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.