BMJ reports on poor pain care in Africa due to opiate fear

The standard of palliative care in Africa is being hit by the reluctance of local health care professionals to use morphine for therapeutic purposes, as well as by poor access to the product, noted the British Medical Journal.

A conference hosted in Nairobi, Kenya, by the Uganda-based African Palliative Care Association, blamed a combination of fear of addiction, excessive bureaucracy, inadequate requisitioning and a reluctance to prescribe morphine outside a hospital context for the lack of support in African countries. In addition to these obstacles, the BMJ's report of the event cited logistical concerns including: the shortage of physicians in rural areas especially; the emphasis on infectious disease programs; geography; the lack of concern among governments and senior medical staff towards deaths.

However, Uganda was singled out as a country where some success have been achieved. Cheap morphine has been made available via trained nurse prescribing. The APCA conference heard that similar improvements are underway in Malawi, Nigeria, Tanzania and Zambia.