Hospital’s partnership with Tanzania mission shines light on end-of-life care

Members of both the Shirati and UPMC Susquehanna Home Care and Hospice teams pose for a picture. From left are, Terry Schneider, of UPMC Susquehanna; Dorothy Kawira, of the Shirati team; Allison Brion, of UPMC Susquehanna; Peter Migenda, of the Shirati team; and Dr. Alexander Nesbitt, of UPMC Susquehanna.

A world where pain medicine is nonexistent, doctors and nurses are limited and end-of-life care is unknown may seem foreign to the average U.S. citizen.

The people of Shirati, Tanzania, see this reality every day.

As 85 percent of the roughly 300,000 population live on about $1 a day, and most don’t have health insurance, dealing with advanced or serious diseases is almost impossible.

“Most people in the world do not have access to any strong pain medicine, hospice or palliative care,” said Dr. Alexander Nesbitt, of UPMC Susquehanna. “When they are seriously ill or dying, they just suffer and die.”

A ray of light has been seen in Shirati through the Shirati Palliative Care program and its now six-year partnership with UPMC Susquehanna Home Care and Hospice.

During a presentation at New Life Orthodox Presbyterian Church on Sunday, Nesbitt and members of Home Care and Hospice joined with Shirati medical professionals to explain the dire situation in Tanzania.

“They are very motivated to teach. To help. To extend God’s love,” Nesbitt said. “We have seen God’s hands numerous times in our partnership.

“God has sustained us,” he added.

In 1934, a mission to Shirati was started by Methodist missionaries from Pennsylvania, according to Nesbitt. Soon a clinic was founded to address the serious medical concerns in the area.

The clinic grew into a hospital that now holds 200 beds.

But, Nesbitt said, despite its advancement, the hospital still is “tremendously under-resourced.”

While it can provide care for a number of illnesses, more serious and life-threatening conditions are beyond them.

Six years ago, UPMC Susquehanna partnered with Shirati Palliative Care, a group of Tanzanian “individuals who are stepping forward to make this better,” Nesbitt said.

Dorothy Kawira, the coordinator of the Shirati Palliative Care program, is one of those who has stepped forward.

She said the group’s goal is to offer a “holistic approach” to caregiving. The approach includes physical, social, psychological and spiritual nurturing.

The team works to educate locals about medical techniques and works against the stigma of potentially life-ending illnesses.

For instance, women with breast cancer or an elderly person who has had a stroke may turn to local healers for help, Kawira said, or will be shunned from the community. Lacking the resources to get professional medical help, these people simply wait to die.

Kawira and her team go from village to village, seeking out these people and offering support.

“We help them understand that (the ill person) is still a human being,” she said. “We need to stay close to him and support him.”

Nesbitt said UPMC Susquehanna’s partnership with Shirati provides it with funding and expertise on certain medical issues. He added that funds for the program come from local donations, not the hospital’s funds.

Much of the program’s funding comes from individuals or groups in the Williamsport area that have offered their support. So far, donations have included the purchase of three motorcycles and 13 bicycles to improve transportation between villages; money to buy medicine, specifically pain medicine; and medical training for members of the Shirati team.

Nesbitt added that the partnership also allows a direct line of communication between the teams so they know how to support each other.

“We pray for each other,” he said.

“We really thank God for the help and support that we get from here,” Kawira said.

Another member of the Shirati team, Peter Migenda, a certified nurse at the Shirati hospital, works primarily with HIV patients in the area.

Migenda said the disease still is prevalent in many African countries and the patients span all ages. Many children with the disease are orphans because their parents have died of HIV.

While the team seeks out people with the disease and gives them the care they need, Migenda said the biggest struggle is battling the stigma throughout the communities.

As this was his first time in the United States, Migenda marveled at the abundant resources available. He cautioned those in the room to be thankful for the many blessings they have and called for prayer.

“When you pray, whom are you praying for,” he asked. “Are you praying for the sick? Are you praying for the needy?

“May God bless you. Pray for us. We’ll pray for you,” he added.

Nesbitt said anyone wishing to donate to the Shirati team may contact UMPC Susquehanna Home Care and Hospice.