The experts say low public awareness, inadequate outreach services and gaps in identifying and treating pain are preventing patients and their families from accessing care that could improve their quality of life.
Speaking at a town hall meeting organised to mark World Hospice and Palliative Care Day, Herbert Mutunzi Lubega, a community health specialist, said many Ugandans remain unaware of palliative care and the support available to patients with serious or life-threatening illnesses.
Palliative care focuses on relieving pain and other physical symptoms while addressing the psychological, social and emotional challenges associated with serious illness.
It also supports families caring for patients. Mutunzi, who works with the Uganda Women Cancer Support Organization, said the organisation continues to receive calls from women and families struggling to cope with cancer treatment and its effects.
Based in Kampala, the organisation uses cancer survivors as peer counsellors to support women who have recently been diagnosed with cancer.
However, Mutunzi said they also receive calls from places as far as Kabale and Fort Portal from families whose relatives have become reluctant to continue treatment.
Some patients, he said, refuse surgery or stop taking medication because of the emotional distress associated with cancer diagnosis and treatment.
He said the challenges differ across age groups. Younger women diagnosed with breast or cervical cancer often worry about their femininity, relationships and sexuality, while middle-aged women may endure pain and avoid seeking hospice services because they must continue providing for their families.
Older women, meanwhile, may believe that pain is an inevitable part of ageing and cannot be treated, discouraging them from seeking medical attention.
Mark Mwesiga, the Executive Director of the Palliative Care Association of Uganda (PCAU), said the challenges reflect wider gaps in access to care across the country.
Mwesiga said only 11 per cent of Uganda’s population has access to palliative care services, while some districts lack even a single facility offering the services.
He called for stronger legal and policy frameworks, improved funding and measures to ensure that restrictions governing controlled medicines do not unnecessarily prevent patients from receiving pain relief.
“We’d like to see legislative arrangements, laws, legislation, Acts of Parliament that speak about and promote palliative care. We’d like to see balancing for funding. We’d like to see a balance of control in medicines that are controlled such that there’s no hindrance to patients who can receive them,” Mwesiga said.
He said this year’s focus is on pain management among older people, including not only physical pain but also the psychosocial distress associated with ageing while living with life-threatening illnesses.
Mwesiga added that expanding palliative care does not always require large budgets, arguing that community-based programmes could help older people recognise when they need assistance and seek care early.
Dr Miriam Ajambo, a principal medical officer at the Ministry of Health, acknowledged that gaps remain in service delivery and pain management.
She said pain is among the most feared experiences of serious illness because of its effects on both the body and the mind.
The government has made pain-relief medicines, including oral morphine, available free of charge through accredited public and private health facilities. The medicine is manufactured locally and distributed to support the management of severe pain.
However, Ajambo said patients still suffer unnecessarily because some health workers fail to identify pain adequately or underestimate its severity, even when patients are already receiving care at health facilities.
The experts say these gaps require improvements in both health worker training and community outreach to ensure patients are identified early and receive appropriate treatment.
Dr Tonje Bell, a palliative care specialist at Kabale Christian Care in southwestern Uganda, said health facilities need to strengthen outreach programmes and identify patients who require care in their communities rather than waiting for them to seek help.
Bell said the facility received a donated ambulance last month to support community-based care, which she hopes will help reach patients who currently struggle to access services.
World Hospice and Palliative Care Day is observed annually in October to raise awareness about palliative care and advocate for access to services that relieve suffering among people living with serious illnesses.
The experts say improving access in Uganda will require greater public awareness, stronger community-level services, adequate pain-relief medicines, and policies that make palliative care available to patients regardless of where they live-URN. Give us feedback on this story through our email: kamwokyatimes@gmail.com
