Introducing APHN new 15th Governing Council

15th Council

Back row: Mr Kwan Kam Fan, Dr Jeanno Park, Dr Maria Witjaksono, Dr Chun-Kai Fangl, Dr Priyadarshini Kulkarni, Dr Richard Lim, Dr Annie Kwok, Prof Yoshiyuki Kizawa, Prof Satoru Tsuneto, Dr Chong Poh-Heng
Seated: Dr R Akhileswaran, Dr Sushma Bhatnagar, Prof Cynthia Goh, Prof Tetsuo Kashiwagi (Stepped down from 15th Council), Dr Ednin Hamzah 
Absent with apologies: Prof M R Rajagopal, Dr Ghauri Aggarwal, Prof Patsy Yates, Dr Yvonne Luxford, Prof Hyun Sook Kim, Dr Jun-Hua Lee

NAME APPOINTMENT MEMBERSHIP (SECTOR)
Associate Professor Cynthia Goh Chairman Elected (Singapore)
Dr Ednin Hamzah Vice-Chairman Co-opted (Malaysia)
Professor M R Rajagopal Vice-Chairman Co-opted (India)
Dr Ghauri Aggarwal Honorary Secretary Co-opted (Australia)
Dr R Akhileswaran Assistant Honorary Secretary Elected (Singapore)
Prof Patsy Yates Honorary Treasurer Appointed (Australia)
Mr Kwan Kam Fan Assistant Honorary Treasurer Appointed (Hong Kong)
Dr Priyadarshini Kulkarni Member Appointed (India)
Dr Maria Witjaksono Member Appointed (Indonesia)
Professor Satoru Tsuneto Member Appointed (Japan)
Dr Jeanno Park Member Appointed (Korea)
Dr Richard Lim Member Appointed (Malaysia)
Dr Yvonne Luxford Member Elected (Australia)
Dr Annie Kwok Member Elected (Hong Kong)
Professor Yoshiyuki Kizawa Member Elected (Japan)
Professor Hyun Sook Kim Member Elected (Korea)
Dr Chun-Kai Fang Member Elected (Taiwan)
Dr Sushma Bhatnagar Member Co-opted (India)
Dr Chong Poh Heng Member Co-opted (Singapore)
Dr Jun-Hua Lee Member Co-opted (Taiwan)

Chairs of APHN committees

Communications: Dr Chun-Kai Fang (Taiwan)

Education: Dr Ednin Hamzah (Malaysia)

Finance: Prof Patsy Yates (Australia)

Human Resource: Mr Kwan Kam-Fan (Hong Kong)

Membership : Dr Annie Kwok (Hong Kong)

Research: Dr Sushma Bhatnagar (India)

Chairs of APHN Special Interest Groups (SIG)

Paediatric Palliative Care: Dr Chong Poh Heng (Singapore)

Pacific Islands: Dr Sue Marsden (New Zealand)

China: Dr Rico Liu (Hong Kong)

Advisory Council (By invitation)

Chair: Prof Tetsuo Kashiwagi (Japan)

Member: Prof Enoch Lai (Taiwan)

Member: Prof Young Seon Hong (Korea)

ALL committee and groups are open for APHN members to join (except finance committee). Please feel free to email the APHN Secretariat at aphn@aphn.org or call +65 6235 5166 to indicate your interest if you will like to be part of the APHN committee or SIG!!

Asia Pacific Hospice Palliative Care Network and Palliative Care Australia : Syringe Driver Exchange Programme

With the phasing out of Graseby syringe drivers in Australia with the introduction of alternatives, significant numbers of these useful devices could be made available for palliative care services in the region.  The Asia Pacific Hospice Palliative Care Network (APHN) and  Palliative Care Australia (PCA) propose a mechanism whereby a palliative care institution (APHN Organisational Member) initiates a request to APHN by filling in the details below. Successful applicants will be informed and PCA will connect them to a donor service in Australia. This arrangement hopes to facilitate a donation of useful syringe devices across international boundaries as well as networking.

Invitation to bid – 13th Asia Pacific Hospice Conference 2019

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The APHN Council is pleased to invite member organizations wishing to host the 13th Asia Pacific Hospice Conference 2019 to send in their application to the APHN Secretariat.  Closing date for submission of application and bid documents has been extended till Friday, 31 July 2015.

