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LIFE BEFORE DEATH #15 -- Nurse in the House

Posted by Greg Schneider on August 28, 2011 at 8:56am
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Tags: "nurse in the house", "hospice africa", uganda
Nurse in the House Short Film 15 of 50 in the LIFE Before Death documentary series about the global crisis in untreated pain and the dramatic life changing effect palliative care services can deliver to patients and their families around the world. In this Short Film we learn about the innovative health policies in Uganda allowing nurses to prescribe oral morphine in the homes of patients. "Sometimes we visit patients in their homes because when the patient has to move it makes the pain worse," explains Martha Rabwoni (Uganda). "The pain if is not treated, the patient is in total chaos -- they cannot think, they cannot do anything, they concentrate all their mind on the pain -- they cannot eat, they cannot dress, they cannot bathe, they cannot move. The relatives in that home -- nobody sleeps." We see Hospice Nurse Charlotte Komunda treating late stage cancer patient Beatrice in her home in Kampala, Uganda. "Many developing countries still have a real problem about the use, importation and manufacture of morphine," explains Eugene Murray (Ireland). "The second thing is having appropriate ways to distribute it. In Uganda, they dilute powdered morphine into water which is which is colored with a dye to indicate the three different strengths and is distributed by nurses in a community using recycled water bottles. That may seem very crude but in terms of pain control that is absolutely transformational." "We need morphine because most of the drugs don't control the pain in cancer patients so morphine is very important," states Nurse Charlotte Komunda. In Beatrice's house we observe Nurse Charlotte utilizing the simple but effective gesture-based communication tools that are used in many parts of Sub-Saharan Africa to rate a patient's level of pain. "Uganda is at an advantage because doctors are allowed to prescribe [morphine] and nurses who have done their 9 month palliative care course can prescribe morphine," explains Dr Faith Mwangi-Powell (Uganda). "But in other countries only doctors are able to prescribe. So sometimes you find that morphine is available but there's no one to prescribe it." "For many people living in rural areas, or poor township areas, their first point of contact is with a nurse clinician," continues Dr Natalya Dinat (South Africa). "Currently we have over 120 nurses who have had specialist training in palliative care and are now able to prescribe it for the patients in the districts," concludes Rose Kilwanuka (Uganda). "So at least as a country, we've increased our number of prescribers." Featuring Martha Rabwoni (Uganda), Charlotte Komunda (Uganda), Eugene Murray (Ireland), Dr Faith Mwangi-Powell (Uganda), Dr Natalya Dinat (South Africa), Rose Kilwanuka (Uganda), Beatrice (Uganda). LIFE Before Death comprises 50 short films themed around pain control and end of life issues, releasing one a week for a year from May 2011. A feature film will be released in late 2011, followed by the release of a television documentary in early 2012. The project is presented by the Lien Foundation and produced by Moonshine Movies. It is also supported by The International Association for the Study of Pain, The Mayday Fund, The Union for International Cancer Control and The Institute for Palliative Medicine at San Diego Hospice International Programs. To Learn More visit www.TreatThePain.com

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  • Greg Schneider August 28, 2011 at 9:05am

    Thanks to Dr. Anne Merriman, Hospice Africa is well ahead of developing countries in terms of getting pain medications to patients, even in rural areas.  Nurses are permitted to dispense morphine.  Please see our fund raising campaign on our main page for Hospice Africa volunteers, please give if you can.  A small donation goes a long way.

    Greg Schneider
    President, HVA

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