World Hospice and Pallia­tive Care Day is marked on the second Saturday of October every year. The World­wide Hospice Palliative Care Al­liance has announced this year’s theme as “Healing Hearts & Com­munities” which highlights the role of grief and the need to heal in uniting humans worldwide.

Dr Haroon Hafeez who is serving as the Consultant Hospitalist & Palliative Care Physician at SKMCH&RCP reveals that palliative care is recognised under the human right to health and the Human Rights Watch advocates for universal access to palliative care because no one should suffer from treatable pain. Palliative care is an approach that improves the quality of life of pa­tients and their families facing se­rious or life-threatening illnesses, such as cancer, through the pre­vention and relief of suffering by means of controlling symptoms, pain, and other psychosocial problems, in a holistic manner. 

Patients may receive palliative care along with treatment intend­ed to cure their illness and it is not limited to end-of-life care.Hospice care, on the other hand, focuses on improving quality of life of pa­tients who are approaching the end of life. According to World Health Organization, worldwide, only about 14pc of people who need palliative care receive it. It is estimated that around 40 mil­lion people are in need of pallia­tive care and 78pc of them live in low- and middle-income coun­tries. There are several reasons for limited access to palliative care in Pakistan and globally. For example, restrictive regulations for morphine and other essential controlled palliative medicines, which often stem from a miscon­ception that improving access to opioid analgesia will lead to increased substance abuse. An­other challenge is limited training opportunities on palliative care for healthcare professionals.

There are also cultural and so­cial barriers related to the concept of pain and suffering amongst pa­tients. There are misconceptions about palliative care as a concept that it is only for the last weeks of life when in reality, this approach is useful at any stage of disease and early delivery of palliative care may reduce unnecessary hos­pital admissions. There is an ur­gent need to increase awareness amongst policy-makers, health­care professionals and the public about palliative care to improve our health systems and quality of life for patients. In Pakistan, both public and private healthcare have been unable to prioritise palliative care. There are only a handful of hospitals that offer pal­liative care in our country, which include SKMCH&RC. Our hospital is a pioneer in the development of physician-led services in pallia­tive medicine in the country. The Internal Medicine Department runs specialist palliative medicine clinics for patients who require symptom management for termi­nal as well as chronic conditions. The clinics are multi-disciplinary consisting of clinical nutritionist, psychologist, play therapist, phys­iotherapist and palliative care specialist nurses. 

We are also supported by an­aesthesia team for interventions for pain control and we have an orofacial pain consultant, who specialises in head and neck can­cer pain and nerve blocks. 

Over the years, we have worked with the relevant authorities to ensure that pain-killers need­ed for palliative care patients are available at our hospitals in Lahore and in Peshawar.At SKMCH&RC, we take care of our patients throughout their cancer journey—whether it is follow-up after completion of active treat­ment or if it is end-of-life-care for patients who are terminally ill—we remain committed to provid­ing treatment with dignity to all our patients. There is a need for hospitals in our country to invest in training opportunities in the field of palliative care to improve quality of life for our patients. We hope to play our part and con­tribute towards building Paki­stan’s capacity to provide pallia­tive care. 

Acknowledging the impor­tance of this field in patient care, SKMCH&RC in Lahore has be­come the first institute in Pakistan to be recognised by the College of Physicians and Surgeons Pakistan to start a two-year fellowship pro­gramme in Palliative Medicine.