Click here to download the bidding document template and the procedure for application.

Please email the bidding document to aphn@aphn.org.

Please note to send your file as “Bidding document for 13th APHC_<your organization name>”

 

1st Online forum Discussion on Paediatric Palliative Care

Poster

APHN has set up our very own online forum platform for discussion on palliative care issues. We hope the forum can serve as a contact point to link individuals involved in palliative care to foster collaboration, share knowledge and start discussions in this area. The 1st forum discussion topic will focus on Paediatric Palliative Care. The forum will be accessible for members to log in from 31 January. Click here to view the forum.

 

Palliative Care NOT included in the outcome document at first Ministerial Conference on Dementia

220515On 16 and 17 March 2015, the Worldwide Hospice Palliative Care Alliance (WHPCA) was delighted to attend the first Ministerial Conference on Dementia at the World Health Organization in Geneva.

Shocking evidence

The evidence presented at the meeting was shocking. It is estimated that 47 million people are living with dementia worldwide, 62% of whom are living in low and middle income countries.

Lack of diagnosis is a critical problem in all parts of the world but it was estimated that 90% of people with dementia in low and middle income countries go undiagnosed.

Evidence of terrible stigma, the restraining of people with dementia, the high prescription of antipsychotics and generally poor quality care was a common theme.

More than one in three people with dementia do not leave their home more than once a week and carers of people with dementia are 20% more likely to have mental health problems.

In addition, despite the huge burden and the lack of any cure or effective treatment, there is extremely low funding and attention being directed at dementia.

Information from the National Institute of Health in the US showed research funding on Alzheimer’s Disease at $566million while for cancer it sits at $5,418 million. This is despite the fact that the economic burden of dementia is huge, estimated at $604 billion globally.

Palliative care for dementia

So given this context where does palliative care fit in? The WHPCA believes that palliative care is crucial to improve the quality of life of people living with dementia and their caregivers and we issued a statement on the first technical day of the meeting which highlighted our position.

There is huge, yet unknown need of the numbers of people living with dementia who require palliative care, yet dementia is a burgeoning issue, or a ‘tidal wave’ as Margaret Chan, Executive Director of the WHO, stated.

In many ways, there were some very positive signs at the meeting that palliative care needs – including at the end of life – of people with dementia are being considered.

This was seen in the preliminary results of a scientific research prioritisation exercise by the WHO which saw ‘quality of life of people living with dementia and their caregivers’ as one of the 7 priorities of the research agenda and, importantly, end of life care and care in the later stages as one of the 10 priority avenues of research.

The Organisation for Economic Co-operation and Development (OECD), a key international player in the response to dementia, has 10 priorities for dementia, one of which is ‘people living with dementia die with dignity in the place of their choosing’.

In addition, countries such as Switzerland and Croatia particularly mentioned palliative care in their interventions and others, such as Saudi Arabia, used very familiar language including ‘adding life to years, as much as years to life’.

‘Person-centred’ discussions

Materials prepared for the conference were very person-centred including a specific hand out on person-centred care. Language throughout the conference was highly focussed on quality of life and human rights and the voice of NGOs and people living with dementia and their carers was evident throughout the meeting.

In addition, there were strong discussions about caregivers and their needs, as well as the need for coordination between health and social care systems.

However, in the call to action that was formulated and released by member states on the final day of the meeting, there was no specific reference to palliative care or end of life care. 

This was disappointing, but it is hoped that there will be a resolution on dementia in 2016 where we can work towards the strong inclusion of palliative care and end of life care for people with dementia. 

Read the full article here.

From ehospice

WHO publishes new edition of Model List of Essential Medicines

050914WHO has published the new edition of its Model List of Essential Medicines which includes “groundbreaking” new treatments for hepatitis C, a variety of cancers (including breast cancer and leukaemia) and multi-drug resistant tuberculosis (TB), among others.

According to the WHO, the move opens the way to improve access to innovative medicines that show clear clinical benefits and could have enormous public health impact globally.

“When new effective medicines emerge to safely treat serious and widespread diseases, it is vital to ensure that everyone who needs them can obtain them,” said WHO Director-General, Dr Margaret Chan. “Placing them on the WHO Essential Medicines List is a first step in that direction.”

