Pain relief in the developing world: the experience of hospice Africa-Uganda

The need for high quality end-of-life care in the developing world is increasingly becoming recognized. One of the core parts of such a service is adequate pain control. Poor health care infrastructures and lack of access to opioid analgesics are common problems. This makes establishing appropriate, sustainable end-of-life care particularly challenging in resource poor settings. Hospice Africa-Uganda has ten years of experience in developing such a service. This paper discusses some of the challenges encountered and how these have been addressed. These include access to opioids, educating of health care workers and influencing policy makers. Factors that have been important in making the service a success, such as choosing an appropriate model of care, and future directions for the organization are discussed.