Countries of work
Namibia
In identifying a significant need for palliative care in Namibia, the US Government has also recognised that there are currently highly limited services available to address this need.
Consequently, APCA began working in the country in 2006 and will be working in-country over the next few years, which has resulted in the appointment of a project co-ordinator – Jennifer Tymon – in September 2007, who reflects below on her new role.
The overall aim of this project is to contribute to Namibia’s response to the HIV/AIDS epidemic by scaling-up palliative care provision through a public health approach that strives to balance quality and coverage. In order to do this APCA will:
- Identify and build a consensus on the needs and priorities of palliative care services at multiple levels of the health system in Namibia;
- Enhance participation in policy dialogue and advocacy for key identified palliative care priorities by the Namibia task force nationally and regionally;
- Provide technical assistance to increase the capacity of key stakeholders in the implementation of palliative care;
- Support the development of a functional palliative care country task force or national association, and;
- Conduct a palliative care public health evaluation in Namibia by 2010.
In order to achieve this, APCA is working closely with the Ministry of Health and Social Services (MoHSS) and with different stakeholders, including Catholic AIDS Action (CAA) and the International Training and Education Center on HIV (ITECH). APCA and CAA are undertaking a pilot programme to integrate palliative care into a home-based care programme in two sites: Anamulenge and Rehoboth. This is ongoing work that it is hoped will lead to further integration in the MoHSS programmes and those of other stakeholders. A national palliative care task force has been formed and training has taken place for 28 health care professionals and over 150 community volunteers. Individuals from the MoHSS and national task force attended APCA’s ‘Palliative Care - Making it Real’ conference held in Nairobi, Kenya, in September 2007, and followed this with a study tour in Kenya and Uganda to look at functioning palliative care services and to identify lessons learnt that could be applied to Namibia.
The Namibian team are keen to develop palliative care services within their country and it is encouraging and exciting to work with them. Many activities will be taking place over the coming year, including a regional drug advocacy workshop to be held in Windhoek in February 2008.
Initial reflections from Jennifer Tymon
Namibia is a country in need of palliative care. As I begin to settle in and learn of the realities of the HIV/AIDS and cancer situations, it seems as though palliative care development and dissemination is long overdue. The Government of Namibia is committed to expanding access to care to all people, and with this commitment comes great hope and challenges.
Topography is one of the great challenges here. With a small population spread over a large land mass, one difficulty is how to reach all people. This is further complicated by the great cultural diversity that exists; with various different tribes, care must be tailored to ensure its cultural appropriateness. Another complicating factor is that Namibia currently has one of the greatest wealth disparities in the world, which is reflected in the healthcare sector. There is a significant difference in the quality of healthcare received in the private and public sectors as well as in the training and compensation for professionals in those sectors.
Despite these challenges, Namibia is poised for great opportunity. The impressive infrastructure makes it easier to navigate the vast landscapes. The commitment of the government promises action from the highest level to ensure that coverage and quality of care are foundations of the national initiative. The energy and creative diversity of the people of Namibia are its greatest resource and will be the vehicle that drives palliative care forward. This is most apparent from the impressive network of community-based volunteers working at home-based care organisations. It is encouraging to be in a setting where the need for palliative care is recognised and its development supported. I look forward to working with the local stakeholders to making palliative care a reality for all Namibians.