Aberdeen charity helps train Ugandan nurses in palliative care
Cairdeas have received a grant of £50,000 to help train medical staff in end of life care in the Eastern African country.
A Scottish palliative care doctor has told of the challenges of helping ease the suffering of dying patients in Uganda - sometimes armed with nothing more than a paracetamol.
Dr Mhoira Leng’s Aberdeen-based charity Cairdeas is celebrating winning a £50,000 UK Government grant to improve the quality of end-of-life care in one of the world’s most deprived regions.
Over 250,000 South Sudanese refugees have poured into Adjumani District, Uganda – an area that until recently only had one district hospital with no functioning x-ray machine.
Now palliative care specialist Mhoira returned earlier this month to the country she’s made her home to continue her lifelong humanitarian work helping the world’s poorest people.
The 56-year-old explained: “It breaks my heart when you know there’s something you could do to ease a person’s suffering, and a lack of resources is stopping that.
“You know, a young friend of mine died of Covid-19 in Uganda last year. He was phoning me from ICU and I’m saying, ‘You are okay, you’re in the right place’, but actually there was a problem with resources, and he didn’t make it. He was just 29.
“Those moments are gutting. I remember only 10 years ago, walking onto a ward and hearing one of my patients screaming and I wanted to just walk off the ward because I knew I had no analgesia to give them. I had to make myself walk in there and do what I could.
“Cairdeas then did a fundraiser and we got oral morphine and since then we’ve never had that problem in Uganda – but this will be happening in many other parts of the world.”
Mhoira added: “One of the biggest health inequalities in the world right now is that almost 90 per cent of the world does not have good access to pain control.
“We often moan about the NHS but in places like Uganda, everybody will know somebody who died with only paracetamol for their advanced cancer pain management.
“This Small Charities Challenge Fund grant from the UK Government will help us really build on the work we’ve been doing in Adjumani.
“It is an impoverished, rural area, which until recently had just one district hospital, which did not even have a functioning x-ray machine. It was serving a 500,000 population, including 250,000 South Sudanese refugees.”
Cairdeas – which is the gaelic word for ‘friendship’ – will use its £50,000 Small Charities Challenge Fund (SCCF) grant from the Foreign, Commonwealth & Development Office (FCDO) to develop palliative care in Obongi district, northern Uganda.
Founder Mhoira says palliative care in hospital settings was relatively new in the UK when she graduated to work at Aberdeen Royal Infirmary in 1987 – but the UK is now a world leader in the field.
Uganda is now the leading African nation for palliative care having recognised the benefits.
Mhoira has so many inspiring stories that help drive her on.
She said: “I always remember a wee eight-year-old Ugandan girl called Catherine who had a fibrotic lung disease and only had a few days left to live. She’d stopped talking to anybody because she was in a lot of pain. All everybody kept saying was, ‘Don’t worry, you’ll be fine. Jesus will heal you’.
“The first thing she said to me was ‘What’s going to happen to me? I think I’m dying but nobody will tell me’.
“So I said ‘I’d like to speak to your mum a wee bit more but I will answer that question tomorrow, but today can I give you something for your pain or to help your breathing?’.
“Her mum told me ‘I just don’t want her to be frightened’ and I gently said ‘Well, she is frightened, and I think the fact we’re not talking to her means she’s even more frightened’.
“The next day Catherine had had a very bad night and she told us ‘I thought Satan was coming to get me’. When I asked why she said ‘Well, people keep telling me Jesus is going to make me better, but I’m not getting better. Does that mean I’m bad?’.
“The desire to protect this wee girl had left her feeling even more lonely and frightened, so I explained how her lungs were not working anymore and discussed her fears and how we could best help her.
“This is the essence of palliative care… listening and supporting what is important to that person and family even when time is short.
“She really wanted to go to church. Her condition made that impossible, so our Ugandan volunteers were able to arrange a wee service round her bed, using her favourite bible stories and songs.
“She asked them to sing, ‘God will make a way when there seems to be no way’. I thought ‘Gosh, that wee girl had worked things out better than anybody else around her’.
“When I saw her the next day, she said ‘I’m feeling much better’. She gave me permission to tell her story to help medics understand what to say to somebody her age and the importance of not avoiding difficult questions.
“Her family got so much comfort from knowing she’d died a much more contented soul.”
She added: “Of course, palliative care is challenging, can even be depressing, it can be overwhelming, but it is also incredibly enriching.
“It is about bringing hope and joy even in the most difficult of times.”