Thousands of terminally ill Moroccans face needless suffering

Thousands of terminally ill Moroccans face needless suffering
Due to a lack of palliative care services many terminally ill Moroccans face needless suffering, said Human Rights Watch in a report released to mark World Cancer Day.
3 min read
05 February, 2016
There is an urgent need for the Moroccan government to expand palliative care services [AFP]

Terminally ill patients in Morocco are suffering needlessly from extreme pain and other symptoms, said Human Rights Watch today.

More than 62,000 Moroccans are suffering from life-limiting illnesses and need palliative care to improve their quality of life each year, argued the US based NGO on Thursday in a 77-page report released to coincide with World Cancer Day.

The government has taken a number of important steps to improve end-of-life care, however HRW found only two public hospitals in Casablanca and Rabat have specific units offering this specific health service but only to cancer patients.

Those suffering outside these cities must either travel in or agonise without effective pain relief.

"There is an urgent need for the Moroccan government to expand palliative care services," said Diederik Lohman, associate health director at HRW.

"Right now, thousands of people in Morocco with cancer and other serious health conditions are suffering needlessly from treatable symptoms."

Thousands of people in Morocco with cancer and other serious health conditions are suffering needlessly from treatable symptoms
- HRW associate health director Diederik Lohman


The situation is especially difficult for the 40,000 Moroccans suffering illnesses other than cancer, such as advanced heart, lung or renal diseases, as there are no palliative care services available for them.

HRW conducted in-depth interviews with 85 patients and healthcare workers in five regions of Morocco between September 2014 and January 2015. It also carried out extensive analysis of Morocco's laws, regulations and policies relevant to palliative care.

Because of the pain I couldn't sleep, I couldn't talk to my friends
- 29-year-old patient


It found that many needing palliative care services suffer severe pain without the appropriate treatment, with four out of five people needing morphine for severe pain relief not receiving it.

"Because of the pain I couldn't sleep, I couldn't talk to my friends," said a 29-year-old man with a tumour in his leg and abdomen and no access to palliative care, reported HRW. "I wanted to crush my head against the wall," he added.

In 2010 and 2012, the government adopted national health policies with strong provisions for palliative care, however implementation has been slow.

For example, although regulations for prescribing morphine were simplified in 2013 there are still legal and educational barriers impeding its use. Few pharmacies and hospitals, for example, stock strong pain medications and few doctors prescribe them.

Palliative care is consider to be an integral part of health care by the World Health Organisaiton, which recommends that it is part of a country's health system.

"Morocco has an opportunity to become a leader in palliative care in the Francophone African region," Dr Mati Nejmi, a palliative care pioneer in the country, told HRW.

"But it will need to significantly increase its efforts to ensure these services are available," he added.