an oozing, smelly wound and he was emaciated. And we said, ok let’s stabilize him until his family takes him home. We started by talking to him, his name was Fred, and by controlling his pain, cleaning his wounds and teaching his wife to clean his wounds. A few weeks later, he was on his feet, still quite sick, but he was able to sit up and to eat and his fever was gone, the smell was gone, and that was in 2002. He’s still alive today. Now this is a patient that if we had decided to give up on him, he would have died by now. He was able to take care of his children, his daughter is now 15 now and he has added to his family by two. One of his goals was to have a son, and now he has one.
Probably less than 20 percent of the patients who need palliative care receive it because it has not really picked up across the country. There are many challenges: we don’t have enough trained personnel, we don’t have enough facilities, and most hospitals are understaffed. But it is better today, and we keep advocating and working with the government.
At Kenyatta National Hospital, the only government hospital with a radiotherapy machine, there are 1,800 patients on the list. The hospital, currently as we speak, can only see up to about 70 patients per day. A breast cancer patient needs a minimum of 25-30 appointments, so it’s not 70 new appointments each day. The queue is very long and even though it’s affordable at Kenyatta, most patients will not make it because they have been put on the 2017 list but now is when they have cancer, and cancer won’t wait.
As Kenyans we need to support these patients. We are hoping to set a campaign to raise funds for radiotherapy at the local level because the international funds won’t last forever. This could make a real difference in people’s lives.