I work for the Togolese Ministry of Health and Social Security Services, where I am responsible for the coordination of the 2017-2022 Action plan which aims to promote and integrate palliative care into all levels of the Togolese health system. The greatest challenge that we face is the lack of health workers trained in research and in palliative care of patients suffering from cancer, as was recently highlighted in an imPACT mission that took place in Togo. We are also in urgent need of resources and capacity building in the domain of cancer control planning, in particular with respect to the establishment of functioning cancer registries and access to radiotherapy using new generation machines.
The objective of the visit made to Brazzaville from the 6 January to 4 February, thanks to a UICC fellowship, was to learn the experiences of another country within Francophone Africa during all steps of cancer patient management, from cancer registries, diagnosis and treatment to palliative care.
My mentor in Congo Brazzaville was Professor Charles Gombe Mbalawa from the University of Marien Ngouabi, who I met at the l’Alliance mondiale contre le cancer (AMCC) congress on palliative care in Benin in April 2017. Thanks to the funding provided by the UICC fellowship, we have established a fruitful collaboration which will, I hope, have a real long term impact, allowing exchanges for training purposes between doctors, nurses and other health professionals of Togo and Congo-Brazzaville.
During my one month visit, I was able to meet and exchange with health professionals from Congo-Brazzaville where palliative care is available, left in the capable hands of the Association Congolaise Accompagner (ACA). The services of CHU Brazzaville have access to morphine-related products, in particular morphine capsule format, including pills or injectable liquid. However, there is an absence of the oral morphine solution made from the powder (recommended by the WHO for its easy manufacture and affordable cost).
I was trained in palliative care and the functioning of the cancer registry in Congo. I also learned about the different ways of announcing of bad news in oncology and also learned new ways to manage cancer wounds. I gained new knowledge about radiotherapy and the mechanism of functioning of the cobalt apparatus and learned about the experiences of patients who have followed radiotherapy treatment.
I have been trained on production of a cancer registry report and innovative advocacy mechanisms for finding sustainable funding for a cancer registry. I also participated in the preparations for the celebration of World Cancer Day (February 4). I particularly appreciated the fact that the palliative care service at the level of the ACA association concerns all patients suffering from potentially fatal pathologies and is not limited to the patients suffering from cancer.
Finally, this fellowship was a really great opportunity for exchange and the sharing of experiences between the Congo and Togo in the field of research activities and palliative care of patients suffering from cancer.
Upon my return to Togo, I plan to organise a 3-day knowledge transfer workshop with other relevant staff in the Division of Non-Communicable Disease Surveillance of the Ministry of Health as well as with doctors, nurses and community health workers at the Sylvanus Olympio University Hospital in Lomé. They will in turn disseminate this knowledge to districts and rural communities as part of a "step-by-step learning initiative" for palliative care. I will also have the opportunity to integrate this experience into my teaching at the University of Lomé as well as within the Togolese network of palliative care trainers.
I hope that this visit will allow me to generate new strategies to strengthen access to palliative care in Togo. Similarly, I hope to initiate new cancer surveillance procedures in the registry. Thanks to this visit, I was able to acquire a real "know-how" and to know better the concrete steps to improve access to quality care for cancer patients.