1. Paediatric Palliative Care in Kenya Busi Nkosi

2. Kenya Current Situation Human Rights Watch Report

3. This was released in 2010. It received significant coverage by the press, thus alerting the government, public and HCPs of the neglected issues of Pediatric Palliative Care and pain relief for children. Following this, Kenya Hospices and Palliative Care Association (KEHPCA) has aggressively been involved in advocating for PPC at the national level

4. Developments Have been slow but are now picking up through strong advocacy by KEHPCA. In November 2010, KEHPCA, with support from ICPCN organized for two pediatricians and one child psychologist to be trained in PPC in South Africa for two weeks. The intention was to develop champions for PPC. Two are currently actively involved in PPC training programmes through KEHPCA, as well as service provision and advocacy.

5. Developments cont. In April 2011, KEHPCA organized a symposium at the Annual Kenya Pediatric Association (KPA) Conference. Over 80 clinicians attended (majority were paediatricians) This generated a lot of interest in PPC and a subsequent request for training.

6. Developments cont. In 2011 August, KEHPCA through the support of ICPCN organized for a 5 day PPC training in Nairobi. 41 Clinicians participated, mostly nurses. 3 senior paediatricians (2 were from the University of Nairobi and one was from Elizabeth Glazier Foundation), 3 young pediatricians and several medical officers participated.

7. Current PPC situation After training Dr. Patrick Mburugu, who was one of the participants, opened the first peadiatric palliative care unit at the Garissa Provincial Hospital, east of Kenya.

8. PPC initiative in Garissa by Dr Patrick Mburugu Garissa Provincial General Hospital PPC unit in Garissa Provincial General Hospital

9. Current situation continued Dr. Deborah Omedo, a pediatrician who attended the course has started to integrate PPC services in the peadiatric oncology ward in Kisii Level 5 hospital. Kenyatta National Hospital, the main referral hospital in Kenya has integrated PPC in the paediatric oncology ward and morphine is now being prescribed for children. A celebrity visits a PPC unit in hospital on World Hospice and Palliative Care Day 2012

10. Current situation cont. The Kenya Hospice and Palliative Care Association is working closely with these hospitals to integrate palliative care services under the Waterloo Projects

11. Current situation cont. In September 2012 the 2 nd training of health care professionals in PPC took place in Nairobi. 43 were trained: 17 were paediatricians (one Peadiatric oncologist (there are only 2 in Kenya) and one was a Provincial Hospital Director as well as a Deputy Director of Medical Services

13. After this recent training: Dr. Liru (and one of the participants in the training) has started Integrating PPC services in Homa Bay Hospital in Western Kenya. This is a district Hospital with a paediatric oncology ward for Burkits Lymphoma and other childhood cancers. He is also integrating it into the children’s HIV/AIDS Comprehensive Care Centres. (He needs a TV, DVD Player, and Toys for these children as a Christmas gift to them this year)

14. Integrating PPC in Kenya hospitals (Nurse Ann of KNH Palliative Care Unit with children in Paediatric Oncology ward)

15. Opportunities Advocacy for PPC to be integrated in peadiatric services at all levels of care. This can be achieved by working hand in hand with the Kenya Paediatric Association and other relevant stake holders. Giving technical support to the University of Nairobi to integrate PPC in their curricula. Conversations are ongoing. Encourage and give support to government hospitals under the Waterloo project to integrate paediatric palliative care services.

16. Challenges Training and Education of Health Care Professionals and Care givers No policies in place for Paediatric Palliative Care in the country Child unfriendly rooms for service delivery in hospitals More awareness needed (public, HCPs, Government) More champions needed Mentorship / clinical placements Funding especially to support new initiatives Drugs for pain control

17. Thanks to: Diana Princess of Wales Memorial Fund ICPCN Open Society Foundation Elizabeth Glacier Foundation Kenya Hospice Care

18. Kenya needs your support to make it happen……these little ones matter to the end.

19. Asante Sana www.kehpca.org