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Developing Palliative Care in Sri Lanka

More than half of all patients with cancer experience pain. In advanced disease, close to two thirds of patients report pain, about half of whom suffer pain of moderate-to-severe intensity. If cancer pain is not adequately treated, it can have devastating consequences that affect the quality of life of patients and their families. Palliative care improves the lives of patients and their families. Watch ‘Life asked Death’ now and learn how palliative care services can be developed in ALL countries.

It is an approach, a way of delivering services that cares for the patient as a whole person, addressing the physical, emotional and spiritual needs and practical concerns, of both the patient and the family. Palliative Care aims to improve the quality of life of a patient facing a life-threatening illness and that of his family.

It should be an essential service provided by the government. The World Health Assembly recommends that palliative care should be part of the healthcare package that governments provide for the whole population, and integrated into the healthcare system including as part of universal health coverage

“Palliative care helps to improve the quality of life of patients in Sri Lanka. Though some headway has been made under the Lien Collaborative, we need to do more especially in the area of integrating palliative care into the healthcare systems.” “We also need to make changes to our policies to provide the dying with better, greater and easier access to pain relief medications.” – Assoc Prof Ghauri Aggarwal, co-leader of the Lien Collaborative’s Sri Lanka program and palliative care specialist from Concord Hospital, Australia.

Sri Lanka, a country with a population of 21 million people, has made strides in the development of palliative care despite the difficulties it faces. The Ministry of Health has changed its policy to approve longer prescription of morphine to outpatients from 3 days to one month. Also, a National Steering Committee on Palliative Care has been formed and has held its inaugural meeting. The Post-Graduate Medical Institute has approved a postgraduate diploma in Palliative Medicine for doctors to be rolled out in 2017. Major government institutions like the National Cancer Institute of Sri Lanka, which are in the process of building up their palliative care services, will become the teaching centers in palliative care in the future. According to the Global Atlas of Palliative Care, published jointly by the WHO and the Worldwide Hospice Palliative Care Alliance (WHPCA), Sri Lanka suffers from inadequate access and availability of hospice and palliative care. Its palliative care activities are heavily donor dependent and hence unsustainable

The usage of morphine is generally low with annual average consumption of less than 5mg/capita, well below world average, contrary to the World Health Organization’s recommendation of oral morphine as the gold standard and essential medication for pain relief that should be available to suffering patients. The scarcity of palliative care and pain relief medicines in Asian countries like Sri Lanka are compounded by other socio-economic issues such as poverty, high patient load and overcrowding at public hospitals and healthcare facilities