Global Palliative Care Community Highlights

2015; Volume 16, No 12, December

Global Palliative Care Community Highlights – initiatives from across the world

Bangladesh raises awareness about hidden patients

In the past two issues of our newsletter we looked at how some of our readers celebrated this year’s World Hospice and Palliative Care Day. Here, Fazle Noor Biswas, a clinical pharmacist in the Centre for Palliative Care, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka, Bangladesh, concludes the series.

The 10th October – World Hospice and Palliative Care Day – was a special day of action to celebrate and support hospice and palliative care around the world. The theme for this year’s event was ‘Hidden Patients, Hidden Lives’, highlighting the difficulties that many patients face in accessing palliative care. Many patients are unable to advocate for their own palliative care needs due to illness or other barriers. With a population of 160 million, Bangladesh is estimated to have more than 0.6 million people in need of palliative care at any point in time. The palliative care community must speak out for these patients, ensuring that they have access to the care that they need.

In Bangladesh, the Centre for Palliative Care and the Palliative Care Society of Bangladesh celebrated the day jointly at Bangabandhu Sheikh Mujib Medical University (BSMMU). To mark the event, the Centre for Palliative Care held a Rally for Palliative Care and an awareness-raising program. About 200 people took part in the rally, joined by the participants of the ‘Ride for Palliative Care’, a cycling event organized by Hospice Bangladesh which took place in Dhaka earlier that day. This collaborative working symbolized our united efforts to increase awareness and support of palliative care in Bangladesh.

The university program was well attended by doctors, nurses and other staff, and several significant guests: the Vice Chancellor and the Deputy Vice Chancellors, chairmen of different departments, the President of the Palliative Care Society of Bangladesh, the President of Sir William Beverage Foundation and a representative from Help Age International. Professor Nezamuddin Ahmed of the Centre for Palliative Care spoke about the need for palliative care emphasizing the research findings of The Quality of Death index and the position of Bangladesh. (See link below).

Dr. Megan Doherty, a visiting Pediatric Palliative Care Consultant presently working at BSMMU, spoke about the need for palliative care by children who are so often ‘hidden’ – it is estimated that globally fewer than 2% of children who need palliative care are able to access it. Many other speakers discussed hidden patients and their hidden needs, such as the example below.

Shakila is a 28-year-old graduate student admitted to the Centre for Palliative Care. She was initially diagnosed with nasopharyngeal carcinoma 12 years ago, but despite many treatments the cancer has spread. Unfortunately at this time, there are no curative treatment options available for her.

Over the past 12 years, Shakila’s family has spent a lot of money on her cancer treatment, and they have lost everything attempting to cure her. When she came to the Centre for Palliative Care, her family had exhausted all of their financial resources paying for her treatments and they could not even afford morphine to treat her pain.

Her elder brother also had cancer and passed away 17 years ago. Sadly her father has kidney cancer and he too is currently on the palliative care ward.

Shakila has pain and a malignant wound, which requires daily dressing. She feels ashamed of the visual disfiguration that her tumor causes. She is very sad at times and wishes to die. She frequently worries about the future of her mother and younger brother and hopes that he will find a job to support the family in the future.

At the Centre for Palliative Care, the team has been providing financial support to ensure that Shakila’s family can purchase the necessary medications for her and her father. The team is focused on providing total care; not only treating Shakila’s physical symptoms, but also her spiritual and emotional needs.

A team of approximately 50 volunteers from the Centre for Palliative Care helped to organize the event, providing coffee and biscuits, and selling fushka (a popular local street snack made from spices and chickpeas) to raise funds. All funds raised will go to the Social Welfare Fund at the Centre for Palliative Care to provide palliative care for patients who cannot afford the cost of treatment. The volunteers also took part in different cultural programs such as stories of shared experiences and self-reflection.

Representatives from Unimed and Unihealth Manufacturers Limited were present, providing doctors with information about the availability of morphine in Bangladesh. This was an important initiative as many physicians are still unaware that morphine is available locally and how it can be used to safely treat pain in palliative care patients.

Overall, the different events succeeded in raising awareness about the need for palliative care in Bangladesh. Events received good local media attention with newspaper articles and coverage on several local television channels.

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