Palliative Care Training in India

Palliative Care Basic Certificate Course in Hyderabad, India

Providing opportunities for physicians to develop their skills in children’s palliative care is one of the key aims of the Children’s Palliative Care Initiative in Bangladesh. Three doctors from Bangladesh have now attended intensive paediatric palliative care training at the MNJ Institute of Oncology & Regional Cancer Centre, in Hyderabad, India.

Dr. Sarabon Tohura and Dr. Nilufar Chowdhury from Dhaka Shishu Hospital and Dr. Momana Begum from Bangabandhu Sheikh Mujib Medical University have attended this one month long training course. All 3 doctors are working in pediatric oncology, treating children with cancer and other blood disorders, where palliative care is a very important part of high quality cancer care.

The training in Hyderabad equips doctors to assess and manage pain in children, including how to prescribe morphine and other opioid pain medications. Additionally, the training also provides practical instruction on effective and sensitive communication with patients, families, and other clinicians

After returning from Hyderabad, each of these physicians has shared their new knowledge with their colleagues, trainee physicians, and nurses within their respective departments through teaching seminars and rounds presentations. Additionally, they have been able to use their knowledge to improve the pain control and communication which they provide to children and families in their clinical practice.

Universal Health Coverage includes Palliative Care for All, especially Poor People.

Last week the Lancet Commissions published their report on Palliative Care and Pain Relief.

The report showed that the Essential Package of palliative care and pain management interventions is affordable in low-resource countries, yet this Essential Package is barely available in these settings.

Here's what the report said:

"The fact that access to such an inexpensive, essential, and effective intervention is denied to most patients in low-income and middle-income countries (LMICs) and in particular to poor people—including many poor or otherwise vulnerable people in high-income countries—is a medical, public health, and moral failing and a travesty of justice." 

"Unlike so many other priorities in global health, affordability is not the greatest barrier to access, and equity-enhancing, efficiency-oriented, cost-saving interventions exist. "

Implementing this Essential Package offers a huge opportunity improve the lives of poor people, at a modest cost. We must start to implement this, especially in Bangladesh, in slums (where we have already started) and in the refugee camps and settlements where the Rohingya have arrived recently.

Here is the essential package and the full report http://thelancet.com/commissions/palliative-care

Rohingya Refugee Crisis

There has been a huge influx of Rohingya into Bangladesh in the past few weeks.

Dr. Farzana Khan, CPCIB Co-Lead, has recently been providing medical care with local humanitarian partners.

For Hats on For CPC, on Oct 13, she took the following photo with some of the children:

She writes: "these smiling children often remind me how to live in the present moment, no matter how harsh the environment is"

A look into what palliative care is available for those with life-limiting illnesses in Bangladesh

In the lead up to World Hospice and Palliative Care Day, the Daily Star published this article which raises awareness about the need for palliative care. 

http://www.thedailystar.net/star-weekend/health/going-gently-good-night-1472035

World Hospice and Palliative Care Day 2017

“Death belongs to life as birth does

The walk is in the raising of the

foot as in the laying of it down” 

― Rabindranath Tagore, Stray Birds

World Hospice and Palliative Care Day, a unified day of action to celebrate and support hospice and palliative care around the world will be celebrated on Saturday 14th October. 

The theme is Universal Health Coverage and Palliative Care – Don't leave those suffering behind. 

We are celebrating this day in Bangladesh with events at many of the hospitals where we work, including:

Dhaka Shishu Hospital- Awareness event in the Conference Hall at 9:30am

Dhaka Medical College Hospital-Share your wishes on the Before I Die Boards from 9am-2pm.

BSMMU-Awareness event in A Block Auditorium at 9am

Rally and Human Chain at the Press Club, at 11am-Human Chain, 12pm- Press Conference

Here is a link to the article which World Child Cancer has published for the day.

Speaking out about the need for pain management in Bangladesh

Recently we published this article (https://tinyurl.com/y8fp7ajr) which describes the incredible burden of pain and other symptoms which are very rarely adequately treated in patients with advanced cancer and other illnesses. 

There are a large number of people living with cancer and other advanced illnesses in Bangladesh. Most of these people will not be able to access cancer treatments which will be curative, as they present very late and cannot be cured. In this situation palliative care can have a huge impact on the suffering which they and their families experience.

We found that 7 out of every 10 patients reported having pain and that it was most often severe.  When we asked whether their pain was adequately treated, we found that 75% still had moderate or severe pain after treatment.  Very few were able to get morphine, which the WHO states is the most appropriate treatment for this type of pain. 

Please check out the new website of the Children's Palliative Care Initiative in Bangladesh which brings together all of our work in one place.

https://childrenspalliativec.wixsite.com/cpcib

18 Months of the Children's Palliative Care Initiative in Bangladesh

I can't believe that it has been 2 years since my last post!  Life has been quite busy, with the birth of my second son and moving back to Canada.

In addition, in November 2015, I was approached by World Child Cancer to develop a project to specifically address the Palliative Care needs of children in Bangladesh!

This project, officially called the Children's Palliative Care Initiative in Bangladesh (CPCIB), has kept me busy for the past 18 months!  The project launched in January 2016, as a pilot project for 1 year. With the experiences that were gained in the first year, we have now been able to expand and further develop the CPCIB and the first phase of this project will run until 2020!

Here is an info-graphic which we prepared to share about the project and it's goals in the beginning.