Increasingly, governments and institutions around the world are using the WHO list to guide the development of their own essential medicines lists, because they know that every medicine listed has been vetted for efficacy, safety and quality, and that there has been a comparative cost-effectiveness evaluation with other alternatives in the same class of medicines.

The list is updated every two years by an Expert Committee, made up of recognized specialists from academia, research and the medical and pharmaceutical professions.

This year, the Committee underscored the urgent need to take action to promote equitable access and use of several new highly effective medicines, some of which are currently too costly even for high-income countries.

Dr Stephen Connor, Worldwide Hospice and Palliative Care Alliance Senior Fellow, noted the significance of the inclusion of new medicines for Hepatitis C and cancer, but said: “Five new medicines – direct acting oral antivirals – have recently come on the market transforming chronic hepatitis C from a barely manageable to a curable condition.

“The new medicines have few side effects and high tolerance in patients. All five products, including sofosbuvir and daclatasvir, were included in the List. But high prices currently make them unaffordable and thus inaccessible to most people who need them.”

The list of essential medicines for pain and palliative care has remained unchanged. Dr Connor said: “It is good to see continued support by WHO for palliative care medicines.”

Read more and access the full list on the WHO website.

From ehospice

Palliative Care Training Program in Silchar, Assam

250515Pallium India, in collaboration with the Cachar Cancer and Research Centre and with the support of International Association for the Study of Pain, organised a two-day sensitization training program in Pain and Palliative Medicine for the final year UG medical students of Silchar Government Medical College. This program was the first of its kind to be organised in the state of Assam. 87 UG students, 9 PG students, HODs of various departments, including the Principal and the Vice principal attended the program. The program was well received by the participants.

For most of the students as well as the faculty of the college, the concept of palliative care was new. At the end of the training, several students expressed interest in getting a better understanding of the practice of palliative care.

There is no palliative care service available at Silchar Medical College Hospital. Apart from one doctor, Dr.Iqbal, and two nurses, Ms. Sarita and Ms Achun, at Cachar Cancer and Research Centre, there are no trained palliative care healthcare professionals there. Dr. Iqbal, Ms. Sarita and Ms. Achun had undergone 6 weeks certificate training in palliative medicine / nursing from Trivandrum Institute of Palliative Sciences.

From Pallium India

Conflict escalation in paediatric services: Findings from a qualitative study

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An article from Media Watch, compiled and annotated by Barry R. Ashpole (Ontario, Canada). More reports can be found at IPCRC.NET

ARCHIVES OF DISEASE IN CHILDHOOD | Online – 4 May 2015 – Conflicts escalate in a predictable manner. Clearly identifiable behaviours by both clinicians and parents are defined as mild, moderate and severe. Mild describes features like the insensitive use of language and a history of unresolved conflict. Moderate involves a deterioration of trust, and a breakdown of communication and relationships. Severe marks disintegration of working relationships, characterised by behavioural changes including aggression, and a shift in focus from the child’s best interests to the conflict itself. Though conflicts may remain at one level, those which escalated tended to move sequentially from one level to the next. Understanding … [this] … provides clinicians with a practical, evidence-based framework to identify the warning signs of conflict in paediatrics.

Read the open access full text article here.

From Barry Ashpole Media Watch: 11 May 2015 (#409)

Children’s palliative care takes root in Bangladesh

210515Teaching about palliative care and pain management needs to be included in standard medical school curriculum, so that physicians can be trained to safely prescribe opioids and manage pain.

Dr Megan Doherty, a paediatric palliative care physician living and working in Dakha, Bangladesh, writes about both the encouraging developments and barriers to accessing palliative care for children in that country.
Imagine treating pain in children with advanced cancer using only paracetamol? This was the situation when I first started working on the children’s cancer ward at Bangabandhu Shiekh Mujib Medical University (BSMMU) in Dhaka, Bangladesh. BSMMU is the largest specialist pediatric oncology centre in Bangladesh, providing care to over 1000 children with cancer. Cure rates for children treated at this center are estimated to be around 50%.

Until August 2013, there was no paediatric palliative care service at this hospital, despite the significant need for these services. Recently, with the support of World Child Cancer we have started to develop paediatric palliative care services within the department of Paediatric Haematology and Oncology at BSMMU. Currently the service consists of myself (a paediatric palliative care physician) and an oncology trainee doctor. While providing clinical services, we are gathering data about the palliative care needs of children at BSMMU, in order to advocate to hospital administrators for the provision of more resources to provide these services.

