DOC’S MISSION TO EASE SUFFERING IN UGANDA We moan about the NHS but people here die in agony from cancer with only paracetamol for the pain
Scots charity Cairdeas celebrates winning £50,000 Government grant which will alllow it to continue to improve end-of-life care in one of the world’s poorest regions
ASCOTS 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 Aberdeenbased charity Cairdeas is celebrating winning a £50,000 UK Government grant to improve the of end-of-life care in one of the world’s most deprived regions.
More than 250,000 South Sudanese refugees have poured into Adjumani District, Uganda – an area that until recently had only one district hospital, with no functioning x-ray machine.
Palliative care specialist Mhoira returned earlier this month to the country she’s made her home to continue her lifelong humanitarian work helping the planet’s poorest people.
The 56-year-old said: “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 OK, 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 on to 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
It breaks my heart to not be able to ease suffering
doing in Adjumani. It is an impoverished, rural area, which recently had just one district hospital, which did not have a functioning x-ray machine.
“It was serving a 500,000 population, including 250,000 South Sudanese refugees.” Mhoira was forced to stare her own mortality in the face after being rushed home to Scotland last June for tests after suffering serious breathing problems. She said: “I’d developed a respiratory problem and had to return to Scotland in a wheelchair because my breathing was really very bad.
“My oxygen levels were really low, which is not great in the midst of a Covid pandemic, so I was back in the UK shielding and really quite sick. I’ve had many investigations and fortunately many of the serious things it could have been, it isn’t, but there was certainly a
space where, as a medic, you always think of all the things it could be and I think that’s the closest I’ve come to contemplating my own death. I think facing your own mortality is something that is very real if you work in palliative care. Seeing first-hand how death is part and parcel of life gives you a strong sense that all our days are numbered. It gives you a live for today outlook. The results were not conclusive but they’ve ruled out the really nasty things I’m now on the road to recovery. I can’t wait to get back to Uganda.” Cairdeas – Gaelic 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. two-year project will empower local community health workers by giving them skills to improve the quality of life of people living with chronic and life-limiting illnesses.
The charity’s work in the region has previously been supported by UK aid through the Tropical Health & Education Trust (THET).
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’s parents were Scottish missionaries and she was born in Papua New Guinea before returning aged two to live in Lenzie, near Glasgow. She’s been living in Kampala for 12 years and is impressed with the support she receives from her fellow medics in the Ugandan capital.
Mhoira said: “My favourite thing about Uganda is just the incredible warmth of the people. They’ve given me a Ugandan name which is ‘Sanyu’ which means ‘Joy’.” “We now take palliative care for granted in the UK, and this gave me a great basis to work within health systems where it is more problematic. “My passion is to mentor and train others, giving them the skills that are a springboard to changing their world.
“Palliative care has always been welcomed because it is a high skill, low resource area that transforms health systems and brings compassion to the heart of care. One of the Ugandan cardiologists said that he wanted palliative care to be in his medical students’ first year of training because he told me they are better cardiologists if they have that empathy with patients.
“I remember another young doctor, who’d just done his basic two-week palliative care training, telling the head of Rwanda’s main hospital, ‘I see people as people, not diseases. I remember they are part of a family. I don’t order unnecessary investigations. I don’t avoid difficult conversations’.
“And then he turned to me and smiled ‘And it feels so much better’. That young man is now doing his PhD in Melbourne and he’ll come back and be one of Uganda’s leading physicians.
“We cannot change the outcome but how can we best help the patient?
“I use the catchphrase ‘Adding life into their days, not just days on to their lives’. It’s about helping their families too. I can think of times when mums have had to take their dead kids home
– wee bodies in a bag – on the bus because they can’t afford any other way. Everyone deserves the right to dignity in death.”
The UK has pledged £210million over five years to the Building Resilience and an Effective Emergency Refugee Response programme to support refugees in Uganda. Minister for Africa James Duddridge said: “I am delighted that Cairdeas is using the UK Government’s Small Charities Challenge Fund to be a force for good in the world by helping some of the world’s most vulnerable people.
“We are committed to supporting Uganda’s ongoing development, while providing urgent, life-saving humanitarian support to refugees and those in the greatest need in the country.” ● FOR more information or to donate please go to cairdeas.org.uk