2017; Volume 18, No 8, August
IAHPC Traveling Scholar’s Report – Egypt
Promoting palliative care and cancer pain control through education and advocacy
In May 2017, IAHPC awarded 28 traveling scholarships to healthcare professionals from 19 countries enabling them to attend the 15th World Congress of the European Association for Palliative Care in Madrid. In the second part of this feature, we hear from one of the grantees from Africa.
Samy Alsirafy is a palliative care physician and professor of clinical oncology in Egypt where the shortage of oral morphine is a major barrier to the development of palliative care. Samy explains how some of the knowledge and experience gained at the congress may be helpful in making cheap oral morphine available for patients in Egypt and countries with similar problems.
With the support of the IAHPC, I was fortunate to attend the EAPC 2017 World Congress in Madrid. It was an opportunity to discuss with international palliative care experts from around the world how to promote palliative care and cancer pain control in Egypt through education and advocacy.
Faced by many barriers, palliative care is at an early stage of development in Egypt with relatively few services providing palliative care for cancer patients. Morphine is the drug of choice for moderate/severe cancer pain control and is considered an essential medicine by the World Health Organization. Since the 1990s, only one company has supplied Egypt with only one form of oral morphine, the 30 mg slow-release morphine (SRM-30mg) tablets. But since late 2014, there has been an ongoing oral morphine shortage in Egypt (except for a short period when a limited amount was made available in early 2016). As a consequence, morphine consumption in Egypt decreased from 23 kilograms in 2013 to only two kilograms in 2014. It is frustrating to see the suffering of terminally ill cancer patients because of the lack of a cheap medicine such as oral morphine. On the other hand, expensive, unaffordable alternatives such as fentanyl, hydromorphone and oxycodone are marketed in Egypt.
My attendance at the congress, gave me the chance to discuss the morphine shortage problem with international experts. With the help of the IAHPC team, I recorded a video about the morphine shortage in Egypt. This may be helpful in making cheap oral morphine available for patients in Egypt and perhaps in other countries with similar problems.
Likewise, there was a chance to communicate with palliative care professionals from my own region: Kuwait, Lebanon, Saudi Arabia and Sudan; in particular we discussed research opportunities to address the palliative care needs in our cultures.
The ‘APCA Atlas of Palliative Care in Africa’ and the ‘Atlas of Palliative Care in the Eastern Mediterranean Region’ represent valuableand up-to-date guides for palliative care professionals and policymakers in our region.
In general, palliative care is at an early stage of development in Arab countries. To date, there has not been a project dedicated to mapping the level of palliative care development in Arab countries. However, during the congress I was able to attend the launch of two important atlases published by the IAHPC, the ‘APCA Atlas of Palliative Care in Africa’ 1 and the ‘Atlas of Palliative Care in the Eastern Mediterranean Region (EMRO)’. 2 These two atlases include almost all Arab countries except those with conflict. The atlases describe available palliative care services as well as the progress in palliative care development indicators: education, drug availability and government policy. They show that palliative care is underdeveloped in Arab countries and represent valuable and up-to-date guides for palliative care professionals and policymakers in our region.
This year, the scientific program of the EAPC World Congress was rich and diverse with inspiring stories of successful palliative care development in the face of barriers.
Links and references
Please click the links below to access the two atlases in PDF version or open source.
1. Rhee JY, Luyirika E, Namisango E, Powell RA, Garralda E, Pons JJ, De Lima L, Centeno C. APCA Atlas of Palliative Care in Africa. IAHPC Press; 2017.
2. Osman H, Rihan A, Garralda E, Rhee JY, Pons JJ, De Lima L, Tfayli A, Centeno C. Atlas of Palliative Care in the Eastern Mediterranean Region.
Houston: IAHPC Press; 2017.
Contact Dr. Samy Alsirafy by email.
If you missed last month’s article, featuring comments and reports from Armenia, Georgia, Lithuania, Malaysia, Nepal and Thailand, check the July issue of the IAHPC Newsletter.
To find out more about IAHPC’s Program Support Grants, and our Traveling Scholarships and Traveling Fellowships, please visit our website. Through these programs we support projects and individuals around the world, especially in developing countries in Africa, Eastern Europe, Asia and Latin America.
You can contribute to this program and help palliative care workers attend and participate in congresses and courses by donating to the Traveling Scholarships Campaign in the Global Giving website.