Children’s palliative care in Bangladesh is in the early stages of development.  A single hospice, Ashic Foundation, located in the country’s capital, Dhaka, provides palliative care for children with cancer, but the need for children’s palliative care is overwhelming. Bangladesh has a population of 164 million, and an estimated 64 million are children. Due to a lack of awareness about the signs and symptoms of cancer and the belief that childhood cancer is not curable, many children with cancer are diagnosed very late, when curative treatment is not possible.

Sustained advocacy efforts bring some pain relief for children
A lack of access to opioids has been a significant barrier to providing palliative care in Bangladesh. When I first started working at BSMMU, it was not possible to prescribe morphine or any other strong opioids. The sustained advocacy efforts of several key palliative care physicians in Bangladesh, resulted in oral morphine becoming available. However, initially despite being available, the pharmacy at BSMMU was not allowed to dispense these medications, forcing patients to travel to another hospital on the other side of the city to actually obtain morphine. Starting last week, morphine tablets and syrup are available directly from the dispensary within the children’s cancer department at BSMMU. Finally, rapid and effective pain relief is available for children with cancer at BSMMU.

There are still many children with cancer who will not receive adequate pain control; the availability of morphine is not enough to ensure all children with pain receive adequate treatment. The majority of physicians in Bangladesh remain afraid to prescribe opioids due to widespread misconceptions about the risk of addiction. Clinicians continue to incorrectly believe that opioids should only be used in patients who are dying. Teaching about palliative care and pain management needs to be included in standard medical school curriculum, so that physicians can be trained to safely prescribe opioids and manage pain. With local partners, we are organizing training seminars, workshops and conferences across Bangladesh to educate health care providers about pediatric palliative care and pain management.

Read more such articles from the International Children’s Edition of ehospice.

From ehospice

Palliative Care as a Model of Care for All Medicine


310315By Dr Jeremy Lim

Summary of talk by: APHN volunteer, Ng Shi Hui

In his presentation, Dr Lim sought to explain why he felt palliative care should be used as a model of care for all medicine, including topics such as the future of palliative care in view of Singapore’s growing silver population.

Palliative care, although only recognized as a sub-specialty in Singapore, is slowly coming of age with stronger government and provider support. There is a growing awareness amongst the population of the necessity of palliative care as a greater proportion of the general population age. Mr Lee Kwan Yew’s recent passing has also highlighted the Advanced Medical Directive policy, throwing into the spotlight once again the value of dying according to one’s own terms. Dr Lim therefore questioned the eventual destination of palliative care – do we wish for palliative care to become a ‘mainstream’ specialty, or does palliative care have the potential to achieve more than that?

Regarding the future of palliative care, Dr Lim felt there were two points that had to be brought into perspective. First is the evolution of medical specialization over the years. Medical specialization originated with the development of medicine, when doctors felt that the greatly expanding body of medical knowledge was becoming too large for a single doctor to master. Furthermore, it was such that many patients often suffered from similar conditions, creating a population of like patients who will be better served by a group of doctors with particular strengths in a certain areas. Vertical specialization was hence introduced and encouraged, where doctors could learn specific knowledge associated to a particular field, allowing them to better serve the population.

While such vertical specialization promotes efficiency and brings about better patient care, horizontal specialization was as a result neglected. It became such that patient care was compartmentalized, and patients facing multiple conditions had to see multiple doctors; each doctor only helped with a specific condition. In such cases, vertical specialization has become increasingly unsustainable. Locally, many patients suffer multiple chronic diseases; it is unpleasant and inconvenient for patients to have to see multiple doctors, and results in wastage in the medical industry. Furthermore, Singapore’s population pool of 5 million is small in comparison to those of large countries such as the United States of America. It is therefore not feasible to train super specialists, where doctors have a large enough patient pool to afford to perform similar operations and treat similar conditions. Locally, doctors with greater breadth are required, in part due to the propensity to see multiple chronic diseases in patients, as well as our small population pool. Dr Lim also further emphasizes this with an example drawn from the 2003 SARS incident, where a general surgery team was quarantined and surgeons specializing in other areas were required to take their place. It was very imperative at that point that these surgeons had the breadth of skills and knowledge required to continue ensuring that patients were being treated in due time. This shows how in Singapore, greater horizontal specialization in the field of medicine should be encouraged.

