Palliative Care
Supporting and giving ease to the terminally ill patients
When Abdul Matin (not a real name) came to know that he had 'Cancer', his whole world fell apart. It was really hard for him to believe it and immediately he began considering himself as the most unfortunate and isolated man on the earth.
The disease brought curse and misery to the family, as the 45-year-old man with four children lost his job, sold off the only piece of land he had to bear the expenses of the costly investigations and injections along with other paraphernalia.
But as the days passed by, the condition of Mr. Matin gradually deteriorated. His mental agony was no less than his physical pain when he saw the future of the family who were about to be on the street. Last few days of his life, he suffered from severe pain, both physical and mental.
Many patients suffering from the end stage of different diseases go through the utmost agony of their life before they breath their last.
"But it is possible to trim down the magnitude of the suffering, both physical and mental to those patients by providing palliative care (PC), a special care for the dying patients with an aim to provide comfort, care and support to the terminally ill patients" said Dr Nezam Uddin Ahmed, Coordinator of the Palliative Care Project of Bangabandhu Sheikh Mujib Medical University (BSMMU).
"Whereas the valid, simple and relatively inexpensive palliative care approach and models that are acceptable and maintainable at the community level do exist in this world, but unfortunately the service is non-existent in Bangladesh", he told The Daily Star elaborating the success story of the Neighborhood Network Of Palliative Care (NNPC) services offered in the Keralla state of India.
Two thirds of those in need of PC live in developing countries. According to the World Health Organisation (WHO), there are around twelve lakh cancer patients in Bangladesh and every year further 2.25 lakh new patients are added to this pool.
"Of the cancer patients in the country, eighty percent come to the doctors in an advanced stage when the disease becomes incurable. However, one third cancer patients can survive for five years if they can be detected early and one third of the cancer is curable." Said Shariful Alam, Director of the National Institute of Cancer Research and Hospital.
A survey done in 2005 in the same institute showed that more than eighty percent of the 7516 new patients attending the out patient department had a monthly income of less than five thousand taka. Understandably, proper treatment remains a distant dream for most of these cancer patients. Only a very handful can buy the treatment even if the cancer is potentially curable. Realistically palliative care remains the only option for majority of the cancer patients in Bangladesh as same as in the developing world.
Though this essential service is non-existent in Bangladesh so far, at least in 13 countries in the world this is treated as an individual subject. Singapore has a developed palliative care base. Asia pacific Hospice Palliative Care Network (APHPCN) is based in Singapore.
While talking about PC, Medical Director of West Clinic Excellence Cancer Centre Dr Steven Tucker told the Daily Star that the service is widely available in Singapore and everyone involved in cancer treatment knows and utilises the knowledge and skill gained in palliative medicine so far worldwide.
"In Singapore, palliative care goes hand in hand with curative cancer treatment approach" he said adding that it was first formalised in the National University Hospital.
"The great certainty of human existence is that we all are born to die. Palliative care has much to offer in easing our passage at the end of life and it has the potential to do this for many million people around the world. It is a moral responsibility of the mankind to provide care to those who leave life, elderly people, the terminally ill people — those dying slowly of cancers and AIDS. The same care and attention that we give to those who enter life," said Graham Arthurs, a palliative care consultant from Wrexham, UK.
Palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.
It also helps the family to cope during the patient's illness and in their own bereavement using a team approach to address the needs of these patients and their families.
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