69 Paliative Care

Eddie Mwebesa

Majority of patients want to, and do, die in their own homes.

Cancer is a significant problem here. There is ONE radiotherapy machine in the country! Patients were having to go to Nairobi to get their radiotherapy, if they got any at all.

Major Cancers:

• Cervical
• Breast
• Oesophageal
• Lymphoma
• Prostate

Cervical and breast is more than half of all cancers seen by palliative care here. KS is reducing.

Hospice Africa Uganda was the 4th Hospice in Africa. Founded in 1993.

Hospice Africa Uganda runs a “roadside clinic”, where they drive along to an area, and meet a patient at a set point.

Cultural differences make it less straightforward to assess pain. For some patients numbers are a difficult thing, have to use metaphors for pain, like in rural children, talking about the weight of a jerry can.

Hospice Africa Uganda made their own liquid morphine for 22 years. Most inexpensive oral morphine inthee world.

Uganda was the first country in the world to allow Nurse prescription of morphine.