Despite being a signatory of a landmark resolution on palliative care at the World Health Assembly in Geneva in 2014, Bangladesh has yet to implement its regulations
Dr Abu Taher Md Saleh, physician for Centre for Palliative Care (CPC) at BSMMU, says they look after patients who have chronic pain after operations and terminal patients of cancer and kidney, heart and liver diseases.
Cancer patients are only treated here if they have done their diagnosis elsewhere already.
Several statistics say the numbers of possible patients is 100 times more than the facilities Bangladesh currently has.
The World Health Organisation says approximately 600,000 people need palliative care at any time in Bangladesh each year.
But the handful of palliative care providers in Bangladesh such as the CPC at BSMMU, National Institute of Cancer Research and Hospital, ASHIC Palliative Care Unit, Shanti Oncology and Palliative Care Unit, Bangladesh Palliative and Supportive Care Foundation, and Afzalunnessa Foundation say they can only provide for a small number of patients.
According to Children’s Palliative Care Initiative Bangladesh (CPCIB), in Bangladesh, 29,000 children with life-limiting and life-threatening conditions need palliative care each year, but only 2% of these children are currently able to access such services.
The organisations that are providing this service can only ensure treatment for not more than 4,000, says Professor Nezamuddin Ahmed, head of the CPC.
“In 2015, Bangladesh stood 79th on a list of 80 countries in terms of quality of life in terminal days, assessed by the Quality of Death Index done by The Economist Intelligence Unit,” he says.
“This shows us what the condition is in this sector,” he says, adding that he believes that the number of patients stipulated by the WHO would be higher in reality.
He says the National Health Policy includes diseases such as HIV and coronary heart disease in the policy but does not have any policy on palliative care. Patients of both diseases are eligible for such care.
“The National Institute of Population Research and Training asked us in 2014 to conduct a national survey on seven cities and asked to make recommendations. We made strong recommendations for bringing palliative care to the mainstream treatment facilities,” he adds.
He says the district hospitals should have at least two beds for such patients with minimum facilities.
Dr Taher says a lack of awareness about palliative care among health professionals, scarcity of trained professionals, psychological aspects of children often ignored by physicians, intention of treatment almost always to cure rather than palliation are the challenges in implementing palliative care.
He says the BSMMU last year started a palliative course with three students initially; there are 10 students this year. The sector is developing and in four years the country will get specialist in this sector as well.
CPC chief Prof Nezam says this year the World Hospice and Palliative Care Day will be observed today with the theme “Living and dying in pain – it doesn’t have to happen.”
“We expect that the government will focus on this issue and take under cognisance for the betterment of patients,” he says.