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Palliative care and pain treatment in Zithulele Hospital and surrounding area 30 September 2011 Annette Dekker Health Grand Challenge Summer of Learning Symposium. Internship: Jabulani Rural Health Foundation. Located in Eastern Cape, South Africa Established in 2007
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Palliative care and pain treatment in Zithulele Hospital and surrounding area 30 September 2011 Annette Dekker Health Grand Challenge Summer of Learning Symposium
Internship: Jabulani Rural Health Foundation • Located in Eastern Cape, South Africa • Established in 2007 • Founded by four doctors • Works in conjunction with Zithulele Hospital • Supervised by Dr. Ben Gaunt and Dr. Karl le Roux • Advised by Professor Joe Amon
Research question: Pain and Palliative Care • Chronic Pain • Pain that occurs over weeks, months, or years, rather than a few hours or a dew days • Palliative Care • Health care that aims to improve the quality of life of people facing life-limiting illnesses, through painandsymptom relief, and through psychosocial support for patients and their families. Palliative care can be delivered in tandem with curative treatment but its purpose is to care, not to cure.
Research question: Pain and Palliative Care • Common diseases in Zithulele Hospital associated with pain and palliative care • HIV and AIDS • Tuberculosis • Cancer • Chronic renal failure • Chronic heart failure
Methodology: Interviews • Quantitative and qualitative • Patient interviews • 45 total • 35 in hospital – general ward and TB ward • 10 in community • Provider interviews • 33 total • Doctors, Nurses, Physiotherapists, Occupational therapists, Social workers
Conclusions: Patients’ perceptions of pain • High levels of pain • 52% rate their pain in last month as highest level of pain possible • Limited understanding of pain • 83% do not know what is causing their pain • When patients do connect pain to disease they appear to do better emotionally
Conclusions: Availability of pain medication and palliative care • Zithulele Hospital • Difficult situations to initiate palliative care • Unknown diagnosis • HIV • Time constraints • Outside of Hospital • Lack of basic pain medications • Limited home based care • Insufficient and expensive transportation
Reflections… • Complexity of issues – micro and macro • Power of awareness • Importance of passionate people …and the Future • Continuation of analysis for senior thesis • Development of concrete recommendations