Families with relatives suffering from terminal illness have raised red flag over limited access to effective healthcare.

A survey conducted in nine referrals, provincial and district hospitals by Rwanda National Palliative Care Unit, indicates that 25 per cent of patients need palliative care services.

For three years, Epifania Mukeshimana, 51, has been nursing her husband who is suffering from acute prostate cancer but has no kind words to a hospital where the husband is receiving treatment.

“It has been disturbing to take care of my husband in the hardest pain for three years screaming from morning throughout without having staff to offer professional help,” said Ms Mukeshimana.

She said although patients can afford simple painkillers on universal health insurance Mutuele de santé, they cannot access palliative care which is more effective.

"He is now receiving religious people to comfort him spiritually but professional palliative care givers are hard to access. And because he usually doesn’t tell when in extreme pain unless he screams, it is hard for us to detect the pain," she added.

“This has not had an impact on me only but also my daughter who had finished Ordinary Level had to postpone her studies to first help me in taking care of his father,” said Ms Mukeshimana. The World Health Organisation indicates that 40 million people worldwide could benefit from palliative care, yet less than 14 per cent receive it.

Among those in need of palliative care at the end of life, 78 per cent are in low and middle-income countries.

Of the 54.6 million deaths in 2011, 66 per cent of those were due to non-communicable diseases (NCDs) and life-limiting disease. Cancer, HIV/Aids, kidney diseases, blood and immune disorders, cardiovascular diseases are among most cases that need palliative care services.

Hategekimana Vedaste, National Pain- Free Hospital Initiative Senior Officer at Rwanda Biomedical Centre (RBC) says that to effectively manage life-threatening conditions, there is a need for community support either spiritually or socially.

“We are still finding it had to treat and provide palliative services to patients who are living in their homes due to difficulties to access the hospitals for painkillers and other psychological services,” said Mr.Hategekimana.

He said all referral and district hospitals have palliative desk with a multi- disciplinary team that includes, Doctors, nurses, social workers, religious leaders, psychologist to provide care to patients in their respective position.

“The main hindrance that we have discovered is many people perceive it that palliative care services are offered to people who are about to die has made many patients not lose interest to get the services,” said Mr Hategekimana.