This week I received a letter from Eunice Kimondo (previously referred to as Alice in Alice�s Journey), an inspirational patient whom I met in Nairobi in 1996 when I was visiting in my capacity as a Palliative Care Nurse.  She gave the sad news that her mother had died of her cancer recently - both had attended the Coast Hospice for symptom control and support.

The founding of the Coast Hospice in 2001 had an enormous impact upon Eunice as prior to this she had to undertake a gruelling 48 hour round trip from Malindi (on the coast) to Nairobi in order to obtain morphine for her pain.

The journey had entailed several rides on overcrowded Public Service Vehicles, sitting on a wooden bench all night on the train and then a mile long walk to Nairobi Hospice.

Since 2000 the seedlings of new hospice services have been planted around Kenya which have enabled more patients to receive palliative care.  These are exciting steps forward but with this comes a greater need for support from us.

Without you, our supporters, we could not assist the Kenyan Hospices in providing comfort to patients like Eunice and her mother.  Our heartfelt thanks to you all for what you do to help us in our work.

Gwyn Sloan, Trustee
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Our services include the administration of chemotherapy using cytotoxic drugs for various cancers and HIV related kaposis sarcoma, which is now greatly increasing due to the HIV/AIDS epidemic.

We run courses in palliative management three times a year in March, July and November.  The courses in March and November are for medical and paramedical professionals involved in community palliative work and home based care.  The July course is for non-medical home based care-givers working with various CBOs.

We need funding for these courses, as most organizations do not have finances to enable them to pay.  We provide the courses free of charge.  The plan is to give training in the home grounds of these organizations instead of calling them to the city, as this will reduce our costs and will enable us to train more people for each organization.

Vehicle for Kisumu Hospice, donated by HCK

Last March we trained 20 people from various organizations.  The course was partly funded by the Center for Disease Control and the Kisumu Hospice.

Our two nurses Dorine and Rhoda are starting their Diploma in Palliative Care in June, financed by HCK. During their week in Nairobi, we are already organizing for volunteer nurses since we still do not have rotational nurses.  The work will still have to go on.

We are grateful to all our donors and pray that the good spirit of help continues to reign.

Dr. Julius Onyango
Chairman and Palliative Care Physician, Kisumu Hospice
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Nairobi Hospice has been operating for over 14 years now, in a semi-permanent structure in the grounds of the Kenyatta National Hospital.  The Government of Kenya has allocated the hospice a one-acre piece of land almost adjacent to where we are currently situated.  Due to the increasing demand for palliative care and training, there has been a need to expand our facilities and hence, the need for a new building.

We have raised over Ksh 4.5 million (£31,000*) since the fund-raising campaign was launched last year.  Every effort is being made to raise Ksh 150 million which is the estimated cost of the building.

One of the strategies that we have in place is the "Buy-A-Brick Campaign".  Each brick costs Ksh 500 and even the �common man� on the street will be able to buy at least one brick.

We are also targeting the local corporate sector in a major way and this year participants in the Mountain Mission will climb Mt. Kenya to raise awareness about the Hospice and funds for the new building.

Jessica Nyaribo
Funds Development/Public Relations Officer,
Nairobi Hospice
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Eighteen people attended a two day volunteers� course, held at Eldoret Hospice in March.  The majority belong to a caring group called the Good Shepherd Organization and include health care workers in private practice, pastors, a school teacher, a University lecturer and others.  They were introduced to the hospice philosophy and to the development of palliative care in Kenya, to the understanding of terminal illness and to the needs of the terminally ill.  Input was given on ethical considerations, confidentiality, communication with the terminally ill and with their families, bereavement support, and the role of a hospice volunteer.  They were also given some practical experience with cancer/HIV/AIDS clients.  Facilitators were drawn from members of staff at the Hospice and nearby hospitals.  Certificates were awarded.  The course highlighted the need for audio-visual equipment which could be used by the staff for learning, by the terminally ill who attend day care, and for teaching during seminars and workshops.

Eldoret Hospice
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Coast Hospice, now in its third year, continues to make significant strides in attending the ever growing number of patients.  Operating from three rooms in the Coast Provincial General Hospital, though rent free, the space is becoming unsuitable for the increasing requirements of both patients and staff.  Growing awareness, facilitated by the Hospice through the annual walk and a one week palliative care course, offered for the first time in January,

Coast Hospice Awareness Walk, October 2003

has resulted in more referrals.  Sadly, most of these referrals are made at a very late stage and as a result some patients are in our care for only a short time.  In one particular instance, we had a patient for only two days.  The need for more space is clear, and the objective of this year�s awareness walk is to raise funds for the purchase of an acre of land for future development.

