Under the Traveling Scholarship program, IAHPC subsidized 18 of its members from low- to middle-income countries to attend the 16th World Congress of the European Association for Palliative Care (EAPC) in May. Each successful applicant received a $USD2,000 scholarship. This is the last of two reports of their experiences at the congress, as well as reflections following it, in their own words.
Dr. Lubna Mariam, Assistant Professor, Radiation Oncology Department, National Institute of Cancer Research and Hospital
From this meeting I came to know the future direction of palliative care.
I learned about much new research: the concept of making palliative care a non-specialized subject and integrating it with a primary health care system was completely new to me. I like it because I believe every health care professional should learn the basic concepts of palliative medicine. In our department, we treat many poor cancer patients at a very advanced stage, or those with metastasis where palliative treatment remains the only option. Palliative radiotherapy comprises a large part of our workload.
It was also a wonderful opportunity to meet palliative care colleagues from different corners of the world, especially the other IAHPC scholars. The stories I heard regarding the establishment of palliative care service in different countries was greatly encouraging.
Poster: Profile of Patients Undergoing Palliative Radiotherapy: A single-institute study from a tertiary care oncology center
Dr. Sanghamitra Bora, Head, Palliative Care, Assam Cancer Care Foundation
I aspire to bring a change in the way palliative care is looked at and give my people the best possible care, which they truly deserve.
I have faced problems that arise from the existence of self-styled palliative care providers who provide low quality and improper care. This has diluted the essence of quality palliative care in the long run, and well-intentioned oncologists have lost faith in the specialty. At the congress, I focused on proceedings that addressed early palliative care and integration of palliative care and oncology. I am sure I will be able to implement the approach I learned, and I hope that Assam will become a model of the early integrated onco-palliative care approach, and that it can be replicated in other parts of the country.
The challenges are many: lack of understanding by physicians and the public about palliative care and its benefits, timely referrals, and denial by patients and their families. It is almost impossible to change their mindset from death denial to acceptance of its reality. And while access to opioids is easier, it still remains a paper tiger, as bureaucracy makes the task complicated.
There is much work to be done.
Poster: Non-referral to Palliative Care: An attempt to investigate major reasons
‘It is my happiness to work as a physician at a pioneer palliative care center with the elderly and chronically ill patients who are seeking little smiles,’ said Yasemin Ozturk, third from right, standing among the executive board of the EAPC Task Force on International Collaboration for the Development of Health Care Professional Guidelines in Palliative Care.
Yasemin Kilc Ozturk, Palliative Care Center, University of Health Sciences Izmir Tepecik Training and Research Hospital Yenisehir Izmir, Turkey
I believe that national and international congresses are the best way to learn about the improvements, challenges, innovations, and needs of third parties. These events widen the perspective of participants, interrupt daily routine, and strengthen opportunities for collaboration.
I play a role in educating GP trainees, palliative care providers, patients, and the public in Turkey about palliative care. I believe that using the new knowledge and acquired skills I have gained from this amazing experience at the EAPC Congress will spread countrywide, adding life to patient days. Better knowledge and skills lead to better palliative care for all!
A huge thank-you to the IAHPC team and donors, who provided this extraordinary setting to collaborate and work on the future of palliative care. It is rewarding to collaborate with PC professionals and leaders on an international level while we all strive for a common cause. I will keep in touch with the people with big hearts I met!
Poster/Presentation: Anxiety Depression Symptoms and Social Support of Informal Caregivers of Palliative Care Patients
Dr Wah Wah Myint Zu, Lead Technician, Palliative Care, Cancer Pain and Palliative Care OPD, Yangon General Hospital
Palliative care in Myanmar, a developing country in Southeast Asia, is taking baby steps. To further palliative care in my country, I will write a report about the congress and send it to policymakers to advocate for their commitment in the development of a national palliative care plan and policy development.
An integrated curriculum in Medication Education will soon be started in Myanmar. Thanks to a palliative care education workshop, I am more confident in handling the undergraduate curriculum. The congress also encouraged me to do more evidence-based research, and confirmed my belief that self-care and support within the palliative care community is crucially important.
The congress gave me new and different insights into our own challenges and barriers in the palliative care journey, and ideas and strength for trying our best for palliative care development in our country.
Dr. Barbara Amity Flores, Palliative Specialist at: FEU-NRMF Medical Center, Manila Doctors Hospital, and Veterans Memorial Medical Center
Quezon City, the Philippines
It was a good experience to meet other people from other parts of the world who share the same interest in palliative care as I do. I realized that other countries share the same struggles of making the service known and more accepted. Knowing that the problems we encounter are no different from their experiences has encouraged me to keep motivated in my goal to increase awareness of palliative care in my country.
I especially appreciated the fact that participants were not all just doctors and nurses but were from other members of the multidisciplinary team: social workers, physical therapists, and psychologists. As I got to know other members of multidisciplinary teams, I appreciated more their roles and contributions, and the importance of having interdisciplinary care providing holistic support for the terminally ill.
In my country, it is mainly doctors who practice palliative care. After the conference, I am now more determined to encourage other members of our multidisciplinary team — nurses, social workers, pharmacists, psychologists, spiritual mentors/leaders and the like — to appreciate, embrace, and practice palliative care.
Poster: Palliative Management of a Pregnant Patient with Pancreatic Cancer: A case report
Neha Tripathi, Social Worker, Cancer Aid Society
Participation at EAPC 2019 was a wonderful experience and resulted in fruitful exchanges and networking.
I was attracted by the selection of topics for the posters, as non-clinical research with practical aspects was preferred. As the social worker for the Cancer Aid Society of India, I have been groomed to provide non-medical aspects of palliative care.
Shaping the future right at the grassroots level was an eye opener, as we have limited options to implement palliative care in our own settings. Currently I am pursuing a six-month Fellowship Program in Palliative Care, and the knowledge I gained at EAPC has stimulated me to improve the palliative care services we provide by targeting the issues that will improve not only the quality of life but also the quality of death.
Dr. Rubayat Rahman, Centre For Palliative Care, Bangabandhu Sheikh Mujib Medical University
I have never been at a conference with such a huge crowd of palliative care specialists together under one roof! I am a beginner in the field and every presentation and discussion made me think to do the same in my country.
Due to lack of services and large need, many curable diseases in this world are incurable in this part of the world. We need to arrange more palliative care training for physicians here, as it is a new concept in Bangladesh, and increase public awareness, as some believe physicians are here to cure everything. I believe that we can achieve more by strengthening the concept of community-based palliative care, as institutions will not fulfill the need.
Moreover, I find dissimilarities in the definition of suffering in an underdeveloped country in comparison to the developed countries. Here, people fight against poverty and for food. So, sometimes it became difficult to define palliative care.
And while we have had available morphine in all forms for the past five years, myths remain. Even physicians are not ready to accept it as a gold standard painkiller for cancer pain. We need to overcome this obstacle by providing more training on how to use opioids, while urging the drug administration to understand the suffering of those with cancer pain.
Stella Mwari Rithara, Palliative Care Tutor
Our main challenge is acquiring training and reading materials; thanks to IAHPC for their well-equipped website, which has been my reference in most cases. I learned a lot at the EAPC Congress, and it was a great opportunity to meet experts in the field like Sheila Payne, with the UK End-of-Life Observatory, and Julia Downing [Chief Executive, International Children’s Palliative Care Network]. Children are a particular palliative care interest of mine, and I was able to connect with Julia and will be receiving book and journals on the topic.
Poster: Are Young Nurses Well Equipped in Dealing with Paediatric Palliative Care?