EMMS International is committed to expanding and enhancing palliative care services in some of the world’s most impoverished communities. Thanks to your support, EMMS has been able to dedicate significant resources to the improvement of clinical facilities, development of specialist training programmes, advocacy for improved access to essential pain medicines and enhancement of legal, spiritual and nutritional support.
Never did we imagine that this would prepare EMMS International and our partners to respond to a global pandemic. But it has.
As the outbreak of coronavirus has become a global health challenge of enormous proportion, our partners who specialise in palliative care have proven to be a vital part of the response in their communities. This often-neglected speciality is proving essential in dealing with COVID-19, especially in resource-poor settings.
Why is palliative care essential in the fight against coronavirus?
Care where there isn’t a cure
There is no known cure for COVID-19. In resource-poor settings, the capacity to manage the symptoms of every critical patient is tragically lacking. Even with significant, coordinated support health systems are becoming overwhelmed. India has seen railway carriages converted into treatment centres just to have space for the growing number of coronavirus cases.
By definition, palliative care is there when curative options are exhausted or unavailable. That might be the case for some time for COVID-19 globally, but particularly in poorer countries.
However, our partners are expert in taking the limited resources they have to relieve the suffering of their patients. Their skills and expertise, applied in this pandemic, will see patients supported and sustained – despite a lack of beds and ventilators – and given a chance to overcome the virus. They will also provide relief and comfort to those who, sadly, will not.
Our partner, INF Nepal, have used their palliative care team to train other healthcare staff on critical skills covering areas like safe care of deceased bodies (for staff and also for community groups like churches); use of syringe drivers; end-of-life symptom management; and good communication skills over the phone or from behind a mask.
Palliative care is holistic
In communities facing entrenched poverty, coronavirus is not only an affliction on those confirmed cases. It limits movement, closes schools, separates families, takes food from the table and causes excessive strain on communities already fighting to lift themselves out of poverty.
Palliative care is holistic. It sees beyond the condition to the whole patient, indeed beyond them to their family and community—the WHO recognises spiritual care as an intrinsic part of palliative care. As health worries increase and churches remain closed, local church partners who are already familiar with supporting palliative care delivery will be invaluable.
As part of the Chifundo project, partners in Malawi have been helping their patients to establish gardens so that they get the much-needed nutrition to help manage their health. These village and kitchen gardens are now a life-line when coronavirus interrupts food supplies and drives up prices. The existing community projects of Duncan Hospital allow them to distribute emergency food supplies to vulnerable widows.
Communities practise palliative care
Lockdown restrictions have closed some healthcare services indefinitely. For those services that remain open, transport is unavailable or unaffordable.
Our palliative care partners work in, with and through communities, including local churches - this has always been the case. Before lockdown, before coronavirus. As such, they have networks in place to follow-up with patients, and they have the expertise of supporting families remotely so they can care for their loved ones. In Nepal, Green Pastures Hospital has set up a telemedicine service allowing them to care for patients who cannot make it to the hospital and to support those with COVID-19 symptoms to access the care they need safely.
Palliative care fights the odds to ease suffering
It can be easy to think that palliative care is not life-saving and is, therefore, not a global health priority. Half of the world’s population —3.6 billion people living in the poorest countries — have access to less than 1% of pain medications distributed worldwide. Despite this lack of resources and often overwhelming needs, palliative care specialists are there doing all they can to prevent unnecessary suffering.
Palliative care will provide invaluable frontline services during this pandemic like they have been doing for many years. It is essential that we support them in their response to coronavirus, but that we continue to value and support them in the future. With your help, EMMS International is committed to doing just that.