About the Project
VISION
The Bombo Palliative Care Project was formed to support local health care teams in the Tanga district of Tanzania to develop and deliver their vision of palliative care services, also known as hospice or end of life care.
GOAL
The current goal is to provide financial support for members of the Bombo Palliative Care Team to obtain education in palliative care: tuition, books and other materials, per diem while on placement in the field, travel costs, communication costs. Our goal may change as the project matures.
HISTORY
In October 2008, Victoria area physicians Dr. Leah Norgrove and Dr. Ambrose Marsh went to Tanzania for 6 months to work as volunteers to help develop palliative care. Their work took them to Bombo Regional Hospital in Tanga on the north east coast of Tanzania.
The wards at Bombo hospital are large, open male and female wards, with very basic supplies and tests, sometimes no running water or power, and only a small array of treatment options and medications compared to Canada. Almost all direct patient care is provided by family members. In the broader community, there is very little in the way of primary health care infrastructures, or access to cancer care or management of chronic diseases.
In addition, Tanzania has been hard hit by the HIV/AIDS epidemic, and although ARVs (anti-retroviral treatment for HIV) are newly available in the last few years, there are many problems that persist and sadly patients are still dying in unprecedented numbers. Palliative care programs seek to care for individuals and their families coping with life-threatening illness including HIV/AIDS. Palliative care in this setting should be developed alongside active care rather than instead of active care.
Leah and Ambrose were fortunate to work with a wonderful team of individuals at Bombo Hospital who were part of the ‘CTC’ (Care and Treatment Centre) which is the name given to the organization of care around HIV/AIDS in Tanzania. A new palliative care team formed at Bombo Hospital under their mentorship.
This team now receives referrals for patients who are nearing the end of life or facing life-threatening illness including HIV/AIDS (about 70%) as well as cancers and other chronic diseases. They carried out a combination of bedside teaching in symptom control, education, and program development with a multidisciplinary team, which included nurses, Assistant Medical Officers (AMOs) and social workers.
Leah and Ambrose became quite attached to this wonderful group of clinicians. The members of the Bombo team were bright, keen, caring and skilled individuals who were well respected by their colleagues. Bombo is a regional hospital moving forward under the wonderful leadership of Dr. Fred Mtatafikolo. The hospital serves as a teaching centre and referral centre and thus is well positioned to be a leader in palliative care for the region.
Leah and Ambrose spent a lot of time discussing with the team what the next steps for the development of palliative care at Bombo might look like. The Bombo team identified their primary need as being more education in home-based care, in-patient care and program development in an African context.
THE BOMBO PALLIATIVE CARE PROJECT
On their return to Canada, Leah and Ambrose created an education fund and started fundraising.
The neighbouring country of Uganda is an African leader in palliative care. Hospice Africa Uganda offers distance diploma and degree programs in partnership with the African Palliative Care Association and Makerere University in Kampala. There is also a diploma program, Nairobi Hospice, in neighbouring Kenya we are exploring for enhanced skills in social work and psycho-social care of the dying.
These courses are primarily distance education with travel to Uganda or Kenya for residential on-site training and examinations. This way Bombo clinicians will not be removed from their vital roles at Bombo while they are learning new skills in palliative care. These individuals will then be in a position to serve as local and regional leaders for palliative care development throughout the Tanga Region. The Bombo Palliative Care Project has decided that accessing these educational opportunities for the Bombo team is where it will focus its initial energies and resources.
Leah and Ambrose receive emails regularly from the Palliative Care Team at Bombo, and the team continues to receive referrals and care for the palliative patients in the hospital
Giving to the Bombo Palliative care Project is an opportunity to give very directly towards the education of these Tanzanian clinicians who provide palliative care to patients facing life-threatening illness. These clinicians will touch the lives of thousands of patients, over the span of their careers. In addition they will teach other clinicians about palliative care, and how to support patients facing the end of life.