Hospice Care in Thigio

August 2015

Our Lady's Hospice in Thigio is changing the stereotypes and perceptions in Kenya about end of life, cancer, pain, and palliative care by helping those most at risk for little to no cost. Founded by a powerhouse sister of the Daughters of Charity in 2009, the hospice is a model in Kenya for the proper care to treat people at the end of their life. When Sister Eileen O'Callaghan arrived in Thigio from Nairobi in 2003, she never imagined that she would create a place that would be a center for the community. After seeing the large number of people suffering from cancer and other terminal illnesses in the area and witnessing first-hand the prevalent fear of death, she knew that something had to change. "There was, and still is, a large fear of people dying in their homes," she explained, in her characteristic heavy Irish accent. "Families would take loved ones out in the forest to die, alone."

When the idea for the creation of a hospice came to her, there was almost no pain relief or care facilities in the region. In May 2010, Our Lady's Hospice was opened by Sister Eileen and two other Daughters of Charity with a team of nurses and staff. Today, the campus has extended to an outpatient clinic, library, and children's daycare and offers programs for the elderly, women, teenagers, and children and adults with special needs. The hospice is one of the only places in the area, and in Kenya, that offers complete palliative care services for an affordable cost. Sister Eileen takes any patient, regardless of their religion and ability to pay. If someone is not able to afford the fees and is not on the national health insurance but still in dire need, Sister Eileen and her team find a way to give them care. However, due to limited capacity and a complete reliance on donations for funding, there are only 9 beds in the hospice with an extended waiting list. 

Despite issues, there is hope going forward that the community will find a way to expand its offerings and provide more care to more people in need. The beauty of Our Lady is the simplicity of it all. Passionate people provide care to others, regardless of their religion, ethnicity, or wealth. The hospice building is a peaceful haven among the bustle of a community center that constantly has children, families, teenagers, and elderly moving rapidly in and out. With proper access to pain relief and care, people can live their days beyond pain: whether it be making it into the day room to watch the ever-popular Nigerian soap operas, being able to sit outside and feel the sun warm their skin, or eat a chocolate. 

If you are interested in donating to the hospice, Sister Eileen O'Callaghan can be contacted by email at thigiohospice@gmail.com or by phone +254-737-499600.

Grace Klomo, one of the two night nurses at sips her tea shortly after finding out that one of the patients, Mary Wangui, died earlier that morning. Grace has worked 12-hour night shifts at the hospice for one year, which can be difficult emotionally as patients often pass away during the night rather than the day.

Margaret Karimi, 48, massages her own hands during a morning in the day room. Because of her cancer medication, Margaret's fingers and ankles swell up - making it difficult for her to walk on her own and feed herself. The nurses and sisters in the hospice help her walk to and from the day room every day, and feed her.

The hospice is the foundation stone of the Our Lady community, as it was the first thing created by Sister Eileen and two other sisters of the Daughters of Charity, a community of women who devote their lives to serving the poorest and most abandoned individuals in society. The Daughters of Charity founded the hospice and church in Thigio, which quickly expanded to offer services for the elderly, women, special needs children and adults, nursey school, and the local youth. Sister Catherine works in the library, while Sister Deborah is the primary administrator and coordinator for the entire community.

Florence Njeri, 29, checks the vitals of Teresiah Wairimu, 67. Florence has worked at the hospice since its opening in May 2010. "I didn't know what I was applying for," she said of how she found the job. "The first few months were very tough, but you get used to it." Carers at the hospice are not qualified nurses, but take care of many things including cleaning, feeding the patients who can't feed themselves, managing diapers, and supporting the nurses and Sister Eileen.

Beatrice Kagunda, a carer at Our Lady, sanitizes and bleaches what was Mary Wangui's bed. Anything that the relatives do not take with them when they retrieve the body of their loved one is donated to the community or thrown out. There is a significantly long waiting list for beds in the hospice, so another person moves into the hospice within two days.

Sister Eileen fills a syringe with a dosage of morphine for Florence Akoth. Because they are a specialized palliative care facility, the hospice does not face any barriers getting or giving morphine. The workers at the hospice are specially trained in palliative care.

Sister Eileen gives Margaret Karimi, 48, her afternoon dosage of morphine. Morphine is necessary for three of the patients in the hospice to live free from pain due to their medical conditions. The other six take less strong forms of pain relief or none at all.

Peter Waweru, 27, and his nephew, David, visit their father and grandfather, respectively, David Waweru, 61, at the hospice. "We are happy with the care that he gets here," Peter said. "Because I don't have a stable job and work different days, I wouldn't be able to do this at home."

Sister Eileen, 78, gives medication to Margaret Karimi, 48. Sister Eileen hand delivers all of the medication herself, as she knows the specific way that each patient likes to take their medication.

Members of the staff at Our Lady pick up Florence Akoth, 29, to move her to her bedroom. Because of the cancer in her hips, Florence is unable to walk or sit up. When she wanted to get out of bed to watch television, the staff found a solution to transport her from bed to the day room so that she could have what she wanted.

 

Florence Akoth, 29, unwraps a Kinder chocolate before settling down for the evening. Florence and the other patients tire easily. Their day exists primarily from 7 AM to 2:30 PM when they can go outside, watch television, or rest in bed.

Sister Eileen speaks with Mary Wambui, 49, after sneaking her a chocolate in the afternoon. Mary suffered from a brain tumor that left her with limited mental capacities, diabetes, seizures, and other health issues. She has lived in the hospice for over a year, and recently attended her son's wedding with the coordination of Sister Eileen and her family.

Sister Eileen collects bottles before heading out of the hospice for the day. She manages all aspects of the hospice at the age of 81, with no sign of halting immediately. She personally speaks with all families when their loved ones are admitted to the hospice, and when they come after death.

Teresiah Wairimu, 67, lies in her bed at dusk. Depending on the health and physical capabilities of patients, Sister Eileen and the nurses will do whatever they can to make the comfortable - whether it be helping them outside to sit in the sun or finding their favorite book. No matter the patient's condition, the staff at the hospice make every effort to help those they care for live their days with some sense of comfort and free of pain.


 

ABOUT THE PROJECT

Working under the close guidance of professional photographers, videographers, and writers, six students from Tufts University were paired with a mix of six photojournalism students and young professional photographers in Kenya to collaborate on a series of character-based, multimedia narratives to bring a human face to the extremity children and adults face in living with life-limiting illnesses without access to pain medications and palliative care, as well as to those working to extend palliative care in Kenya.

The hope of the project is that medical professionals, government officials, and activists in Kenya and beyond will be able to use these narratives in their campaigns to expand palliative care and break the logjams that currently prevent access to pain medications.

It is important to note that Kenya is not alone in its challenge to meet the palliative care and pain management needs of its citizens. This is a widespread issue.  

 

The project was sponsored by the Public Health Program of the Open Society Foundations

This is a project of theProgram for Narrative and Documentary Practice of the Institute for Global Leadership at Tufts University.