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Alyssa Tilly, MD
Alyssa Tilly, MD
Medicine/Pediatrics · Chapel Hill, NC


Hospice and Palliative Medicine in Malawi


August 27th
Lilongwe, Malawi

Project Description

This project seeks to assess and support the palliative care efforts at Kamuzu Central Hospital (KCH) in Lilongwe, Malawi. I have been to Malawi three times previously as a Med-Peds resident and return now as a hospice and palliative medicine fellow. I will be traveling as an affiliate of UNC Project-Malawi, whose mission includes improving clinical training and the overall quality of care in Malawi. This project has several aims. First, I will identify high priority areas for educational interventions and support in hospice and palliative medicine by spending time with the palliative care team clinically and meeting with key stakeholders. I also plan to visit a local community hospice to further experience and understand how this system operates and establish a collaborative relationship with them. Secondly, I will assist in providing a palliative educational session to all staff who work in pediatric oncology. Finally, I will be working on a research project validating a translated quality of life survey for use in assessing symptom burden and quality of life in the adolescent and young adult oncology population. This tool can then be used to assess the efficacy of future interventions targeting the high priority areas identified.

Population Served

KCH is a tertiary referral hospital in the capital city of Lilongwe in central Malawi. Malawi is located in sub-Saharan Africa and is among the least developed countries in the world. KCH is one of two teaching hospitals in the entire country. It serves a population of 5 million people. This hospital sees many seriously ill patients but the palliative efforts are under-supported. Through exploring current palliative efforts and assisting in palliative education, I hope to support the care of both pediatric and adult patients who are seriously ill in this resource-limited setting.

Expected Impact

The expected impact is the identification of key areas of improvement and formation of plans for future projects and educational interventions to effect change. The educational training is expected to expand palliative knowledge among oncology nurses to improve their clinical practice. Assisting in the validation of the quality of life survey will allow for future use of this validated survey in palliative care studies, assessing baseline quality of life among varying oncology populations and for use in analyzing interventions. In summary, this project will serve as the foundation for a longitudinal partnership with KCH to improve the breadth and quality of end-of-life and palliative care in Malawi.


Trip Photos & Recap

I spent a month in Malawi working to improve palliative care clinical services, research, and education. I was primarily based at Kamuzu Central Hospital (KCH) in Lilongwe, but also able to visit and experience a local community hospice and the robust palliative care service at Queen Elizabeth Central Hospital in Blantyre, Malawi. This opportunity allowed me to meet the key stakeholders in palliative care throughout Lilongwe and Malawi as a whole, setting up collaborative relationships for the future. I was able to support and advocate for palliative care education, clinical care, and research efforts, and hope to continue this relationship going forward.