Secondly, Dr Lim felt that the palliative care paradigm has to be addressed. Currently, medicine has developed a very reductionist model – it is about finding a solution to a problem; a cure to a condition. Such is a very linear way of approaching medicine, and it does not consider the fact that in this era of many diseases, there usually is more than a single cure to a condition. Dr Lim proposes the interpretive model, where doctors seek to earn patients’ trust and know their values, eventually accepting, such as in many cases of palliative care, that there is no war against dying. Dying is instead seen as part and parcel of life, with patient-centric care underlying all medical treatment.

From these two points, one can see that there are diverging medical goals currently seen in Singapore. For one, super-specialization, to an extent, promotes rigorous academic pursuits and medical efficiency. The palliative care paradigm, however, focuses greatly on patient-centric care, and may in certain instances run counter to the concept of ‘curing’ patients, which many associate to efficiency.

A change is therefore required, and Dr Lim feels that the model of ‘knowledge, attitude, practice’ is insufficient and simplistic in such a case. He refers to the seed and soil analogy, where the seed refers to a doctor’s personal skill and mindset, and where the soil is an enabling environment and an awareness of global changes. The professional community needs to be clear about the direction of palliative care, specifically in which way one would collectively like it to lead. Dr Lim feels that healthcare professionals working in the field of palliative care need to decide on how much of palliative care consists of specialist knowledge and skills, vis a vis a philosophy of care. It is only then can appropriate strategies be implemented to embed palliative care principles in medicine and healthcare, furthering the medical industry as a whole, as well as the specialist development of palliative care.

Palliative care in South Asia: A systematic review of the evidence for care models, interventions, and outcomes

An article from Media Watch, compiled and annotated by Barry R. Ashpole (Ontario, Canada). More reports can be found at IPCRC.NET

130515BMC Research Notes | Online 30 April 2015 – The increasing incidence of cancer and chronic diseases in South Asia has created a growing public health and clinical need for palliative care in the region. As an emerging discipline with increasing coverage, palliative care must be guided by evidence. In order to appraise the state of the science and inform policy and best practice in South Asia this study aimed to systematically review the evidence for palliative care models, interventions, and outcomes. The search identified only 16 articles, reporting a small range of services. The 16 articles identified India as having greatest number of papers within South Asia, largely focused in the state of Kerala. Nepal and Pakistan reported a single study each, with nothing from Bhutan, Afghanistan, Maldives or Bangladesh. Despite the large population of South Asia, the authors found only 4 studies reporting intervention outcomes, with the remaining reporting service descriptions. The dearth of evidence in terms of palliative care outcomes, and the lack of data from beyond India, highlight the urgent need for greater research investment and activity to guide the development of feasible, acceptable, appropriate and effective palliative care services. There is some evidence that suggests implementation of successful and well-developed community based models of palliative care may be replicated in other resource limited settings.

Read the full text article here.

Nurses successfully complete Basic Certificate palliative care training programme at Khon Kaen, Thailand

1205015Nurses from every region of Thailand last month completed the sixth Basic Certificate Course in Palliative for Nursing (BCCPN), a six-week training programme supported by Thai Palliative Care Society (THAPS) and Thai Health Promotion Foundation.

The alumni will go back to their respective hospitals, furthering their care for those who are in need.Hopefully, more patients will have a better palliative care service from these pioneers. So far, there are 86 nurses across the country that have completed the course.

The BCCPN programme was launched in 2011, with the collaboration between Karunrak Palliative Care Centre, Khon Kaen, Thailand, and the Institute of Palliative Medicine, Calicut, India.

The objectives of this course are to give fundamental knowledge in palliative care for the delegates. Alongside Associate Professor Dr Srivieng Pairojkul, the current president of THAPS, Dr Suresh Kumar from the Institute of Palliative Medicine is also a recurring lecturer and has helped in facilitating the course throughout its existence.

The delegates started their course with intensive lectures, covering palliative care issues such as symptoms assessment and management, communication skills, ethical issues, legal issues, psychosocial issues, and referral systems.

