PakMediNet Discussion Forum : Medicine : palliative care, Third world and Pakistan
palliative care, Third world and Pakistan
Palliation is a word unknown in pakistan medical community as is the word empathy, Although most of the third world countries suffer from the same problem, but quite a few of them are trying whatever they can do to improve the life of very sick. Apparently there is no institute or organization in pakistan whihc is offering pallaitive care in an organized manner.
Even institutes like Shaukat Khanum hospital, Shifa international hospital, Noori and inmol hospital, and so well known for great health care, Agha khan university hospitals and all kinds of CMH (Military hospitals) are devoid of this basic health.
Posted by: yasirPosts: 90 :: 04-10-2004 :: | Reply to this Message
Re: palliative care, Third world and PakistanWhy is it like that? I think perhaps we generally want to burry our head in sand, and not expect death. I do not know but it is something I always wondered. It would be good to hear other people's views..
Posted by: memonPosts: 28 :: 09-10-2004 :: | Reply to this Message
Re: palliative care, Third world and PakistanI believe Pakistan offers a much better system in palliative care than many western countries. The many palliative centres that I have been familiar in the west, accept patients when life expectancy is six months or less. They provide comfort measures for the patients with pain relief and supportive care. In most of the places in Pakistan palliation is provided at home. Patients are amongst their families and loved ones for the most part. Although they may not have access to the modern analgesics and other means of supportive care, they are still at home and between family members. For the most part in the west, the terminally ill patients do not die in their homes but rather in long term facilities or other palliative care centres. Lets pause for a minute and try to visualize our own last days. What would be our preference? The western style palliative care centres? Or our homes between our families?
Posted by: NizamPosts: 82 :: 10-10-2004 :: | Reply to this Message
Re: palliative care, Third world and Pakistan
check this link please
http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0010005s
Posted by: drkhawajaPosts: 37 :: 28-10-2004 :: | Reply to this Message
Re: Re: palliative care, Third world and Pakistan
http://hab.hrsa.gov/tools/palliative/chap19.html
http://www.hospiceinformation.info/
http://www.medsch.wisc.edu/painpolicy/publicat/cprguid.htm
http://www.who.int/cancer/palliative/projectproposal/en/
[Edited by docosama on 10-28-2004 at 03:59 PM GMT]
Posted by: drkhawajaPosts: 37 :: 28-10-2004 :: | Reply to this Message
Re: Re: Re: palliative care, Third world and Pakistan
http://www.medscape.com/viewprogram/3345_pnt
[Edited by docosama on 10-28-2004 at 04:00 PM GMT]
Posted by: drkhawajaPosts: 37 :: 28-10-2004 :: | Reply to this Message
Re: palliative care, Third world and Pakistan
Thank you very much for the feedback and wonderful thoughts.I have read all the web links suggested by different doctors, and I conclude that my concern is shared by many in the field of medicine.
I like to address Dr Nizam opinion, As he has a bit different view of palliative care, I believe he is confusing long term care with palliative care, As most of the eastern families provide love and affection to their loved ones, but believe me they can not act as narcotic anlgesics, which are corner stone of palliation. without any knowledge of disease, expected complications, and without knowing what can happen next. I feel sorry for those families who, while taking care of very sick, find themselves in very diffcult situations, as when there loved one gets more sick after midnight, or develops a new complication, they do not have access to any help. Not even a free phone help line for reassurance.
So i just want to ask you all and dr nizam are we happy with eastern family based palliative care with total emotional and ignorant support, helpless families facing the problem all alone.
or you will like to choose an organized paliative care, with proper attention to
1.education of families about disease
2.pain meds availability at dor step
3.home nursing care if required
4.oxygen etc iv fluids if required
In short Dr Nazim Forgot to remeber the fact that Palliative care is meant for both patient and families, not just patients.
As when someone is so sick to need palliative care, families suffer; thier life style, jobs etc are disrupted. In pallative care education and rteassuarnce of fmailies is a core component.
lets see what we think as pakistani/ eastern doctors
sugestions/ coments are welcome
Posted by: yasirPosts: 90 :: 18-11-2004 :: | Reply to this Message
Re: palliative care, Third world and Pakistan
Dr Yasir,
Thanks for the comments and I respect your perspective.
Nizam
Posted by: NizamPosts: 82 :: 20-11-2004 :: | Reply to this Message
Re: palliative care, Third world and PakistanI thank all who forwarded these messages.I think education is the key.Palliative Medicine in Usa is no longer comfort care in the last six months but given at the same time as curative care.The movement is strong here in the USA and I also see ii growing in countries around Pakistan-Singapore,India,nepal.What we need is champions who have a passion for this since the hurdles are many.I still plan come to pakistan in july and August 2005,I would like to talk to more people about the and still contemplating about what aspects to talk on - faculty,medical students of a medical school.
Posted by: zahirashamPosts: 2 :: 16-06-2005 :: | Reply to this Message
Re: Re: palliative care, Third world and Pakistan
I am sure many doctors will welcome your effort, i believe best target is medical students.I have personal experience of working with young doctors, they are very receptive and practical.
Good luck
Posted by: iqbalmdPosts: 22 :: 19-12-2005 :: | Reply to this Message
First Palliative physcian in Pakistan
I worked as a palliative physcian in the queen elizabeth Hospital in malaysia and was trainned at the Daw house hospice at Flinders University South Australia.
I worked along with Dr Ranjit Mathew Oomens to set up th e first Palliative care unit in the govt sector in malaysia.
I am now involved with the Palliative care hospice movement in pakistan and have been Helping Prof Agha Shabbir as a facilitator in trainning workshops in Palliative care.
Posted by: Dr RiazrPosts: 2 :: 10-01-2010 :: | Reply to this Message
Re: Re: palliative care, Third world and Pakistanyou have very rightly ponited out that we are much better in palliative care as we have the support of the families, however, family also needs support and services to get a relief from thier own psychosocial distress and other comforts. nowadays the family dynamics are changing and we need to look at new innovative ways to deal with such problems. moreo and more families are working and dynmaics previously prevailing is not the same now.
Posted by: nasuliPosts: 3 :: 11-02-2012 :: | Reply to this Message
Re: First Palliative physcian in Pakistan
Dr Riaz, its nice to hear that you are part of the hospice care movement in Paksitan. i am a nurse from Aga Khan University and currently serving in a faculty position. i am very passionate to work in this area of palliative care and currently chosen this as my special area of interest for my PHD studies at University of Alberta, Canada. it would be of great assistnace if you can let me know the current activities or progress in this area in Pakistan and how my dissertation can support or bring about change in this neglected area of care in Pakstian.
Looking forward to your reply. my email adress is nasreen.sulaiman@aku.edu
Posted by: nasuliPosts: 3 :: 11-02-2012 :: | Reply to this Message
Re: palliative care, Third world and Pakistan
Assalamoalikum.
yes you are right that there is no organization or society for palliative care in Pakistan but being as a postgraduate trainee in the past in shifa international hospital we have efficiently carried out this task.our Residents are trained in a way what kind of care has to be given to particular patients and whats are the limit of care and what kind of care has to be given to each individual patient.this is because we have multidisciplinary approach for such patients .for example we have oncologist,physicians,pain management team and trained nurses to performed these tasks.we need to start palliative care specialty as soon as possible in our country and I request CPSP that they should start it without delay.Thanks Dr Anwar Ali Registrar Medicine Shifa college of medicine
Posted by: dr.anwar81Posts: 2 :: 26-05-2014 :: | Reply to this Message