" In Africa, the notion of time is different: when visiting a sick person at home, you stay more than an hour. It is a way to care for the patient that makes him feel important." John Rhee mentioned this within his presentation at the University of Navarra. Rhee is a medical graduate student at the School of Medicine at Mount Sinai (New York, USA).

Rhee gave a presentation on "AFRICA: A medical student at Hospice Africa Uganda” as part of a series on “Palliative Care on Three Continents,” organized by the ATLANTES program, the School of Medicine at the University of Navarra and the Navarra Palliative Care Society. The lectures series takes place at the Navarra College of Physicians in order to introduce doctors to worldwide palliative care programs.

In his presentation, John Rhee focused on staying at the Hospice Africa Uganda (HAU), one of Africa’s most prestigious care centers. Among other activities, he conducted home visits because, in Africa, patients are not routinely admitted to hospitals.  

"My visits were not just about administering medication, but also about caring for patients’ social and psychological dimensions. They are going through difficulties, as I saw just by being in their houses. Sometimes things are as simple as the distance they need to walk to the toilet or even that the house does not have a bathroom at all," he explained.

As Rhee mentioned, in Uganda, there are few resources and palliative care is not subsidized by the government. "Many people cannot receive this care because they cannot afford treatment," he said. Although they have help from NGOs, including funding for free consultations and medicines, and there are numerous national and international volunteers, according to Rhee "this is not a sustainable funding model… The HAU lost some of its international funding in the last year and, therefore, has had to stop some projects," he regretted.

 

 

A Leader in Africa

 

As Rhee noted, in Africa, Uganda is one of the countries with the most developed palliative care system due to several factors, including the fact that the Ministry of Health supports palliative care, the law allows nurses to administer opioids since there are not many doctors, and it is easy to access services and training programs— for example, the HAU offers a diploma in palliative care.

In addition, the HAU is carrying out an education plan on the use of morphine to explain to families and professionals how to administer it and its effects. They aim to combat the widespread fear of using this drug. "I saw one patient take less than what he needed and remain in pain, and others who refused to take it at all," Rhee pointed out.