They will further their training by working with patients at Srinagarind hospital, Khon Kaen, Thailand.

During the last week of the course, they will be evaluated in every aspect of their skills through case presentations and a final examination.

So far the feedback has been overwhelmingly positive. Three major positive themes are that course participants felt that they could improve their skills and their knowledge, and also expand their palliative care networks – a crucial factor for sustainable work.

Some delegates reflected that they could benefit more if the course were extended into eight weeks.

The next BCCPN course will be held this May.

Apart from BCCPN, Karunrak Centre also provides courses such as Palliative Care for Pharmacists, and many more.

Visit the Thai Palliative Care Society website to find out more.

From ehospice

Hospis Malaysia Foundation Workshop in Palliative Care

Hospis Malaysia23 – 26 May 2015 @ Hospis Malaysia, Kuala Lumpur

This four (4) day Foundation Workshop in palliative care will provide clinicians, senior nurses and other allied healthcare providers a general overview of palliative care. Topics like clinical assessment, communication skills and clinical management will be covered. Teaching is done in small groups with hands-on training, case studies, role plays and patient interactions instead of the didactic lectures used in most teaching settings.

The facilitators of this workshop are Dr Rebecca Coles-Gale (Clinical Health Psychology, Battle Health Centre, Telham House UNITED KINGDOM), Dr Tan Eve Lyn (Physician, Palliative Medicine, Liverpool Hospital, Sydney, AUSTRALIA), Dr Ednin Hamzah (Vice Chairman, APHN, CEO / Medical Director, Hospis Malaysia), Dr Sylvia Mc Carthy (Deputy Medical Director, Hospis Malaysia), Dr Chong Lee Ai (Palliative Care Doctor, Hospis Malaysia) and Dr Lim Zee Nee (Palliative Care Doctor, Hospis Malaysia).

All APHN inidivdual members will be entitled to a discounted rate. Click here to download the program information.

For registration instructions, please visit the Hospis Malaysia website here.

Mortal shell and mortal lessons: reflections from the passing of Thai Buddhist monk, Venerable Khamkhian

080515Venerable Khamkhian, one of the most respected Buddhist monks in Thailand, passed away peacefully at his temple last August due to Oesophageal cancer. Ekkapop Sittiwantana of the Buddhika Foundation and Tharin PHenwan, MD, reflect on what we can learn from the way he handled his death.

In most circumstances, famous monks in Thailand are given the most aggressive treatment that their local hospital could offer, usually against their own will. This is because, as venerated members of Thai society, they mostly have privileged access to advanced care at the hospitals, and their disciples also want them to ‘live’ as long as possible.

However, Ven. Khamkhian had successfully overcome this fate and could pass away as he had wished, peacefully and consciously, at his temple.

This led to other questions, such as: “How could he achieve a peaceful death?” and “What can we learn from it?”

Following his death, more than 200 people joined in a forum held by Thai Palliative Care Society (THAPS) and Buddhika Foundation. The main objective of this meeting was to announce his passing and discuss what we have learnt from it. Buddhist monks and doctors who took care of him also partook as well.

From the discussion, key contributions which lead to Ven. Khamkhian’s peaceful passing are:

Good attitude towards death

Ven. Khamkhian himself regularly practiced mindfulness, making him fully aware the very nature of life. One of his teachings was to be “free from self and attachment”. It teaches us about how all things in nature change over time. This means that all things and phenomenon in nature – living and non-living – are all ephemeral and will eventually succumb to nothingness at the end. Hence; there is no him, me, pain, cancer, etc. Therefore there is no need to feel attached to those things because they will eventually become nothing.

From this mentality, he could cope with his cancer and upcoming end very well. He also lived up to his teaching by refusing any unnecessary advance treatment that would prove futile and decided to stay at his temple among his disciples where he felt belonged.

Written, clear Advance Directive

Ven. Khamkhian had completed his advance directive a long time before his passing. He clearly stated in his living will that he:

  • Would not want unnecessary treatment that would only prolong his life; and
  • Wished to stay and pass away at his temple.

He also instructed his followers as to how to prepare his body, as well as specifying the requisite tools for the ceremony after he had gone. The healthcare team and his disciples who also acted as his carers were all fully aware of his wishes and humbly accepted these.

