Management Team

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Created: Wednesday, 28 April 2021 16:12

Mrs. Deliwe Kacheche Head of Operations	Dr Chimwemwe Kabaghe Clinical Lead
Mwandida Nkhoma Nursing Lead	Alex Chitani Trainings Officer

Who We Are

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Created: Wednesday, 28 April 2021 16:10

The Palliative Care Support Trust is a charitable trust supporting palliative care provision at Queen Elizabeth Central Hospital and the surrounding communities in Blanytre District, Malawi.

History

The trust was registered in April 2007 but members of the trust were already previously providing care through the hosptial and Tiyanjane clinic.

What we do

The Palliative care support trust works to support, promote and develop palliative care services to patients and families in Blantyre district and in surrounding communities.

Where we work

Paediatric Care

Details

Created: Wednesday, 28 April 2021 16:02

Umodzi is a Chichewa word meaning ‘unity’. It is also the name of the children’s palliative care team in Queen Elizabeth Central Hospital. We see the children who have incurable disease e.g. cancer, HIV, heart disease or brain damage. While the children are in hospital, the Umodzi team of two clinicians, two nurses and a play lady seek to improve the quality of life for them and their families. We provide medicine, information, help with the extra expense of having a child in hospital, and then visit them after they get home. QECH is a government hospital, with relatively few staff and facilities. Most of the patients are poor, and many travel a long distance to hospital, arriving with little food and possessions. Extra help for families struggling to care for a child who is not going to recover makes a huge difference.

Home visits

The team visits children at home who are unable to travel back to the hospital but need further help. This can mean the difference between them receiving the strong pain killers they need or having to do without. Along with medicines, we can take food and extra equipment, and the visit provides support for families caring for a chronically sick child.

Outpatient care

Some children return to see the Umodzi team in the clinic after they have gone home from hospital. They can be seen in our office in a quiet and friendly setting, with room to play. We supplement the drugs that the government hospital pharmacy can provide, and take time to listen to problems. Patients become our friends over months and some carers return after their child’s death to talk about what happened. We are working within the paediatric ARV clinic to contribute our skills and provide a play lady.

Specifically, our service falls in the following:

     i. Pain and other symptoms management

          - Specialist nurses and doctors who have training in pain and symptom management covers medical issues. Other symptoms may include nausea, vomiting, constipation and breathlessness. 

     ii. Social Support

         - A social worker, who handles the familial, practical, and sociological aspects of a patient's life 

    iii. Counseling/Emotional Support

        - A specialist covers a patient's emotional and psychological needs. 

    iv. Spiritual Care

         - A chaplain and spiritual care advisor, explores meaning and purpose, assesses spiritual needs, and asks if the patient has a faith community or support team in place. 

    v. End of Life Care

        -Support is given to people who are nearing the end of their life. It's an important part of palliative care.

Adult Care

Details

Created: Wednesday, 28 April 2021 14:50

Tiyanjane is the adult palliative care service from PCST. At Tiyanjane we are in a privileged position to make a difference to the quality of life, medical care and follow up of some of the patients and families in Malawi living with incurable diseases. Many people we see have AIDS, cancer or both. Many of them are under the age of forty. We operate in a resource poor setting within the government health sector which is under constant strain from large numbers of patients many of whom have advanced disease. There are limited diagnostic facilities and poor staff to patient ratios. Doing a proper assessment of pain and providing appropriate pain relief can make a big difference. The privacy of a clinic room allows the team to listen to and advise of issues of concern, helping to support families in the care of their patient at home. In the community the Tiyanjane nurses work with volunteers and families helping to provide support and bring relief to patients in their homes. In-patient adult care Holistic care is delivered to patients on the medical wards at Queen Elizabeth Central Hospital. Drugs are supplied from the main hospital pharmacy or supplemented by PCST specifically to assist with pain and/or symptom control. Adult clinics We offer a weekly out-patient clinic to follow up patients with Kaposi’s sarcoma and a weekly general clinic for any other patients needing palliative care. Discharge planning Tiyanjane provide the link between the patient, their family and their return home from hospital. After a brief physical assessment and some time for discussion on what the problem is and how to take care of the patient at home, appropriate referrals can be made – to other clinics and /or community based services. Specifically, our service falls in the following:      i. Pain and other symptoms management           - Specialist nurses and doctors who have training in pain and symptom management covers medical issues. Other symptoms may include nausea, vomiting, constipation and breathlessness.       ii. Social Support          - A social worker, who handles the familial, practical, and sociological aspects of a patient's life      iii. Counseling/Emotional Support         - A specialist covers a patient's emotional and psychological needs.      iv. Spiritual Care          - A chaplain and spiritual care advisor, explores meaning and purpose, assesses spiritual needs, and asks if the patient has a faith community or support team in place.      v. End of Life Care         -Support is given to people who are nearing the end of their life. It's an important part of palliative care.

