Member EMMS International: Compassion in Action in Malawi Palliative Care

Care and Compassion

“I had no hope, but you brought hope to my life, and now I am a smiley and healthy young mother. Thank you.”

These are the words of 24-year-old Tikhale, a patient of Nkhoma Mission Hospital, one of EMMS’s Chifundo partners. As a new mother, Tikhale had the devastating news that she was HIV positive. In addition, she had skin cancer and had contracted tuberculosis. This trail of diagnoses cast a long shadow over Tikhale and her family, but they found hope in the palliative care support of the Nkhoma Mission Hospital team.

“The palliative care team welcomed me and treated me very well. There is a bond between us. I always feel safe when I see your faces there, knowing that my problems are solved at last. I trust your team. You never lie to me, but you tell me exactly what needs to be done so that my life can change.”

Without such specialist care, Tikhale and others like her are left without the care they deserve. As a result, they can spend a great deal of time and money in search of assistance and on hopeless ‘cures’. Instead, Tikhale found a caring community that could help her come to terms with her illness and liver her life to its fullest, free from pain and anxiety.

Through Chifundo, 63,516 people were helped, 94% live in hard-to-reach areas, and 55% of them are women.

A network of Compassion

The Chifundo project was built on the success of METHOD, another EMMS International project made possible thanks to UK government funding. METHOD introduced a palliative care degree programme in Malawi (only the 3rd of its kind in Africa) and established centres of excellence that could offer specialist care and give more healthcare workers a chance to learn these essential skills.

Through Chifundo, the palliative care skills and expertise were spread to 26 of 27 mainland districts. As a result, 30 rural health facilities achieved APCA standards and provide good quality free palliative care by adequately trained staff.

One such clinic was St Josephs Hospital in Chiradzulu district, which reached level 2 APCA standard, the highest possible for a facility of its size.

St. Joseph’s was mentored in Chifundo by EMMS International’s partner Palliative Care Support Trust. St. Joseph’s is a model mentee, in that it is still using the training and equipment that Chifundo brought to it and continues to care for families in need of palliative care. In Chifundo, St. Joseph’s had to prove and develop many things, including a properly equipped clinic room, staff trained in palliative care, availability of different types of pain-relief drugs, home visits to all patients at least monthly, referral of all palliative care families to training in conservation agriculture, and provision of food to palliative care families.

By the end of Chifundo in 2021, St. Joseph’s had cared for 110 families in need of palliative care over the three years of Chifundo. It is now caring for 40 palliative care families and will continue to do so, with new families enrolling as long-standing patients die or move away.

Compassion through crises

Nobody expected the global healthcare crisis caused by the coronavirus outbreak. Nonetheless, healthcare systems that were strengthened by the Chifundo project put that strength to continue serving their communities with compassion through the pandemic.

Kitchen gardens that were designed to improve patients’ nutrition and support their treatment meant households were more resilient to the economic impact of COVID-19. As Malawi continues to bear the brunt of the climate crisis, the skills they have learned are helping hold back the hunger faced by many others.

“I am very grateful to EMMS for the Chifundo Project. Many patients have had their nutritional status improved. In Malawi, food shortage is a major challenge, especially in households where they have patients with life-threatening conditions. Family members spend much of their time taking care of the sick.” - Nurse Mary, Palliative Care Support Trust.

Three demonstration gardens helped 23 facilities to integrate agriculture support services into their palliative care provision. The gardens and support services helped improve nutrition and food security for 5,830 malnourished patients.