Large multidisciplinary team with good communication skills

His followers, Buddhist monks and laymen, volunteers and health care team, had pledged themselves to take care of their master during his time of need. Apart from taking care of the basic needs and medical care, they also screened other faithful pilgrims that hailed from various places just to see Ven. Khamkhian one last time. They also gave a clear explanation regarding his condition to the non-stop arrival of the faithful ones and had to take turns in a small team to prevent burnout from taking its toll.

Access to palliative care in the community

Ven. Khamkhian’s temple in Chaiyapum district has a good access to a hospital which provides palliative care services. The team at the hospital also has good palliative care knowledge and does community visits. These factors enabled Ven. Khamkhian to stay at his temple while receiving adequate care all the time.

Even though Ven. Khamkhian has already left his mortal shell, he has imparted the very mortal lessons to us all: how we live is how we die; how being mindful and accepting is a factor in reaching a ‘good death’; how palliative care – a growing and much needed trend in Thailand – respects people’s lives and answers their wishes.

Find out more about The Buddhika Foundation’s Peaceful Death Project and THAPS online.

From ehospice

China – Launch of central government supported social service project

The 2015 Launching of the Chinese Social Work Education Association’s Hospice Care Demonstration Project—A Central Government supported Social Service Project

Translated by: APHN News Team (China) – Shen Yue
Edited by: APHN Volunteer, Djin Lai

070515On March 7,2015, the launching ceremony and training meeting of the National Hospice Service project was held in Jiangxi University of Finance and Economics (JUFE). The event was hosted by the Chinese Social Work Education Association and the Li Ka Shing Foundation” Heart of Gold” National Hospice Service Program. Dr. Luo Minjie, the director of the Li Ka Shing foundation’s “Heart of Gold” National Hospice Service Program; Professor Shi Bonian, vice-chairman of Chinese Social Educational Association; Jue Shandong, assistant to the president of JUFE; Xie Kuaisheng, deputy director of Jiangxi Provincial Civil Affairs Department of Social Work; and Professor Wu Yinsheng, honorary president and consultant of first affiliated hospital of Nanchang University Hospice were among some of the esteemed attendees who spoke at the meeting. Yin Zhonghai, the vice-president of JUFE’s humanities school hosted the meeting. During the launching ceremony and training meeting, universities’ specialist social work groups and hospice social-workers talked about the service experience, the service’s details, and they learned the methods of hospice care in an impassioned atmosphere, leading to the successful foundation of the project implementation.

The project aims at supplying specialist social work service to patients and families of patients with terminal cancer who live in poverty, with the direct aims of relieving the pressures caused by facing death and imminent separation from loved ones, improving the quality of life and “the quality of death”, and promoting peace of mind for patients and families. In the long-term, the project also develops valuable palliative social work experiences, establishes a medical social work personnel, and outlines principles of professionalism. The project also serves to build bridges between doctors and patients, reduce doctor-patient conflicts, promote the establishment of social work service and positions among medical units, and increase the awareness of palliative service among the general public. In addition, it embodies the concept of holistic care, and creates a social atmosphere for the development of medical social work.

The demonstration project includes 16 large hospitals and engages 16 community service personnel in each of the provinces (municipalities). Community service personnel are volunteer faculty and students from the provinces’ universities who commit to undertaking the hospice program in the hospital setting, in which they will supply specialist social work services to poor terminal cancer patients and their families. Chongqing, Gansu, Guizhou, Hebei, Heilongjiang, Henan, Hunan, Jilin, Jiangxi, Liaoning, Ningxia, Qinghai, Sichuan, Shanxi, Shanxi, and Xinjiang are among some of the provinces participating and involves approximately 9,400 volunteer hours.

The hospice project received strong support from the central government for the social service demonstration project in 2015, which was managed by Ministry of Civil Affairs Authority, a civil society organization. This project was also supported by matching funds by the Heart of Gold National Hospice Service Program, and was specifically implemented by the Chinese Social Work Education Association.

The National Hospice Service project reflects the modern medical model that supports the well-being of both the mind and body of the people. The project also introduces the role of the medical social work specialist which can promote the standardization of hospice social work service, and the establish of professional system. Besides the demonstration of feasibility, the project also projects a vision of the future medical social work model in hospice care.

From Li Ka Shing Foundation Newsletter