Bobi Odiko
Public Relations Officer, Coast Hospice
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I recently visited Meru Hospice and accompanied the palli-ative care nurse on her daily visits.  It was clear how much the patients and their families appreciate the hospice staff and the work they do.  The home visits are vital to the success of the hospice programme, and yet the hospice does not own a vehicle.  The lack of a four-wheel drive results in long treks for staff to get to patients� homes.  It also means there are no home visits when it rains, and it rains a lot in Meru.

One of the patients we visited was Lucy Mwenda who is 40 years old and has been suffering from ear cancer for 14 years.  Lucy is the mother of 4 children, the oldest being 17.  She came out to welcome us and apart from facial palsy, at first glance, there does not seem to be anything else wrong with her.  Only when she sat next to me did I see the hole in the side of her head, covered by a light head scarf.  There was a foul smell emanating from her ear and I could literally see Lucy�s brain. I was horrified at the sight, yet touched at this woman�s strength.

What comes through with Lucy is her will to live and take care of her kids.  Lucy has no money to pay the hospice, and cannot afford to go to the district hospital anymore.  For her, getting the medicines and the visits from the hospice is something she thanks God for each day.  The hospice also assists Lucy�s husband in very practical ways.  He has needed as much psychological support as Lucy has needed medical.  He is caring and attentive and obviously loves and admires this small-framed woman who has refused to die.

With warm regards from rainy and muddy Meru.

Angeline Siparo,
Director of Policy for USAID in Kenya
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A very warm welcome to the new CEO Margaret Mbogo who joined Nyeri Hospice in March.  Margaret has a wealth of experience in palliative care and previously worked for a 220-bed hospital in Kijabe, central Kenya.  We wish her well in this challenging position.

A day care nurse and a social worker look after the spiritual and physical care of patients and relatives at the Day Care Clinic.  Patients are treated to a well-balanced diet prepared by our office assistant-cum-cook and a few volunteers who come in turns each Wednesday.

The Doctors on Rotation Programme has continued to benefit both doctors and patients, not only in the hospice but in the hospitals where the doctors practice.  Increased timely referrals from the doctors who have undertaken the rotation are an indicator of the success of the programme.  We sincerely thank the Community Fund for making this possible.

Last year, all members of staff undertook in-house training in psychological health counselling and stress management.  The Board has also made it possible for Saraphina Gichohi and Jane Riungu (Nyahururu Satellite) to take the Diploma in Palliative care offered by Oxford Brookes University and Nairobi Hospice.  The tuition is kindly funded by Hospice Care Kenya (Long Live HCK!)

Having a fundraiser for the last 18 months has made tremendous changes in our fundraising efforts.  Last year, we raised over Ksh 800,000 (£5,500*) from a Charity Walk and this year our Charity Golf Tournament has so far raised Ksh 760,000.

The Nyahururu Satellite project is up and running and is based within the Nyahururu District Hospital.  The government nurses who run an HIV/Aids counselling clinic also take care of the cancer patients.  A Board of Directors has already been appointed and we look forward to when all the systems are in place so that the hospice may run independently.  It is yet to be registered as a charitable trust but an application has been made.  We thank all those who have contributed to make this project a reality.

Florence Kiama
Adm Secretary, Nyeri Hospice

*At the time of going to press the exchange rate was Ksh 144 to £1

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Eighteen months of hard work came to a successful conclusion for the seven students on the second course of the Diploma in Palliative Care, a collaborative project between the School of Health and Social Care, Oxford Brookes University and Nairobi Hospice.  They were the centre of attention at the second graduation ceremony held in Nairobi on Saturday 5th June 2004.

On this occasion, the venue was the garden of the British High Commissioner, Mr. Edward Clay and his wife, Ann.  The ceremony took place on the verandah of their private residence, and the students, together with their teaching staff, processed through the grounds and passed the seated guests to take their places in the front row.

After speeches by Mr Rob Wondrak, (Assistant Dean of the School of Health and Social Care), the High Commissioner himself, and Dr. Verjee (Chairman of Nairobi Hospice), the proud graduands stepped up to receive their Diplomas.  They were followed by Mrs. Brigid Sirengo, who was warmly applauded for her achievement in gaining a BSc Degree in Palliative Care.

