Reflections on the challenges and opportunities for palliative care in Nepal

Abstract

Palliative care in Nepal has been developing over the last 20 years, led by pioneering doctors and nurses who have gained experience in the specialty, often while working overseas, or who have had the opportunity to do clinical attachments abroad. Recently, in collaboration with international palliative care specialists, a national strategy has been developed and adopted to guide future development so that palliative care for all who need it can be provided. This article explores the faith-based context for palliative care and describes the particular issues Nepal faces, the work of Christian mission organizations in supporting palliative care development, and the need for religious and cultural sensitivity.

Palliative care services for cancer patients in Nepal, a lower-middle-income country

“…17 Similarly, United Mission to Nepal supports palliative care development by establishing hospitals in rural parts of the country to provide holistic care and International Network for Cancer Treatment and Research (INCTR) has been involved in providing education and training as well as financial support to the hospices. 17,18 On the basis of various dimensions of palliative care, Nepal is classified as 'Category 3a' with isolated palliative care provision. 7 This means that the development of palliative care services are still patchy in scope and not well supported, heavily donor dependent funding, limited morphine availability, and services not proportionate to the huge population size.…”

“… 17 Similarly, United Mission to Nepal supports palliative care development by establishing hospitals in rural parts of the country to provide holistic care and International Network for Cancer Treatment and Research (INCTR) has been involved in providing education and training as well as financial support to the hospices. 17 , 18 …”

“…20 NAPCare has developed the National Strategy for Palliative Care, which focuses on pain management in co-ordination with Ministry of Health (MoH) and WHO with support from Two Worlds Cancer Collaboration, Canada. 17 , 20 , 21…”

“…There is also a hospice in the Shechen Monastery at Bouddha established by a Buddhist charitable foundation named Karuna-Shechen which provides palliative care to needy patients. 17 , 23 …”

Development of Oncology Nursing in Nepal: Historical Perspective

“…Papanicolaou smear technique to identify early cancerous changes in the cervix.Nurses are key in case finding positions because they work with patients and have the opportunity to observe signs and apply knowledge in discerning cancer in such areas as the skin, breast, cervix, oral cavity, where the disease frequently occurs. There have been various interactions with experts from other countries, the collaboration between the International Network for Cancer Treatment and Research (INCTR) and the Nepal Palliative care group prepare the concept of palliative care guidelines 14. …”