The concept of twinning between towns and cities has been around for some time. The idea behind this has been to promote cultural and commercial ties. The concept continues and in 2010 the Council of European Municipalities and Regions (CEMR) released “Twinning for Tomorrow’s World – a Practical Handbook” because they appreciated the strength of the concept and how it helps “sustainable development, economic co-operation, the preservation of cultural heritage and a dialogue for peace”.
More recently we have seen the concept of twinning emerg between palliative/hospice care programs. While many examples exist, this article highlights two twinning projects between sites in British Columbia, Canada and Nepal that have come out of a broader palliative care initiative in Nepal with the International Network for Cancer Treatment and Research (INCTR) and the Nepal Network for Cancer Treatment and Research (NNCTR).
The PAX (Palliative Access) team of INCTR ( http://www.inctr.org/programs/palliative-care-pax ) has been visiting Nepal since 2002 following a request from Nepalese colleagues to help support their development of palliative care initiatives in the country. In the years following, the INCTR PAX international faculty has assisted programs through site visits, education, training and mentorship as well as meeting with government officials and policy makers to help improve access to opioids and other essential medications in Nepal.
Dr. Robin Love (Nanaimo) with the team in Bhaktapur
From these collaborations, some centers in Nepal expressed a desire to also enter into a closer relationship with a specific hospice palliative care provider. The first of these “twinning” relationships occurred in 2007 between Nanaimo Hospice and Bhaktapur Cancer Care Hospital (BCCH) and then subsequently between Victoria Hospice and B.P. Koirala Memorial Cancer Hospital (BPKMCH) in Bharatpur.
Both twinning projects seek to provide mutual benefits through the transfer and exchange of knowledge and expertise in palliative care between organizations and individuals. The vision of the twinning project between Victoria Hospice and BPKMCH is “To achieve quality end of life care for all through shared resources, knowledge and expertise” and the Nanaimo-Bhaktapur project is based on the mission statement: “The hospice palliative care communities of Nanaimo and Bhaktapur have come together, in friendship, to share resources and to learn from each other’s experiences and cultures, in order to enhance compassionate care and comfort to the dying and their families.”
Palliative Care Team at BPKMCH providing care.
Dr. Bijaya Neupane, Dr. Sushil Singh, Nurse Mina Ranabhat with patient at BPKMCH
Since the beginning of these twinning projects, there have been multiple visits by Canadian health professionals as well as support for Nepalese health professionals to obtain additional palliative care training in Hyderabad, India at the MNJ Institute of Oncology. The latter collaboration between INCTR and Pallium India resulted in a one month training program led by Dr. Gayatri Palat, an IAHPC Board Member. Most recently through the support of IAHPC and local fundraising in Victoria, nurse Mina Ranabhat and Dr. Bijaya Neupane (Medical Director) visited Victoria Hospice. Mina’s experiences are highlighted in the IAHPC September newsletter at http://www.hospicecare.com/news/11/09/travel_scholar.html . To learn more about the twinning project between BPKMCH and Victoria Hospice, please visit the website at http://sites.google.com/site/nepalhospicetwin
Following the establishment of these twinning relationships Susan Breiddal, a counsellor with Victoria Hospice, created a Canadian website, “OneHospice” with the mission to advance palliative care through the promotion and support of twinning projects by providing the tools for Canadian Hospices to enter into mutually respectful and beneficial partnerships with health care providers in other international communities.
By supporting individual projects they hope to advance towards fulfilling their vision: “A twin for every Canadian hospice”. For more information please visit the site at www.onehospice.com or to see a video about the Nanaimo Bhaktapur project and learn more about twinning visits see http://partnersincompassion.wordpress.com
Dr. Fraser Black (MD, CCFP, FCFP) is Associate Director of the Palliative Access Program (PAX) of the International Network for Cancer Treatment and Research (INCTR) and has worked on palliative care initiatives in many countries including Nepal, India, Tanzania and Brazil. He has practised palliative care over the last 14 years providing care to both adults and children. He is currently the Medical Director of Victoria Hospice in Victoria, Canada as well as a Consultant with the BC Cancer Agency. He is an Associate Clinical Professor with the University of British Columbia as well as International Associate Faculty Member with the Institute of Palliative Medicine at San Diego Hospice.