People of AMPATH: Dr. Hussein Elias
As the number of Kenyans afflicted with non-communicable conditions such as heart disease and cancer increases, so does the need for palliative care services. With the generous support of donors and partners in Kenya and North America, Dr. Hussein Elias, a family physician and adjunct faculty in the department of family medicine at Moi University, is growing AMPATH’s team to meet that need.
Palliative care is medical care that seeks to improve the quality of life of patients and their families facing the problems associated with life-threatening illness. It does this through early identification, impeccable assessment, and treatment of pain and physical, psychosocial and spiritual distress. In Kenya, there are a limited number of centers providing specialized palliative care services and a lack of clinically-based training opportunities.
Dr. Elias joined AMPATH last year. He works alongside colleagues in MTRH, helping to provide care, training and engaging in research. The palliative care program also works collaboratively with Living Room International, an organization that provides hospice services in western Kenya.
“AMPATH has provided me with opportunities to begin actualizing the vision of expanding palliative care programs,” said Dr. Elias. “The time I have spent at AMPATH has given me a broad experience in conducting research, providing training and mentorship, developing leadership skills and provision of clinical care to patients. Through AMPATH, I have been able to connect with many specialists from various parts of the world thereby increasing my knowledge base, developing collaborations and receiving mentorship towards achieving my goals,” he continued.
Dr. Ken Cornetta and Dr. Hussein Elias
One of Dr. Elias’ AMPATH Consortium colleagues is Indiana University’s Dr. Ken Cornetta, who first travelled to Eldoret as part of a clinical fellowship in palliative care in 2014. He was so inspired by the palliative care team’s dedication that he was compelled to return. “Now with 11 trips under my belt, I continue to learn from my Kenyan colleagues and am grateful for the opportunity to participate in their important work,” Dr. Cornetta said.
Dr. Cornetta stresses that while treatment of pain and symptoms is a large part of a palliative care practice, a very significant component involves discussion around serious illness and end-of-life care. “We consider the patient and their family and strive to respect their wishes regarding the manner and extent of information communicated. Paramount is discussing these issues in a caring and empathetic manner. This is truly an art not a science. The exchange of ideas between our Kenyan colleagues and the growing number of North American palliative care physicians within AMPATH is an extremely valuable part of this collaboration,” he said.
Dr. Elias said that some of the long-term goals related to palliative care include integrating services into the routine HIV, cancer and other chronic disease clinics and creating links between primary care providers and palliative care specialists. The team would also like to partner with national organizations such as the Kenyan Hospice and Palliative Care Association and Hospice Care Kenya to increase public awareness and governmental support for palliative care services.
In addition to delivering care, the palliative care team aims to increase palliative care training and education of health care workers at all levels in public and private health care facilities to increase the available workforce to meet current and future needs in palliative care. A critical part of this effort is development of a higher diploma palliative care course for nurses and physician assistants that is nearing final approval from the National Clinical Officer and Nursing Boards. Working with the MTRH College, the team developed a curriculum that will allow graduates to be recognized as specialists in palliative care. Dr. Elias looks forward to recruiting the first class of trainees once those approvals are obtained.
Training practicum for community health volunteers
A longer-term goal is development of a clinical fellowship for physicians that will serve as the first board certification program for palliative medicine in Kenya, added Dr. Cornetta.
As the workforce grows, the next challenge will be to expand beyond the current hospital-based program and begin to provide services at the community level. Dr. Elias has already begun to lay important groundwork for this by training Community Health Volunteers (CHV) on the tenants of palliative care. “While CHVs have limited medical training, they play an important role in rural Kenya and can serve to identify those in need of palliative care,” he said.
As palliative care services expand, AMPATH’s research infrastructure will help Dr. Elias and his colleagues determine the best ways to optimize care delivery.
”The established structure and organization at AMPATH allows one to operate smoothly, receive mentorship, participate in local and international education activities and provides important infrastructure for conducting research studies,” concluded Dr. Elias.
Dr. Elias with community health volunteers