In 2011, The True Colours Trust made a small grant to improve palliative care for children at the central hospital in Blantyre, Malawi. This came after Fred Chiputula, a Clinical Officer at the hospital, expressed concern about a lack of vital follow-up care for his patients when they were discharged. District hospitals rarely had trained staff, consistent stocks of morphine, an appropriate clinic space, or funding for a palliative care service.
The project was a success so True Colours, in partnership with the Diana, Princess of Wales Memorial Fund, awarded a large grant to roll out the work across the south of Malawi. Hospital leaders were educated about the transformational effects of palliative care and clinicians were trained. Work was also done to improve the availability of pain-reducing morphine. Hospitals were funded to install dedicated palliative care clinics.
In 2016, the project was expanded to the remaining two regions of the country, informed by learning from the south. In 2017 a new Bachelor of Science degree in Palliative Care was launched, also supported by True Colours, and a new generation of leaders is now emerging to run services.
The landscape has been transformed over the last decade, thanks to the hard work and tenacity of True Colours’ partners. Each district of Malawi now has a dedicated palliative care clinic with trained staff. There is a consistent supply of morphine across the country and all districts include palliative care in their budgets.
Malawi is now ranked among the top 29 countries in the world for palliative care integration, sitting alongside the UK, USA, Australia and Germany - a remarkable achievement. One of the key successes to date is that many elements of palliative care delivery in the country are funded by the Ministry of Health, meaning they are truly sustainable.
True Colours’ support for work in Malawi amounts to over £3m and the Trust plans to continue work in Malawi for at least a further five years, focussing on addressing the remaining gaps in palliative care provision.
While the facts and figures are impressive, it is the individual case studies that really show the impact made. Take the story of Robert – a young father who had developed an unknown neurological condition leaving him housebound and unable to sit or stand. Following a visit from his District Palliative Care Team, Robert was provided with a wheelchair to allow him to sit up, leave his house without assistance, and even to hold his newborn baby. This was hugely significant to Robert and his family, demonstrating the difference that good palliative care makes.