In a break with tradition, Mr. Wondrak then invited the students to address the assembled guests.  Each of them spoke about what the course had meant to them and of their determination to make a difference to the lives of the families with whom they work.

Once the formal ceremony was over, the graduates and their guests were able to relax in the beautiful surroundings of the High Commissioner�s gardens, which made a perfect backdrop for all those so-important photographs of the proud graduates in their gowns, hoods and mortar-boards.

An excellent buffet lunch under the awnings on the lawn rounded off a perfect day, a fitting climax to the long months of hard work, reading, reflecting and writing.

Our warmest congratulations go to the graduates who include:

Gillian Chowns
Senior Lecturer/Senior Social Worker in Palliative Care

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Fund raising events such as coffee mornings, sponsored walks, jumble sales, musical events and church appeals are important ways of raising money for the hospices.  The Trustees and staff are always happy to come and give talks about the work that we do (we also have videos available for loan).  Please help if you can.

Six such events in the last six months have raised over £5,000 for the cause, so a very big THANK YOU to:

Tony & Margaret Parrish of Kingsbridge, and The Revd Peter & Tiggy Davies of Haverfordwest for hosting coffee mornings in March who between them raised £544.

Drs John & Rosemary Moore for holding a reception and raffle at Guy�s Hospital in December which raised over £2,000 for HCK and Nairobi Hospice.  They would like to thank everyone who donated such splendid prizes.

The Revd David & Kim Maylor of Spalding who climbed three of the country�s highest mountains, Ben Nevis, Scarfell Pike and Snowden in less than 24 hours during the Three Peaks Challenge.  In May they found themselves knee deep in snow at the top of Ben Nevis.  They raised over £600 for the cause.

Audrey Davies and the Inner Wheel Club of Gately & District who held a Mince Pie Morning in December, a Coffee Morning and plant sale in May and a Summer Tea in June.  These events raised over £600 in total (half for HCK).

Mr & Mrs David Miles and Iain & Gwyn Sloan for the Summer Serenade extravaganza.  It was a sell-out!  The evening of June 19th was chilly but our hearts warmed when we were entertained in the beautifully restored barn of North Moreton House, near Didcot.  Our sincere thanks to Mr and Mrs David Miles who hosted the event and to Iain Sloan (tenor), Sue Black (soprano), Pamela Rudge (alto), Gregory Swinford (bass) and Miscellany (female vocal group).  All the artists very generously gave their time freely, for which we are extremely grateful.  We were treated to a rich menu of music from Opera to Africa.  Guests were welcomed with a champagne reception and then picnicked on the lawns in the interval.  It was a memorable evening and we are delighted to report that the event raised nearly £1,666 for HCK.

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Venue for Summer Seranade - the restored barn at North Moreton

We are also grateful to the Community Fund who awarded HCK a grant of £65,169 in 1999 for a four-year project entitled Doctors on Rotation.  The grant rep-resented 75% of the cost of the scheme and HCK funded the rest.  The scheme, operating at the hospices in Nairobi and Nyeri, sponsored doctors for secondment to the chosen hospice for a three month period.  During that time, the doctor took part in every aspect of hospice work.  After three months, the doctor returned to his or her own speciality aware of the scope and value of palliative care for patients for whom cure is no longer possible.  The scheme has been extremely valuable since palliative care is not taught in medical schools in Kenya.  Through careful financial management we were able to extend the scheme to a fifth year.  Sadly funding came to an end in February, but with the aid of a grant of £10,000 from the Allan and Nesta Ferguson Charitable Trust we are able to extend the programme for a further six months.

Liz Salmon, Coffee Morning 24th July.  From 10.30 at: 31 Grange Grove, Islington, London N1 2NP

Gordon & Anne Davies invite you to their 8th Annual Kenya Coffee Morning on Saturday 9th October 2004, from 10.30am, at "Salama" 15 Blundell"s Avenue, Tiverton EX16 4DL (Tel 01884 254744).

The second Malaika Ball, Bristol Marriott Royal Hotel 19th March 2005.  If you are able to help with sponsorship (or raffle, tombola and auction prizes) or are interested in purchasing tickets for what promises to be a superb evening then please do contact the office (0117 907 4205) or Gwyn Sloan on 01684 561074.  Ticket price £45 to include sherry reception, dinner, wine, port, coffee and mints.

Please support events if you can,
or organize one yourself.
You can make a difference - please help!

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