Challenges of Hospice and Palliative Care in Nigeria Essay Example

palliative except in hospice care the focus is on caring for and making the patient as comfortable as possible and not finding a cure for the illness the patient presents regardless of what it is.

It is applicable in disease conditions like cancer, stroke, end-stage renal, liver, diabetes and HIV/AIDS. Patients generally may suffer physical pains, social, emotional and spiritual distress that often result to “total pains” but most times the care often focuses mainly on the physical aspect of the disease. (Oyebola, 2013) Nigeria being the most populous country in West Africa with population of over 140million people should by way of saying be at the forefront of palliative and hospice care. However, this is not the case. Palliative care was formally introduced to the Nigerian government, policymakers and general public in 2003. . . . Prior to this time, a few private-owned and missionary hospices existed in obscurity in the country (Onyeka, 2011)).

Presently, there are three palliative care centers in Nigeria: Centre for palliative care, at the University college Hospital, Ibadan, located in the South-western part of Nigeria; Hospice Nigeria, located in Lagos also in the South-western part of Nigeria and; the most recent, Pain and Palliative Care Unit, established in September 2008 as part of the Multidisciplinary Oncology Centre of the University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla, Enugu.

Enugu is in the South-eastern part of Nigeria. One can therefore say that Palliative care in Nigeria is at infancy stage and need I say, inadequate to say the least. What are the challenges that Palliative/Hospice care is encountering in Nigeria? Lack of recognition and inclusion as a policy

by the government Although, there are few publicly owned palliative care units, they can only do so much on their own. The government needs to take over responsibility and announce palliative care as a much needed policy for the citizens of the nation.

As it turns out, government does not even recognize the need for palliative care and the already existing centers are overwhelmed with the increasing number of patients seen. Government can also help by introducing Hospice/Palliative care into the curriculum of Medical students. Issues such as meticulous attention to complex symptom control, whole-patient care, interdisciplinary team approach, enhanced communication skills, support programs for the bereaved and the many ethical concerns relevant to the end-of-life care (Seely, Scott & Mount, 1997).

Delayed presentation and diagnosis of terminally ill people It is a norm here for people who are ill to try to wave the feeling of symptoms aside hoping it is nothing and it will go away eventually. Meanwhile early diagnosis is always key. Sometimes, not doing anything about the symptoms a patient is feeling make it easier to believe that there is no serious damage happening to the body and that the symptoms will go away after sufficient rest. Others tend to prefer to go via the traditional method (Alternative medicine) for cure. This is mainly because most people cannot afford healthcare and the use of herbs is relatively cheaper that to go to the hospital.

As a result, by the time all resources have been exhausted and the symptoms still present if not worse than before, the patient eventually visits the hospital; the case is always almost far too gone

for any treatment. And all that can be done is to try to reduce patients’ pain and care for them till they pass. And even then, doctors are forced to discharge such patients as they have no resources for taking care of such lost cases. Overwhelming large numbers of patients needing palliative care In Africa alone, it is estimated that about 2. million people die annually from HIV/AIDS, while more than 0. 5 million die from cancer; Nigeria currently has the third largest number of people living with HIV/AIDS, after South Africa and India (Akinwande et al, 2009). Approximately 100,000 new cases of cancer occur in Nigeria annually (Ana, Sridhar & Asuzu, 2010). It is therefore not hard to imagine how populated the few active palliative care centers available will be. Definitely the available professionals and staff cannot shoulder the demands of the patients. Lack of trained professionals

Since palliative care is somewhat a new and emerging practice in Nigeria, there aren’t enough professionals who have been trained and have experience with palliative care. Cultural believes about death It is common knowledge that here in Nigeria, it is culturally unacceptable to talk about death or dying. Many people find it hard to come to terms with the idea of dying one day and that is why many people do not come to the hospital when they are ill for fear of the verdict of death. The few people, who do accept death and dying as a natural course of event, prefer to do so in the comfort of their home among friends and families.

Even doctors are sometimes either being forbidden by the

family to tell the patient that they have a limited time to live for fear of what the news might do to them. As a result of this, many doctors find it hard to break a bad news to their patients. They are skeptical about discussing a patient’s case especially if it is known that the patient has little time to live. In a people where dying or death is not common talk and is not discussed freely, it puts palliative care in a crippling position.

Personally, I have recently reached a stage in my life where I am liberating myself and keeping my mind open about any news of sickness or death. Nigerians should come out of their shallow thinking and mentality and try to understand that death is a part of life and whether we like It or not, when it does come, it doesn’t matter what you do or where you run to. It is saddening to see patients having to go through gruesome pains even as they are dying because there are no adequate pain management services, health care professionals lack the necessary knowledge or the patients are ignorant or choose to be ignorant about their conditions.

The people have to speak up and speak out for the government to hear and understand how pressing the need for palliative care is in the health care industry. Palliative care should be included in the curricular of medical students’ right from the first year. Nigerians should try to educate themselves; stop the nonchalant attitude and backwardness towards terminal illness, death and dying, attend various workshops and seminars that are always being

organized to raise consciousness about palliative care.