The Marginalized

The Challenge of HIV/AIDS

According to the World Health Organization (WHO), HIV is still a major global health issue.

In the area where we work in Uganda, AIDS was first observed in the early 1980s. Since then we have been engaged in developing programs and materials to educate for the prevention of the spread of HIV, in outreach programmes, involving hundreds of local health volunteers. >>> read more.

Obstetric Fistula Repair

Obstetric fistula (vesico-vaginal fistula or VVF) develops from prolonged and obstructed labour. Usually the infant is dead upon delivery, and the mother is left with severe internal damage, leaving her incontinent, in acute pain, and with great difficulty in walking.

The skilled surgery to correct this problem requires very long apprenticeship. Sister Ann Ward is an MMM obstetrician who has spent over 40 years in Nigeria, where she established a specialist centre at Itam known as the Family Life Centre. Her pioneering work in corrective surgery for this problem has been internationally acclaimed.  >>> read more.

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Palliative Care

Using Hospice as a philosophy of compassionate holistic care, Dame Cicely Saunders focussed on the patient rather than the disease and introduced the idea of 'total pain', including psychological, spiritual, and physical aspects. She experimented with a wide range of opioids to controlling physical pain and included the needs of the patient's family. She discussed her philosophy in tours of the United States, where Florence Wald, the dean of Yale School of Nursing, heard Saunders speak. She worked with her in Saint Christopher’s and brought the principles of modern hospice care back to the United States, establishing Hospice, Inc. in 1971.

In 1965, Swiss psychiatrist Elisabeth Kübler-Ross began to consider the social responses to terminal illness. Her book, On Death and Dying, was influential on how the medical profession responded to the terminally ill. Kübler-Ross helped to focus attention on the types of care available.

In some places 'hospice' came to mean a place where people who had no other means of support were sent to die. For hospice care to be recognized as a new specialty, the name 'palliative care' was given. 'Palliative', from the Latin pall, meaning blanket or cover, embraces the care of the whole person. It is the care of people with chronic or terminal illness and their families, when the curative mode of therapy is no longer an option. The aim is to alleviate symptoms and distress, with particular emphasis on pain relief. With pain controlled, patients have space to make decisions and to make peace with themselves and God before they die. WHO recognizes that it is a human right for a person not to die in pain.

MMM has been involved in hospice and palliative care in a number of countries. These included Uganda and Ethiopia, where services  were initially associated with providing end of life care for people with AIDS. Later, with the recognition of the overlap of cancer and AIDS-defining illnesses, services were broadened to include people with chronic and terminal illnesses. We handed over our palliative care programmes in Ethiopia in 2010 (MMM Counseling and Social Services Center) and in Uganda  in 2013 (Kitovu Mobile). We are now involved in this ministry in Tanzania and Malawi.



See alsoSister Carla's Palliative Care Diary