Faith and palliative care: a partnership of care in low- and middle-income countries

ABSTRACT

The provision of holistic palliative care has been identified by WHO as a human right, important for all people, at all ages, with all life-limiting illnesses. When faced with death and dying, issues of meaning and relationships with others, the world, and with the sacred are intensified even more in communities where faith and spiritual beliefs have a significant place. Being able to understand the significance of dying and interpreting the experience and period of living with life-limiting illness, presents an important challenge for palliative care. This article sets out the contribution that faith communities have made in understanding the significance of spiritual issues in health and in delivering palliative care in lower to middle-income contexts where palliative care has been prioritised.

L’OMS a identifié la délivrance de soins palliatifs holistiques en tant que droit humain important pour toute personne atteinte d’une maladie limitant l’espérance de vie, quel que soit son âge. Lorsque l’on est confronté à la mort et à son processus, les interrogations sur le sens et sur les relations avec les autres, le monde et le sacré gagnent en intensité, et plus encore dans les communautés où la foi et les croyances spirituelles occupent une place importante. La capacité de comprendre le sens du processus de la mort et l’expérience et la durée de vie avec une maladie limitant l’espérance de vie représente un défi important pour les soins palliatifs. Cet article décrit la contribution des communautés confessionnelles à la compréhension de la spiritualité dans la santé et la délivrance des soins palliatifs, dans des contextes de revenus faibles à moyens où les soins palliatifs sont devenus prioritaires.

La OMS ha calificado el cuidado paliativo holístico como un derecho humano de importancia para todas las personas, de todas las edades, que padezcan cualquier enfermedad que limite la vida. Cuando una persona se enfrenta a su muerte o al proceso de morir, los temas de sentido y las relaciones interpersonales, con el mundo y con lo sagrado, cobran mayor intensidad, especialmente en aquellas comunidades en que la fe y las creencias espirituales desempeñan un papel significativo. Los cuidados paliativos enfrentan un reto formidable a la hora de comprender el significado de la muerte e interpretar aquello que se experimenta durante la etapa de la existencia marcada por enfermedades que limitan la vida. El presente artículo da cuenta del aporte realizado por las comunidades de fe en aras de comprender la relevancia que conlleva la incorporación de temas espirituales en la salud al momento de brindar cuidados paliativos a personas de ingresos bajos o medios, precisamente el sector priorizado para la implementación de dichos cuidados.

KEYWORDS:

• Social sector – Health
• Aid – Development policies
• Civil society

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes on contributors

Elizabeth Grant is Assistant Principal (Global Health) and Director of the Global Health Academy at the University of Edinburgh. Liz leads the University’s Compassion Initiative and co-directs the Zambia UK Health Workforce Initiative. Liz is responsible for a wide portfolio of online global health MSc programmes and research.

Mhoira Leng is a specialist palliative care physician based in Kampala, where she leads the Palliative Care Unit at Makerere University, Uganda. Mhoira is Medical Director of Cairdeas International Palliative Care Trust, Scotland and sits on the Board of Directors of the International Association for Hospice and Palliative Care.

Kellen Kimani is a public health-trained doctor from Kenya. She is studying for a PhD at the University of Edinburgh. Her research focuses on palliative care in Africa, with special interest in understanding the needs of patients living and dying with non-malignant terminal illnesses.

Elizabeth Namukwaya is a palliative care physician in Mulago Hospital Palliative Care Unit, and Honorary Senior Lecturer Palliative Care Unit, Department of Medicine, Makerere University College of Health Science, Uganda.

Ivan Odiit Onapito is the Pastoral and Social Support Coordinator at the Makerere Palliative Care Unit at Mulago Hospital. Ivan supervises local volunteers who provide practical support to the patients.

Julia Downing is the Chief Executive of the International Children's Palliative Care Network, a Honorary Professor at Makerere University, and a Board member of the International Association for Hospice and Palliative Care and the Worldwide Hospice and Palliative Care Association. She is a nurse and has worked in palliative care for 25 years in the UK, Uganda, and Eastern Europe.

Additional information

Funding

These studies were funded by: Cairdeas International Palliative Care Trust; Charles Darwin scholarship and Lennie Gordon bursary from the University of Edinburgh and the Diana Princess of Wales Memorial Fund; University of Nairobi; The Diana Princess of Wales Memorial Fund; and EMMS International.