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Latin America and Caribbean Regional Palliative Care Report,
December 2003

Prof. Dr. Marco Tullio de Assis Figueiredo, Federal University of São Paulo-Paulista School of Medicine and International Association for Hospice and Palliative Care

There were a number of meetings and conferences in Brazil this year pertaining to palliative care. A short summary follows:

XII Academic Medical Congress  (medical students) of the State University of São Paulo,  Botucatu Campus. 26 September to October 3, 2003, Botucatu,SP.

As this event had taken place during the regular graduate period of classes, the sessions were displaced to the evening hours. Thus on September 29, 2003, the program was entitled "Night of Palliative Care to the Terminal Patient" with the following presentations were given: A) Introduction to Palliative Care and Presentation of the Pain and Palliative Care of the Clinic Hospital of the State University of Sao Paulo, Botucatu Campus, B) Palliative Care: Humanization of Suffering at the End-of-Life, C) Palliative Care and Neonatology, a New  Challenge, D) Abbreviation of Life of the Terminal Patient.

VI SIBRAD-Brazilian  Symposium of Home Care, September 13 to 15, 2003, São Paulo,SP. Course 3 End-of-Life and Bearevement:  Presentations: Palliative Care: Principles, Limits and Possibilities; Death: Hospital & Home; Theory of Affectional Attachment; Models of Home Care: a Global Vision.

II International Meeting of Palliative Care of the Public Servant Hospital of Sao Paulo State,  September 19 and 20, 2003, Sao Paulo.

International Conference: Palliative Care - A Right
Round Table: Justice, Right and Palliative Care.

: Treatment of Pain in Palliative Care
Round Table: Teaching of Palliative Care in Brazil.

International Conference
- To Die with Dignity,
Panel - Practical Aspects in Palliative Care; Emergency in Palliative Care;  Nursing Care at the End-of-Life; The Family and the Social Work.
Round Table: Pain in Palliative Care: Drug Treatment; Hypnotherapy in the Treatment of Pain; The Nurse and the Person with Pain; Pain in Pediatrics.

International Conference - Care in Bereavement,

: The Passage Between Life and Death: A Psycho-Spiritual Perspetive
Round Table - Death and the Religions; Catholicism; Spiritualism; Evangelics.

Conference:  Palliative Care and the Society.

VII Brazilian Congress of Internal Medicine; I International Congress of Urgency Medicine; I International Congress of Family and Community Medicine, and I National Symposium of Palliative Care, October 1 to November 2 of 2003, São Paulo.

Dr. Marco Tullio de Assis Figueiredo was the organizer of the I National Symposium of Palliative Care. The entire event had an attendance of 4100 persons, 70% of them were medical and nursing students. The President of the BSIM (Brazilian Society of Internal Medicine), Pro. Dr. Antonio Carlos Lopes (UNIFESP-EPM) created the Chapter of Palliative Care within the BSIM, and Dr. Marco Tullio was nominated its first President. The purpose is to promote, teach and spread palliative care philosophy, principles and practice to general practitioners and internists throughout Brazil.

The symposium program included an overture conference by Dr. Antonio Carlos Camargo de Andrade Filho, a pioneer in this country since 1986 who was trained in UK.

There were talks about the medical an nursing aspects of palliative care, as well as of psychology and spirituality; round tables on control of pain and symptoms, on death and bereavevement, on new perspectives of palliative care such as AIDS, neuromotor diseases, chronic heart, renal and pulmonary diseases,  geriatrics, on domiciliary visits. One opening was given to a family carer to talk frankly about his experience with his mother dying of advanced colon carcinoma.

Comment:- With many courses, free talks, posters, and chats encompassing such a large field of medicine, the average attendance was about 110 persons. As has been my experience, students, lay people, and the ushers and technical crews of the audictoires, were  the most interested, and formed the after-speeches groups that gathered around the professional speakers

X Course of Palliative Care of the medical and nursing students of UNIFESP, November 2003, São Paulo.

This year the course maintained its regular attendance of 50 people. It marked 10 years of joint voluntary efforts of graduate students and professionals, under the leadership of Marco Tullio de Assis Figueiredo. These courses have been responsible for the introduction of one class of palliative care in the Basic Oncology Discipline beginning in 1977; an annual course - Thanatology, also since 1977; the establishment of the Elective Discipline in Palliative Care in the graduation level (restricted to 14 students), since 1998; the creation of the Outpatient Clinic of Palliative Care with active home care assistance started in 2000; the creation of the Setor of Palliative Care in the Discipline of Internal Medicine since 2002

The multiprofsssional staff is formed by voluntaries. Recently, one male nurse with 11 years of ICU experience was transferred to the Setor of PC. Dr. Maria Goretti Sales Maciel, an experienced GP and head of the Palliative Care of HSPE, was approved in a public contest at the UNIFESP-EPM, and designated to work at the Setor.

In spite of the financial difficulties of the country, Palliative Care, notwithstanding the medical class indifference towards it, is gradually becoming a novelty in the scientific meetings. We shall continue to spread the news in an evangelical way.

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