International Association for Hospice & Palliative Care

International Association for Hospice & Palliative Care

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Promoting Hospice & Palliative Care Worldwide


2006; Volume 7, No 2, February



Many ways to help support palliative care.

Main Index:

IAHPC's Homepage

Message from the Chair & Executive Director:
Kathleen M. Foley, MD
Liliana De Lima, MHA

Article of the Month:
Dr. Ripamonti

IAHPC Traveling Scholars’ Reports

Regional News:
Greece, USA & India

Book Reviews:
Roger Woodruff, MD

IAHPC Board Member Retires

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Webmaster's Corner:
Anne Laidlaw

Editor's Notes:
Dr. William Farr

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IAHPC Traveling Scholar’s Reports

Postgraduate training course for Eastern-European professionals at the Budapest Hospice House

October 10 – 14, 2005

Thanks to the generous support of the IAHPC Travelling Scholarship Program I was one of several people who participated in the postgraduate training course for Eastern European professionals in Hungary .

Hungary is one of a few Eastern European countries that has successfully made many achievements in palliative care development. With almost 14-years of experience, and a willingness to be helpful in the promotion and development of hospice in other countries, the program at the Budapest Hospice House was most useful and interesting.

The chance meeting between me and a doctor from Lviv, the Ukraine , who also participated in the course, was most interesting. Moldova , the country where I live, and the Ukraine are neighbours and we have similar obstacles in the way of palliative care development. Our meeting in Hungary , our mutual discussions, the sharing of common problems and possible ways to solve them was an unexpected and doubly useful part of the course.

The meeting began in the Budapest Hospice House. Its director, Katalin Muszbek, introduced us to the team and we became acquainted with the structure of the whole institution and visited all of it. Then Dr. Muszbek discussed with us such important topics such as the “state of art” in palliative care in Hungary , its current development and how the Hungarian experience can be helpful in palliative care development in Moldova and the Ukraine . Such topics as palliative care policy, strong opiate provision, palliative care organizations’ management and finance were all discussed during the course.

Another important issue discussed with Katalin Muszbek was psychosocial support and communication with a person who has an incurable disease. This topic was brilliantly addressed by a team of two psychologists. They discussed how to break bad news; how to communicate with the whole family about where the terminally ill patient is in their disease process; and how to do both of these things with people of different ages.

We met with the medical staff of the 10 bed inpatient ward of the Budapest Hospice House. We participated in the daily patient rounds and case discussions, both of which permitted us to share and to learn about the management of terminally ill patients.

I was very impressed by the organization of the volunteer system that was successfully integrated into all aspects of the care for the benefit of patients and caregivers.

Fundraising in palliative care was an additional topic for discussion led by two excellent professionals. The Hungarian experience, plus a great deal of practical advice, was extremely useful since in many Eastern European countries, where palliative care service is not a part of the State Health Care System, financing is one of the most difficult problems to solve.

Two of the days during the course were dedicated to visits to two other palliative care institutions located outside of Budapest . One of them was situated in the south of Hungary , in the town of Pecs . It consists of an inpatient department with 14 beds, organized and supported by the Saint John Order. Its experience with hospice management, fundraising, psychological issues and clinical management were interesting because of differences and similarities observed earlier in the capital.

Another palliative care institution that we were delighted to visit was one of the early pioneers of the Hungarian hospice movement – the Erzsebet (Elizabeth) Hospice. It is situated in the north-eastern part of Hungary in the town of Miskolc . Dr. Csaba Simko shared with us their 10-year experience in homecare, inpatient care and bereavement. The Hospice is a recognized educational centre for the country and region.

The training course was excellent because it briefly covered almost all aspects of palliative care with attention to very useful and essential details of how hospice is practiced in various regions within Hungary

I’d like to express my personal gratitude to IAHPC for making this training possible, for providing the financial support of my trip to Hungary and I send a special thanks to all my new Hungarian friends who made our stay in Hungary so pleasant. This experience provides me with the confidence that we are on the right track in our own efforts to establish palliative care in the Eastern Europe region.

Click photo to view larger image

Natalia Carafizi, MD,
Charity Foundation for Public Health “Angelus Moldova”,
Hospice “Angelus”, Chisinau, Moldova
IAHPC Travelling Scholar to Hungary


The IAHPC recently sponsored Dr. Msemo Diwani from Ocean Road Cancer Institute in Dar es Salaam, Tanzania, to attend the international conference Palliative Care - Mind, Body and Spirit organized by the University of Cape Town in South Africa in December 2005.

I would like to extend my appreciation to the organizer of the conference for their excellent work with the organization of the conference. The conference was opened by the deputy minister for health of South Africa who has been a staunch supporter of palliative care programs in the country. There were six separate sessions in the conference addressing various palliative care subjects. These were clinical palliative care; palliative care development; pediatric palliative care; education and research; psychosocial; and spiritual care. All plenary speeches and break away sessions were equally good.

Most of my time was spent in pediatric palliative care where I felt that I had a lot of knowledge gaps to fill and, in deed, I did. The afternoon sessions which were interactive workshops were wonderful. It was nice to hear people from different backgrounds discuss common problems and to reach a consensus. I was inspired by almost every person I talked to during this conference. This meeting helped me learn from leaders in palliative care and improve my skills in developing a similar program for my home institution.

I am very grateful to IAHPC for this traveling scholarship which has helped us to build our capacity to develop palliative care in our country.

Dr. Msemo B. Diwani
Ocean Road Cancer Institute
Muhimbili University College of Health Sciences
Dar es Salaam-Tanzania

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