Spreading the gospel of end-of-life care in Nigeria

The issue of death and providing a network of supportive care for the dying and their families is the main advocacy of a foundation established in memory of Late Kolawole Durosaro, to ensure that there is an improved end-of-life care for people in Nigeria. YEJIDE GBENGA-OGUNDARE reports


In the traditional African society, the issue of death or dying is usually treated as a taboo: something that should not be talked about and civilization has made no difference in people’s attitude towards addressing issues of their own mortality or that of their family members.

This reticence has not only caused many to die untimely and in discomfort, but has made the issue of end of life care a mirage in many African societies especially in Nigeria.  Though death is inevitable, some people have stated that there is a need to ensure that the last days of any individual are spent in as much comfort as humanly possible and with dignity no matter the condition of their health.

The immediate family of Late Kolawole Durosaro, who lived from 1954 to 2014, due to their experience at the time of his death, put up a foundation to orientate the public on the importance of end-of-life care in Nigeria and to put in place a network for families of people facing end-of-life crisis to make life better for them.

The family created a foundation in honour of their father as a vehicle for which this vision will be carried out and the foundation known as Kd Bykond was launched in the United Kingdom in May with a memorial lecture, while the Nigerian version was held in Ibadan, last week as a training for people whose family members are facing end-of-life crisis.

One of the daughters of the Late Kolawole Durasaro, Oreofeoluwa, came up with the vision in order to ensure that other families have a more pleasant experience and adequate medical support during the transition process of their loved ones. The Director of the foundation, Olusola Durosaro, is also a direct descendant of the late Durosaro.

The Kd Bykond foundation which is basically focued on educating, promoting and creating awareness for compassionate care from the nursing and medical personnel and advocates for effective pain management and control in terminally ill patients, has started its work in Nigeria in partnership with Community Hospice and Specialist Clinic in Ibadan.

The hospice led by a pain and palliative consultant, Dr Folaju Oyebola, will be working hand in hand with other specialists both in UK and Nigeria, late Durosaro’s daughter, Oreofeoluwa, Olusola Durosaro and other descendants of the late Durosaro to pioneer an effective course for end-of-life care in Nigeria.

It is the belief of the Kd Bykond foundation that dying matters should be talked about and given a holistic approach to make the end-of-life period not only comfortable for the victim but also easier on family members as they support loved ones in the journey towards the end.

The first memorial lecture which was held in the United Kingdom in honour of Late Durosaro brought experts together to talk on issues that would otherwise be brushed under carpet in an interactive manner.

The first topic: “End of life care–A holistic approach,” was taken by Dr Ayo Akinmoluwa, Associate Specialist in General Adult Psychiatry at Oxleas Foundation NHS Trust, Queen Elizabeth Hospital Woolwich, London while Mrs Olusola Odubanjo, a Senior Nursing Sister and the Ward Manager of Osler ward, Basildon and Thurrock University Foundation, NHS Trust, took the topic, Nursing interventions in end of life care.

The opening speech at the lecture was given by a direct descendant of the late  Durosaro, Mrs. Celestina Adekoya, while the matriarch of the Durosaro family, Mrs Bisi Durosaro also took a session to talk about her experience when her husband was facing end-of-life crisis and the difficulty involved in getting him adequate medical intervention and mental as well as emotional support from medical officers.

Also, Dr. Gbola Otun, a Consultant Psychiatrist at North Essex Partnership University, NHS Foundation Trust, took a lecture on supporting the needs of the family in an end of life situation (a mental perspective).

An interactive session followed this where people openly expressed their views on the inadequacies of the Nigerian society in putting priority on end of life care and the need for a framework to assist relatives emotionally during the trying period.

Dr. Akinmoluwa in his paper explained that the pioneering studies of Elisabeth Kübler-Ross on death and dying, begun in the 1960s, adding that the study has afforded valuable insights into the evolving emotions, experiences and the needs of the dying person which at that period is very sensitive and crucial to ensure that the person dies in comfort and gets all the needed relief.

According to him, the components of end of life care includes adequate pain relief to patients with advanced illness, control of fatigue and exhaustion, loss of appetite and weight loss, nausea and vomiting as well as difficulty in breathing, relief of suffering, provision of comfort and companionship, spiritual support, when possible, a death that is compatible with the dying person’s wishes and advanced directives and writing of will.

He added that the needs of a dying person needs diverse interventions which can only be arrived at if there is a framework of care; invasive interventions which may include advanced cardiac life support, or supportive interventions such as educational, emotional, physical like palliative care, hospice, psychological counselling, and legal assistance or social assistance to individuals, their families and significant others in the last stages of a terminal illness.

The foundation believes that the provision of network of supportive care for the dying is of utmost importance as it makes life easier on both the dying and the immediate family and advocates that there should be provision of humane and competent care at the end of life in ways that preserve the dignity and autonomy of the patient.

The Kolawole Durosaro family through the Kd Bykond foundation also advocates the need to distinguish clearly between aggressive and palliative forms of treatment and to establish guidelines for the care of patients for who further cure-oriented treatment will be of no benefit.

The conclusion at the lecture is that death is inevitable and no one knows the time and pathway; a prolonged illness or sudden death and the affected individual could be anyone.

The foundation made a call to treat affected people with compassion, encourage end of life care principles and asked that everyone expend their energies and resources to promote, help and work for the affected as a little help will go a very long way in making the transition easy and more bearable for the dying and the family.

The Durosaro family further reiterated their commitment to ensuring that the gospel of end time care spreads through communities especially in South West  Nigeria and through the foundation create a framework for the families of people facing end of life crisis to ensure that they have adequate care and support.

For them, until there is a change of orientation and the provision of required end of life care facilities, the duty of the foundation is not done.