PAIN is one of the latest woe in John Bizmungu's life.

!No Relief in Sight? :

A recent major study by The Lancet Commission on Global Access to Palliative Care and Pain Relief described a ''broad and deep abyss'' in access to painkillers between rich countries and poor ones.........

Rwandan by birth, he has lived here as a refugee since his family was slaughtered in the 1994 genocide. A cobbler, Mr. Bizimmungu used to walk the streets asking people if he could fix their shoes.

Now, at 75 and on crutches, he sits at home hoping customers will drop by. But at least searing pain from the cancer that has twisted his right foot is under control.

''Oh! Grateful? I am so, so, so, so, grateful for the morphine!'' he said, waving his hands and rocking back back in his chair.

''Without it, I would be dead.''

Mr. Bizimungu's morphine is an opioid  closely related to the painkillers now killing 60,000 Americans a year - a situation President Trump recently described a ''health emergency''.

The cobblers desperate need exemplifies a problem that deeply worries palliative care experts :

How they can help the 25 million people who die in agony each year in poor and middle-income countries without risking an American-style overdose epidemic abroad or triggering opposition from Western Legislators and Philanthropists for when ''opioid'' has become a dirty word.

The American delegation to the International Narcotics Control Board, a United Nations Agency,'' uses frightening ''war-on-drugs rhetoric.'' said Meg O''Brien, founder of Treat the Pain, an advocacy group devoted to bringing palliative care to poor countries.

''That has chilling effect on developing countries,'' she said. ''But it's ridiculous - the U.S. also has an obesity epidemic, but no one is proposing that we withhold food aid for South Sudan.''

Uganda has implemented an innovative solution. Here, liquid morphine is produced by a private charity overseen by the government. And with doctors in short supply, the law lets even nurses prescribe morphine after specialized training.

About 11 percent of Ugandans needing morphine get it. Inadequate as that is, it makes Uganda a standout not just in Africa, but in the world.

Yet there is very little opioid abuse here; alcohol, marijuana and the chewing of the Khat leaves are far bigger problems.

The Sadness in Honor and Serving of the latest  Global Operational Research on Poverty, Pain and Sufferings and Solutions continues to Part 2. !WOW! thanks author and researcher Donald. G Mcneil Jr.


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