“Kenyan children in acute and chronic pain suffer needlessly because of government policies that restrict access to inexpensive pain medicines- like morphine, a lack of investment in palliative care services, and inadequately trained health workers,” Human Rights Watch said in a report. The report urges the Kenyan government, and donors, to work towards improving pain treatment for everyone, and ensure that the youngest and most vulnerable sufferers, sick children, are not left out. They should not be suffering needlessly.
The report, "Needless Pain: Government Failure to Provide Palliative Care for Children in Kenya," that was shared with health sector stakeholders in a meeting supported by GTZ Health Sector Programme, found that most Kenyan children with diseases such as cancer or HIV/AIDS are unable to get palliative care or pain medicines. Kenya’s few palliative care services provide counseling and support to families of chronically ill patients, as well as pain treatment, but lack programs for children. In addition, the majority of sick children are cared for at home, but there is little support for low-cost home-based palliative care. Health care workers lack training in pain treatment and palliative care, and even when strong pain medicines are available, they are often reluctant to give these medicines to children. The report notes that the Kenyan government has taken a step in the right direction by establishing a few hospital palliative care units in recent years. But much more needs to be done to stop sick children from suffering needlessly.
The report notes that the Kenyan government does not purchase oral morphine for public health facilities as it does other essential medicines despite the fact that the World Health Organization considers oral morphine an essential medicine for treating chronic pain, as does Kenya’s own drug policy. As a result, oral morphine is available in just seven of the country’s approximately 250 public hospitals. Although 250,000 people in Kenya are on antiretroviral treatment, all the morphine in the country could treat pain in only 1,500 terminal cancer or AIDS patients.
International donors are also neglecting pain treatment, says the report. For example, the US President’s Emergency Plan for AIDS Relief (PEPFAR) spent US$534 million in Kenya in 2009. PEPFAR finances palliative care services such as counseling at hundreds of health facilities, but few have morphine to treat severe pain.
The report calls on the Kenyan government to make oral morphine available in all public hospitals, to ensure that health care workers are trained in palliative care, and to integrate children’s palliative care into its health services, including home-based care.
Health sector partners participating in the report dissemination meeting held on 5th November 2010 at the Serena Hotel with support of GTZ Health Sector Programme also made a number of key recommendations. The partners underscored the need to develop policy on palliative care; broaden the supply of essential drugs including procurement; train health workers on palliative care, develop clear guidelines on palliative care, address the issue of reluctance by health providers to administer morphine and create demand for morphine by removing barriers around prescription; include palliative care in revision of the health sector strategic plan, stronger partnership with private sector to address the problem of palliative care; health systems strengthening.
Stakeholders attending the meeting were also encouraged to make an effort to implement the recommendations provided in the report.
The GTZ Health Sector Programme works in partnership human rights watch to promote the right to health. Access to quality health care by all Kenyans, especially the vulnerable is a key area of GTZ HSP support in Kenya. Providing for networking and sharing knowledge is a particular focus of GTZ policy work.2010-11-07
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