In the last 10 years Tanzania has seen a significant increase in Non-communicable Diseases affecting children, youth, adults and the elderly which has resulted in an increased burden for the Health Sector and families/community at large. A large percent of these patients need palliative care or/and hospice. FHPCP was started in 2012 to address this situation as there were no palliative services in Singida Municipality. Until this Programme was initiated, there was no treatment for this target group in Singida Municipality; patients were discharged home to die with no treatment, even for control of their pain. Faraja Hospice and Palliative Care Programme (FHPCP) provides home based treatment and care, including morphine for severe pain, for these people. According to the National Policy Guideline on Palliative Care Services (December2012) palliative care is a human right and Tanzania wishes to address it even though the resources of the government for doing so are poor and scarce.
Having discovered that patients with terminal illness had no care, especially of their pain, more investigation was done by us. It was found that there is a definite need for hospice and palliative care in Singida. Faraja Centre CBHC saw that this population could be served and cared for from the Centre. It had a Doctor with 35 years of medical experience in Tanzania who was very interested in helping to solve this problem. FHPCP began as a Pilot Programme in 2012. Very soon the number of patients increased to the point of convincing the Programme that palliative care, especially End of Life Care, was needed in Singida.
Firstly, the Medical Officer in Charge, and Nursing Officer in Charge of Singida Regional Referral Hospital were contacted to get their opinion as to whether there was a real need. They were very enthusiastic and encouraging. The Municipal Manager was contacted and gave us permission to contact the Local Government Leaders in the various Wards. Ocean Road Cancer Institute (ORCI) Dar es Salaam was visited. It was found that they had no arrangement for follow-up and care in the patients’ local areas, but the Palliative Care Department agreed to communicate and to facilitate ongoing care locally for Singida patients. Also at this time the Tanzania government issued a National Policy Guideline for Palliative Care Services (Dec2012). Palliative Care was a totally new concept to the patients needing it but, when it was explained to the patients and their families, it was readily accepted and welcomed.
FHPCP contacted and took the advice of Hospice Africa Uganda (HAU), which pioneered Palliative Care in Africa, and decided on a Home Based Programme model instead of an institution. It was decided to follow on the 20 years experience of HAU and to adapt it to our local situation. FHPCP began as a Pilot Programme in Singida with one medical doctor, one nurse and a part-time driver. The plan has been to start small, build on our experience and to expand when and if possible. From its beginning in August 2012 until the end of 2017 the Programme has enrolled 303 patients out of which 176 have died. At any one time there are between 85-95 patients currently being cared for by FHPCP.