Volume 24, Number 8: August 2023
Filling a Knowledge Gap: Palliative care training on now in Lesotho
By Tebello Lepheane, Founder
Starlight Oasis of Hope Hospice, Kingdom of Lesotho
Education and training is one of the operational pillars at Starlight Oasis of Hope Hospice (SOHH). We have known for years that there is a knowledge deficit among health care professionals in the Kingdom of Lesotho when it comes to palliative care. Those who need palliative care suffer in silence, and their families have little or no support.
I, myself, am a nurse trained in Lesotho, but only became aware of the concept of palliative care when I arrived in the United Kingdom.
SOHH conceived a plan to train health care professionals in 2018, but lacked the budget. It took concerted outreach to partner and collaborate with other African and international organizations to launch online training sessions.
3 Steps to Quality Care
Despite Limited Resources
1. Quality painkillers can maximize quality of care with limited resources. Lesotho has limited morphine supply and access, and many health facilities have no liquid morphine. We are working with other stakeholders to improve access to World Health Organization essential medicines.
2. Speaking to patients and families in a culturally sensitive, clear and compassionate way is a zero-cost skill that is one of the great pillars of palliative care provision. We can provide quality care when we attend to their priorities, such as dealing with their pains and suffering, mobility challenges or loss of income due to disease progression.
3. Palliative care providers can maintain a good referral system and liaise with other departments and stakeholders to source timely support.
200 providers receive training
We are now training 100 health care and social care professionals from all 10 districts, including those from health institutions/colleges. Participants include doctors, educators/lecturers, nurses, pharmacists, social workers, spiritual counsellors, and pastors. The program embodies the multidisciplinary teamwork that is the core of palliative care. This online training program began on July 11 and runs for eight weeks. A second batch of another 100 participants is scheduled to begin on September 5.
Hospital teams are next
A 10-day, in-person program for teams from district hospitals will begin October 23 in the capital city of Lesotho; these sessions will be conducted by Starlight Oasis of Hope Hospice (SOHH) and Palliative Care Works (PCW). It aims to empower these teams to become palliative care champions. SOHH, PCW, and the Ministry of Health have pledged to continue to support and mentor participants.
Team training topics include:
- culturally sensitive communication; spiritual & emotional support
- pain assessment & management; symptom management
- cancer care needs
- self-care
Lesotho is seeing an increasing cancer burden and complex issues related to noncommunicable diseases, such as diabetes and hypertension, and there is a great need to tailor care that responds to patients as required by a Universal Health Coverage mandate.
Who Helped Make the Training Possible
The African Palliative Care Association contributed by granting access to Project ECHO and related background support.
PallCHASE helped with Project ECHO logistics and admin tasks and provided course content for the online sessions.
Palliative Care Works provided course content for the in-person training.
Project ECHO provided tele-mentoring expertise, including the platform upon which the online training takes place.
Additionally, the Ministry of Health and Ministry Social Development Lesotho allowed staff to train.
What does "comprehensive care" in Lesotho mean?
Good communication is the basis for good care. We speak to patients and their families in a sensitive way, allowing them time to express their challenges, which, in turn, helps collectively prioritize their care in a holistic way. Comprehensive care means attending to physical challenges—such as pain and issues with wounds and other symptoms—but also emotional, spiritual, and social issues. The role that palliative care workers have should never be underestimated: they play such a big role in assessing and tending to the social needs and challenges of patients and their families.
Our hope and prayer is that the Ministry of Health and Ministry of Social Development can work collaboratively so that we can have clinical social workers within the multidisciplinary team in district hospitals. This would be a big step in ensuring that the needs of patients and their families are attended to in a holistic and comprehensive manner.