Sunday, November 1, 2015

World hospice and palliative care day

Recently, we celebrated World Hospice and Palliative Care Day in Bangladesh.  This is an annual global event to highlight Palliative Care.  

Did you know that less than 98% of children who need palliative care in developing countries don't have access to it? 

There are 29 000 children in Bangladesh who don't get the need palliative care that they need every year. 

What this means for an individual child is that the strongest pain medication they might get is paracetamol, no morphine. In many cases no one ever tells them or their families that the child is dying. And when a child dies, there is no one to help the family cope with their grief. 

In Bangladesh, less than 1% of children get the specialized palliative care that they need at the end of their lives. It often means that a child is left alone with their fears and anxiety as no one tells the child what's happening. 

In Bangladesh, doctors often don't know how to explain to a family that their child is dying. The doctor may be nervous or unsure of how to have this discussion, because they've never been trained in how to communicate with families about serious illnesses.

I'm reminded of a 10 year old girl that I cared for last year.  I'll call her Yasmin.  When she came to the hospital, she had a very advanced cancer in her leg, and I knew that it wouldn't be possible to cure her. I was able to control her pain with morphine and to answer her questions and calm her fears.  

As she understood that she wasn't going to get better, she shared with us that she wanted to go home and be surrounded by her friends and family.  We were able to make this happen.  She went back to her village in the countryside.  She died surrounded by the love of all of her friends and family.  She didn't die in a hospital far from home, in pain, afraid and confused.

Research has shown that when children receive palliative care, the quality of life for them and their families is vastly improved. In fact, good quality palliative care, may even extend their life. 

The reality is the majority of doctors and nurses in Bangladesh never receive training in how to provide palliative care, they don't receive training in medical or nursing college and they don't receive training in their post-graduate training. With training, health care workers can be taught how to prescribe morphine safely for children, how to talk to children and families and how to support their emotional and spiritual needs. 

When a child is in contact with just one health care professional who is trained in the basics of palliative care, the child's pain is relieved, their emotional and spiritual needs are met and their families feel supported as they face the unimaginable. 

Here's a link to the eHospice article about the World Hospice Palliative Care Day Event which was held at BSMMU recently.