Funding cut shuts pain unit

The palliative care unit at Charlotte Maxeke Johannesburg Academic Hospital has been shut down.

Foreign funding was unexpectedly cut in December.

The unit had three specialist nurses and was established by radiation oncologist Professor Selma Browde in 2000 for patients suffering from uncontrolled pain or emotional distress.

Browde was at pains to explain that her definition of palliative care included more than helping terminal patients cope with pain.

She believes that all patients should have their pain managed scientifically.

Doctors had referred patients to the unit if they were having difficulty in controlling pain or determining what was wrong.

"Emotions are important because they influence how a person experiences the disease and the pain. The emotions affect perceptions of pain. There is no 'one size fits all'. Every patient is an individual. Every individual reacts differently."

She believes doctors do not know enough about managing a hospitalised patient's distress.

"The fault lies not with the doctors [but] in medical and nursing education, which does not include the doctor-nurse-patient relationship."

The unit trained medical students in the management of pain, both physical and emotional.

Ken Boffard, former professor of medicine at Charlotte Maxeke, praised the unit.

"Selma is correct. Palliative care is not just a hospice. It includes alleviation of all acute symptoms, including relief of acute pain and suffering, for example following an operation.

"This is generally taught very badly in medical and nursing schools, and is applied very randomly. Her team fulfilled an extraordinary role at the hospital, especially in raising awareness, and in education."

Charlotte Maxeke has had numerous crises in recent weeks. Last week, the cardiothoracic unit lost its accreditation for training registrars in heart surgery.

The hospital was also unable to spend R53-million of its R80-million equipment budget because the Gauteng department of health withheld the money and did not approve the purchases of equipment, most of it diagnostic.

Now the unit has only one volunteer nurse, once a week.

Browde said she was working with the department of health to find funding for the unit.

"We are working together." Department of Health spokesman Prince Hamnca said the hospital was not affected by the closure of the palliative care unit. He said cancer patients were being helped by nurses.