Payments accepted through 
Dr. Faith Mwangi-Powell is Executive Director of the Uganda-based African Palliative Care Association (APCA). Dr. Mwangi-Powell worked in Community Health before moving to the Diana Princess of Wales Memorial Fund in London, UK, where she managed funds for palliative care for Africa. “Once you get into palliative care, especially in Africa, you come into contact with cancer,” she says.
In 2005, Dr. Mwangi-Powell moved to Uganda to help set up APCA. “Being a new organisation it’s important to make ourselves-and our needs-known. And we are very interested in collaborating with other organisations working in the cancer field,” she says. She travels widely, advocating the need for more investment and greater awareness of palliative care.
For many years the health debate in Africa focused on HIV/AIDS and other infectious diseases like Malaria and TB. Cancer was low on the list of priorities. But many African countries are facing an impending cancer crisis with up to a million new cases a year by 2020. Dr. Mwangi-Powell says the most common cancers in Sub-Saharan Africa are breast and cervical in women, prostate in men, and Karposi’s Sarcoma in both sexes.
A particular problem in Africa is that up to 80% of cancers are diagnosed at an advanced stage. Education and early detection are vital if the region is to effectively combat the growing threat. But lack of resources is a huge problem. “Even when cancer is detected early, we don’t have the resources to treat patients,” says Dr. Mwangi-Powell. “What is worse? Not knowing you have cancer, or knowing you have it but cannot get treatment? How can we promote investment in early detection if we don’t have resources for treatment too?”
In palliative care, the biggest challenge in Africa is access to pain medication. “If you’re talking about palliative care but you are unable to control pain, then you’re not doing your job,” says Dr. Mwangi-Powell. Morphine, which is not expensive, is the best drug to control severe pain. But in many parts of Africa there are restrictive regulations on the use of morphine, meaning that many people do not have access to it. “There are some countries where morphine is available but only a few people have the authority to prescribe it, while in others the process of getting morphine from the source is so complicated that many patients don’t even bother to try,” says Dr. Mwangi-Powell. “There’s a belief among the health profession that morphine is addictive and is going to be abused. But that’s an outdated way of thinking and needs to be addressed.”
Still, Dr. Mwangi-Powell believes there are grounds for optimism. She says that in the two years APCA has been operational, they have seen a great deal of progress. There is much goodwill and interest and many countries are asking what they can do to help improve the situation. “The needs are many and have to be prioritized. But we are advocates and must keep pushing, because freedom from pain is a human right,” she says. “We work towards improving the quality of life for cancer patients, or to help ensure a comfortable death, with dignity.”
“In Africa, literally every day, hundreds, possibly thousands of people die needlessly in pain from cancer for want of pain relief that could cost literally pennies rather than pounds. The basic infrastructure and resources to cope with the new health epidemic is basically not there and we have to do something about it.” - former British health minister Alan Milburn
Share the story