African Solutions for African Problems

Dr. Faith Mwangi-Powell

The director of the African Palliative Care Association (APCA) is an action-oriented facilitator who believes she and her young organization can change the world - or at least the 17 African member countries of APCA, where people are dying in pain.

Dr. Faith Mwangi-Powell, who completed community health training in Kenya and later earned a Ph.D. in women’s studies, moved her family from London to Kampala, Uganda, in January 2005. Her mission, as APCA’s inaugural director, includes: to develop an effective organization that can help up-scale palliative care services; to establish palliative care standards throughout Africa; to enlist government support in making opioids readily available; and to educate health workers to provide high quality end-of-life care.

While in London, Dr. Mwangi-Powell worked with The Diana, Princess of Wales Memorial Fund, which supports palliative care initiatives in Africa. “One of the challenges we faced is that palliative care training in Africa is very, very limited,” Dr. Mwangi-Powell recalls. At a 2002 meeting in Cape Town, South Africa, however, palliative care professionals from six African countries came together to establish an African-wide agenda.

“What became clear is that it’s not just about training, but about how that training is applied and how national policies are set. We needed a dedicated organization to move the agenda forward. That’s how APCA was born.”

APCA’s Cape Town Declaration, published in 2004, calls for African solutions for African problems, urging collaboration among African nations and encouraging the monitoring and evaluation of palliative care programs as they develop. A steering committee organized an inaugural conference, hosting representatives from 22 African countries and other international players, and the President’s Emergency Plan for AIDS Relief in Africa (PEPFAR). The Bush administration had committed $15 billion to the continent’s soaring healthcare crisis, earmarking $2 billion for palliative care. A small grant from PEPFAR helped establish the APCA office, which now has 26 staff.

“APCA’s key issues are education, training, technical assistance and advocacy,” says Dr. Mwangi-Powell. “How can we get the government to change drug regulations? How can we educate people about morphine use and how can palliative care be integrated into medical training? Even though we are not hands-on, our agenda is patient-driven. What’s good for the patient? That became our central question.”

Dr. Mwangi-Powell’s strength is organizational development - identifying and connecting people who can effectively address the problems of introducing palliative care to African nations. “Six people in each country is all it takes,” she declares. “We conduct an overview, identify the challenges, prepare an action plan and then determine how to use our limited resources wisely.

“My job is to create a platform from which everyone doing palliative care can speak with one voice,” she continues. “If you have a national agenda, it’s easier to come together as a group. It’s about ownership. We are not here to say ‘you should do this,’ but rather ‘what do you need?’

“Palliative care should be available for everyone who needs it. It’s got to be done, and we are doing it.”

Marcia Landskroener for INCTR