IAHPC Traveling Fellow’s Report

Background

Victoria Hospice, Canada, and B.P. Koirala Memorial Cancer Hospital (BPKMCH), Bharatpur, Nepal, have been in a twinning partnership for the past few years (see One Hospice, Canada’s Guide to Palliative Care Twinning Projects at www.onehospice.com ). There have been numerous visits to Nepal by Victoria staff and volunteers to participate in formal and informal education as well as working at the bedside to provide patient care with their Nepalese colleagues.

Thanks to a Traveling Fellowship grant I received from IAHPC, I was able to travel to Bharatpur where palliative care services continue to grow. There is a twelve-bed inpatient palliative care unit, an outpatient palliative care clinic and an inpatient consultation service available to other services in the hospital. There is a dedicated palliative care physician and 6 nurses. I spent my time working in the unit with nurses, meeting families and patients, providing counseling and bedside teaching. I participated in their six-week training course, staff training sessions, and I provided written materials and other resources to demonstrate how theory is applied in real life situations.

Observations

I am very pleased to see that our partnership is solidifying. We are fortunate to have several key people in leadership positions who are dedicated to palliative care and have worked to define our partnership. There is, however, much to be done. At this point, the hospital is providing morphine and a major drug company has announced that liquid morphine will soon be available at a reduced cost. There are gaps in services such as follow-up care in the community and psychosocial issues that result from a practice of withholding the diagnosis and prognosis from patients.

Future plans

We will continue to build our relationship with Bharatpur Hospice through onsite visits, correspondence, providing written materials, training and teaching and offering funds for needed items. We also hope to provide funds for staff members to continue to attend professional development programs and to share this information with professionals in other parts of the country.

Conclusion

Our twinning project has accomplished a great deal even though there is a tremendous amount of work ahead of us. All of this will continue to move palliative care forward because of the work of many dedicated individuals who help increase access to palliative care for all Nepalese who face cancer and other life-limiting illnesses. I wish to thank the International Association for Hospice and Palliative Care for providing the funding for my Traveling Fellowship.

Ms Susan Breidal
PhD student in Education-Curriculum and Development and in Intercultural Communication and counselor at Victoria Hospice Society in Canada.