Until March 2025, Brian Newton was the main income earner for his young family. Aged 27 and healthy, he worked as a driver in a gold mining site in Machakos, in Eastern Kenya, and he was able to support his household away from home. But what began as bouts of exhaustion and at times difficulty breathing would eventually rob him of consistent daily wages at the gold mines. Within three months, even walking short distances left him severely breathless, with a persistent cough. Relying increasingly on painkillers, he returned home in October and was admitted to Homa Bay Teaching and Referral Hospital in a weakened state.
“After a month in hospital, a doctor and a counsellor came to speak to me and explained that the state of the disease would be lifelong and require a constant supply of oxygen. I would need an oxygen concentrator,” Brian says. “I was very troubled with that news since I knew I could not afford an oxygen concentrator. But she also explained that I did not need to stay in the hospital if I had one, as MSF later offered to buy me one. That was a relief.”
Further investigations confirmed chronic obstructive pulmonary disease (COPD), with advanced respiratory failure requiring long-term oxygen therapy.
About 20 kilometres away, in Nyalkinyi area in Homa Bay county, 67-year-old Monica Anyango Onduko has lived with arthritis for 10 years. Her journey has been marked by chronic pain and multiple admissions in different hospitals. She finally turned to the Homa Bay County Teaching and Referral Hospital, where she found the care she needed.
Brian and Monica’s experiences reflect a largely unmet need for palliative care in Kenya.
According to Kenya’s Ministry of Health (MoH), an estimated 800,000 people require palliative care services every year in the country, yet fewer than two percent can access them. Many patients face not only complex health conditions, but also financial hardship compounded by weak health financing, limited health coverage, few trained providers, and poor access to essential medicines.
In Homa Bay, MSF works closely with the Ministry of Health palliative care unit to provide basic and specialised healthcare for patients living with chronic diseases and advanced illness requiring palliative care. MSF has supported trainings and implementation of palliative care guidelines developed by the Kenya Hospices and Palliative Care Association (KEHPCA).
“Palliative care is a compassionate, proactive and holistic approach that supports people living with serious, life-limiting illnesses long before the end of life,” explains Victor Oriema, an MSF-supported MoH palliative care nurse in Homa Bay County Teaching and Referral Hospital.
It does not replace active treatment, but works alongside it, ensuring that comfort, dignity and humanity remain at the centre of care, even when a cure is not possible.
“It is individualised and focuses on managing disease-related symptoms and relieving suffering in all its forms – physical, emotional, social and spiritual – while improving the quality of life for both patients and their families, and should not be misunderstood as care only reserved for the final days of life,” he says.
Through a dedicated mobile palliative care team, MSF is bringing services directly to patients, ensuring care continues beyond hospital walls and into homes.
“I started home-based palliative care in June 2025 after a discussion at the hospital wards with the medical team and my family. I had been admitted for three days after several other admissions earlier,” Monica says. “After much thought, we agreed to go for home-based palliative care.”
The mobile palliative care team delivering care includes doctors, nurses, counsellors, social workers and community-based workers all working together to meet the needs of people receiving care and those close to them. Before settling on home-based care, they carry out assessments and conduct home visits to ensure the home environment is right for the patient.
With support from MSF, Brian started on palliative care at home to treat his COPD “This oxygen concentrator has given me a new lease of life, as I am not too tired all the time. At least I can move around the compound occasionally,” Brian says.
Belinda Odhiambo, Monica’s daughter and caregiver, explains, “I used to take mum to the hospital during her frequent visits, but now I do not have to spend more time and money on that, allowing me to work and support the family better.”
She adds, “Counselling sessions help me to cope, and the extra support like food stuff we receive makes me feel settled and hopeful. The weight is lighter.”
Challenges still exist. Strengthening the health workforce, enhancing MoH collaboration for home-based services and integrating cultural coping practices into care are critical to ensuring equitable, effective and patient-centred palliative care.
This home-based palliative care approach recognises that families are not just caregivers but central partners in preserving dignity, comfort and connection throughout a patient’s journey. The mobile palliative team currently cares for 39 patients and conducted 256 home visits in the first three months of the year.
“Pain management has worked so well,” Monica says. “Since the chest pains and back pains are no longer there, I can do some chores in my house. The only thing I cannot do is walk for a long distance and uphill.”
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