Palliative care in Africa: a global challenge.

We are often asked what challenges Rwanda has faced in the development of palliative care and its integration into the healthcare system. In the past, patients have been barred from accessing strong analgesics to treat moderate to severe pain, but thanks to health initiatives, this is slowly changing. Rwanda is an example of a country where only a few years ago, access to morphine was almost impossible. Albert Einsten said 'in the middle of difficulty lies opportunity' and this sentiment could not be more relevant to the development of palliative care programmes. Through advocacy, policy, and staunch commitment to compassion, Rwandan healthcare workers are proving how palliative care can be successfully integrated into a healthcare system. As a global healthcare community, we should be asking what opportunities exist to do this across the African continent. Champions of palliative care have a chance to forge lasting collaborations between international experts and African healthcare workers. This global network could not only advocate for palliative care programmes but it would also help to create a culture where palliative care is viewed as a necessary part of all healthcare systems.

Investigation of the persistence of closantel residues in bovine milk following lactating-cow and dry-cow treatments and its migration into dairy products.

Closantel is a veterinary drug used to treat liver fluke in cattle and sheep. A provisional maximum residue limit (MRL) of 45 µg/kg in milk has been set by the European Union. The purpose of this study was to investigate the persistence of closantel residues in milk and the migration of residues into milk products. Following dry-cow treatment, residues ranged from undetectable to 8.7 µg/kg at the first milking. Following lactating-cow treatment, residues detected ranged from 278 to 482 µg/kg at day 1 post-treatment and were detectable above the MRL for 52 days and detectable for 198 days. At day 2 and day 23 post-treatment, the milk was collected and dairy products manufactured. Closantel residues concentrated in the cheese, butter, and skim milk powder. The results indicate that closantel is best used as a dry-cow treatment.