Regional Reports
From Scotland
International Palliative Care Awareness and Training Seminar Report of a meeting held at the RoyalCollege of Physicians, Edinburgh, on 1st October 2009, to describe and stimulate links between Scotland and other countries in palliative care. An abstracted report follows..
“The interest and medical resources available in Scotland for supporting international palliative care are considerable.This was apparent at a meeting to exchange information about existing Scottish palliative care links with health organisations in Russia, India, Albania and several African countries…
Dr Leng gave a “global glimpse” of palliative care and, in particular, the challenges of working in Uganda and India. The purpose of the seminar was to highlight what is already being done and what more is needed to address the huge unmet need for palliative care, teaching and training, policy development, and symptom management for end of life care globally… For most of the world’s population, and in particular for those in sub-Saharan Africa, freedom from pain is a pipe dream.
Even though Uganda leads the way in Africa, making oral morphine widely available through nurse prescribing, less than 10% of dying patients there have access to palliative care. In other African countries the numbers are much lower; while in India 80% of all palliative care takes place in only one state, Kerala.The seven rich nations in the world consume 84% of the world’s therapeutic morphine but have only 10% of the world’s population, while in resource-poor countries access is blocked by bureaucracy, myths about the dangers of morphine, or simply by indifference of the medical profession and the public to the plight of the dying…
Dr Bruce Cleminson, a GP from Shetland, with experience in palliative care, has been involved, for two weeks each year for the past 11 years, in educational facilitation in Samara, in Russia, as part of a team of doctors and nurses from the UK and Geneva…there is presently no Oral Morphine available in Samara, so syringe drivers can make a huge difference…
Dr Martin Leiper, a consultant in palliative medicine at NHS Tayside and Elizabeth Swain, a retired GP from Kirkintilloch, described work in Albania and Eastern Europe for PRIME (www.prime-international.org.uk). In Albania palliative care is not regarded as a medical speciality. “How” they asked “does one influence government policy to introduce it as a specialty?” Nor are oral opiates available in Albania. They too found cultural blocks when trying to tell the truth to a dying patient with strong negative denial from relatives.
Ruth Wooldridge, co-founder of the Nairobi hospice, and a member of Help the Hospices International Hospice and Palliative Care Reference Group, introduced the recent Palliative Care Toolkit of which she is co-author… The handbook has been translated into many languages, and can be obtained from TESSA (Open University dissemination to sub-Saharan Africa) or from Help the Hospices website (www.helpthehospices.org.uk)...
There is great enthusiasm in Scotland for supporting palliative care overseas. This must be offered with cultural sensitivity. Long-term partnerships are encouraged. It is important to focus on training all levels of staff, including caregivers, to ensure improved quality of care is widely available…”
Dorothy Logie
Public Health Consultant
[email protected]
Mhoira Leng
Specialist in Palliative Medicine
Head of Palliative Care
MakerereUniversity and MulagoHospital, Kampala
Medical Director
Cairdeas Trust
[email protected]
Scott A Murray
St Columba’s Hospice Chair of Primary Palliative Care
University of Edinburgh
[email protected]
From Kenya
Kenya is finally making progress in integrating palliative care (PC) into the existing health care curricula! The Bachelor of Science in Nursing is reviewing their current curricula and has agreed to include 45 hours for PC that will be examinable. This is a large increase from their previous curriculum of four hours and it will be included in all institutions proving this course since they all use a national curriculum.
The University of Nairobi (UoN) School of Medicine and the Kenya Medical Training College (KMTC) are also planning to increase the number of hours. The UoN is now including examination questions on PC for their students – a first. There is also a lot of excitement from dental and pharmacy schools as well.
Dr Zipporah Ali
National Coordinator
Kenya Hospices and Palliative Care Association (KEHPCA)
From Norway
PRC - European Palliative Care Research Centre
“The European Palliative Care Research Centre (PRC) was officially launched on October 15, 2009. PRC’s overall aim is to improve palliative patient care, including end of life care, through research of highest quality in an international setting.‘We are too small, and too few, not to work together across national borders’, says Professor Stein Kaasa, who is the leader of the new centre as well as a researcher at the NTNU Faculty of Medicine's Pain and Palliation Research Group.
PRC is based at NTNU's Faculty of Medicine and at TrondheimUniversityHospital, and was established with recommendations and support from the European Association for Palliative Care (EAPC). The Norwegian Cancer Society has awarded a major grant of 15 Million NOK (1.8 Million Euro) to help establish the new centre. Additional support has been awarded by the Open Society Institute (USA), the Floriani Foundation (Italy) and by an unrestricted grant from Nycomed.
The centre will coordinate groups and individual researchers across Europe along with researchers in the USA, Canada and Australia.”
Click the following to Learn more about PRC
From the Country of Georgia
Dear all,
I want to announce that oral morphine is now available in Georgia!
I want to express my gratitude to you all. Without your help and support and sharing experiences with us, it would have been impossible to reach opioid availability in Georgia.
With best regards and love,
Pati Dzotsenidze, MD
IPPF Fellow
Neuro-oncologist
Board member of the Palliative Care Association “Humanists' Union”
Tbilisi, Georgia
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