THE TERMINALLY ILL; WHAT IS THE CHRISTIAN RESPONSE?

By

Dr. Kikule

Hospice Africa (Uganda)

 

 

We need to understand what we mean by “the terminally ill”. At the time one talks of terminal illness the disease is no longer responsive to curative treatments. This is a time a doctor can be tempted to say “I am sorry, there is nothing I can do.”

In Uganda this is a common scenario in patients with HIV/AIDS and Cancer. Why is this so?

·         Cancer patients report too late for curative treatment.

·         Less than 5% of those who report to the Uganda Cancer Institute can afford treatment (chemo; radio; surgical)

·         Less than 1% of patients with HIV/AIDS can afford ARVs.

 

THEREFORE PALLIATIVE CARE IS THE ONLY HUMANE RESPONSE.

 

What is palliative care?

According to WHO, Palliative care is:

 

“The active total care of patients whose disease is no longer responsive to curative treatment. Control of pain and other symptoms and of psychological, social and spiritual problems is paramount. The goal of treatment is achievement of the best quality of life for the patients and their families.”

 

Hospice Africa (Uganda).

Started in Uganda in 1993 in response to the above stated need. There are 3 hospices in Uganda; Hospice Makindye (the Headquarters), Mobile Hospice Mbarara and Little Hospice Hoima. Therefore 2003 is the 10^th anniversary year for Hospice Africa (Uganda). The objectives of Hospice are:

1.    To provide palliative care to patients and their families.

2.    To carry out training programmes so that palliative care can be available to all in Uganda.

3.    To encourage palliative care in other African countries.

 

Hospice takes care of patients in their own homes – ours is home-based care. Currently the number of patients on the programme is approximately 269. These patients are referred to Hospice from hospitals in and around Kampala, form private practitioners and also through what we call self-referrals. Pain is the main reason for referral in 98% of cases and it is controlled using ORAL MORPHINE. Palliative care is holistic care embracing the whole patient; the physical, the spiritual, the social and the psychological.

 

SO WHAT IS THE CHRISTIAN RESPONSE TO THIS SITUATION?

Please bear in mind that having a terminal illness does not make a person responsive to the Gospel. Many patients at this stage are angry, afraid, they have guilt in their hearts etc. Even if such a patient needs the Gospel he/she has to deal with these issues before responding to the saviour. Therefore:

1.    Seek God for peace and acceptance of your own mortality. Is your death a settled issue in your life?

2.    Be conscientious in your studies in palliative care. Nothing re-assures patients like a skilled doctor.

3.    Become proficient in the management of pain using oral morphine.

4.    Get as involved in the care of the terminally as your time and circumstances permit.

·         Become a volunteer with Home care teams such as Hospice or TASO (The AIDS Support Organisation)

·         Get acquainted with the palliative care services network and become part of the network, such as the Palliative Care Association of Uganda.

·         Never discharge a terminally ill patient with the words “Sorry, there is nothing I can do”. Connect the patient to a palliative care facility or at least tell the patient what is available and where in the way of palliative care.

·         A terminally ill patient needs a lot of time. You need to learn to give this time to explain what is happening and why, to explain treatments the patient is subjected to, to answer questions disturbing the patient, etc.

·         As an association adopt terminally ill patients to look after and walk with those patients and their families through this difficult time.

·         Tend to you own faith daily because the experience of looking after the terminally ill until death comes can be exhausting and spiritually depleted.