On-going Research

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Created: Wednesday, 28 April 2021 14:29

Adult Care

Tiyanjane is the adult palliative care service from PCST. At Tiyanjane we are in a privileged position to make a difference to the quality of life, medical care and follow up of some of the patients and families in Malawi living with incurable diseases. Many people we see have AIDS, cancer or both. Many of them are under the age of forty. We operate in a resource poor setting within the government health sector which is under constant strain from large numbers of patients many of whom have advanced disease. There are limited diagnostic facilities and poor staff to patient ratios. Doing a proper assessment of pain and providing appropriate pain relief can make a big difference. The privacy of a clinic room allows the team to listen to and advise of issues of concern, helping to support families in the care of their patient at home. In the community the Tiyanjane nurses work with volunteers and families helping to provide support and bring relief to patients in their homes.

In-patient adult care

Holistic care is delivered to patients on the medical wards at Queen Elizabeth Central Hospital. Drugs are supplied from the main hospital pharmacy or supplemented by PCST specifically to assist with pain and/or symptom control.

Adult clinics

We offer a weekly out-patient clinic to follow up patients with Kaposi's sarcoma and a weekly general clinic for any other patients needing palliative care.

Community care

Our main focus for community care is at Ndirande - a township on the edge of Blantyre with a population of around 200,000. A palliative care nurse is based at the health centre who takes referrals from both the hospital team and community based volunteers, spending most of her time travelling to patients' homes to deliver support, advice and clinical care. Twice a month the community team has a doctor's visit. Ways to deliver care to those living in Blantyre district but outside Ndirande are being developed in collaboration with the hospital.

HIV counselling & testing

Around 3,500 patients per year are tested for HIV from the medical wards. National guidelines are followed for HIV Testing and counselling (HTC) and quality standards. Couple testing is encouraged where possible.

Discharge planning

Tiyanjane provide the link between the patient, their family and their return home from hospital. After a brief physical assessment and some time for discussion on what the problem is and how to take care of the patient at home, appropriate referrals can be made - to other clinics and /or community based services.

Our Partners

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Created: Wednesday, 28 April 2021 14:27

Much of the success behind developing palliative care in and around Blantyre relies on the development and maintenance of local, national and international partnerships. Locally we work with Ministry of Health (Queen Elizabeth Central Hospital and various district level services) and the College of Medicine. Nationally we work with the Palliative Care Association of Malawi and other regulatory bodies such as Central Medical Stores and the Pharmacy, Medicine and Poisons board as well as other palliative care services providers. Internationally we are mentored by Hospice Africa, Uganda as well as receiving financial support from a variety of donors.

International Partners

I. ICCO – Cooperation

This is a Dutch organization that has been in existence for almost 50 years now. The organization’s goal has been to fight poverty and injustice. ICCO – Cooperation has partnered with PCST in the project called “Continuum of Care for vulnerable children needing palliative care in Malawi”. ICCO provides financial and technical support to this project. For more information about the strategic plan for ICCO – Cooperation, please visit their website www.icco-international.com

II. True Colours Trust

True Colours Trust is a UK based organization which is dedicated to working toward the improvement of lives of children with disability and those with palliative care needs. PCST has been a beneficially of True Colours Trust’s support that has seen the implementation of the first phase of STEP UP Project under PCST. Further to that, True Colours Trust has been providing core budget support for Tiyanjane clinic and Umodzi children palliative care clinic. For more information on True Colours Trust work, please visit the website www.truecolourstrust.org.uk

III. EMMS – International

EMMS international works in Malawi, India and Nepal to help people have access to good quality and dignified health care. PCST has partnered with EMMS to upgrade palliative care services to tertiary level using APCA standards. EMMS is also working with PCST to provide a needs assessment study on learning needs in palliative care for Malawi. EMMS with PCST have plans to work toward developing a multidisciplinary Centre of Excellency of learning for palliative care providers. For more information on EMMS international’s work, please visit www.emms.org

IV. Other Partners

African Palliative Care Association (www.africanpalliativecare.org )
Help the Hospice UK (www.helpthehospices.org.uk)

Local Partners

Palliative Care Association Of Malawi (PACAM) – www.palliativecareassociationofmalawi.org
Mulanje Mission Hospital – www.mmh.org
Nkhoma Mission Hospital – www.nkhomahospital.org
Ndi Moyo palliative care trust – www.ndimoyo.org