When I was student at University of Rwanda College of Medicine and Health Sciences, one of our lectures used to say: “a good physician is not judged by the scores but by the eyes of their patients”. He was right; I have seen peace, hope and dignity in the eyes of patients when they are treated as human beings not as a bur- den of the society.

Most physicians and health providers have been trained to manage curable diseases and provide care to all patients but the realities showed that some of the diseases could not be cured. When the doctors pronounce, “there is nothing we can do”, the patient is referred for “palliative care”.

The World Health Organization in 2002 defined palliative care as “an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and im- peccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.

Palliative care starts at the diagnosis of the lethal diseases, provision of care until death and even after the death of the patients because it includes families. It provides relief from pain and other distressing symptoms, affirms life and regards dying as a normal process. It neither hastens nor postpones death but it integrates the psychological and spiritual aspects of patient care into patient management.

In palliative care, we never say “there is nothing we can do”. It is care be- yond cure, a concept of humanity and a backbone of modern medicine. Patients with life-limiting illnesses have so many problems that health workers feel overwhelmed and powerless to help. It is a multidisciplinary team fo- cus to care for the person beyond the disease.

We cannot cure the incurable but we can control many of the symptoms, which cause distress. We cannot take away the pain of loss but we can stand with those who are grieving and share their sadness. We do not have all the answers, but we can listen to all the questions. TSM

Dr. Christian NTIZIMIRA, Palliative care Expert & Educator
Kibagabaga Hospital, Palliative Medicine Fellow, OhioHealth

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