Palliative care: financial catastrophe avoided?

Impoverishing health expenditure

A World Health Organization and World Bank Group report shows that 6% of the population, across 37 countries, was tipped or pushed further into extreme poverty because they had to pay for health services out of their own pockets. When the study factored in a poverty measure of $2/day, 17% of people in these countries were impoverished, or further impoverished, by health expenses.

Read the full article here.

How palliative care helps families avoid financial catastrophe?

In the face of a life-threatening disease, what are you thinking of? The acute pain from the disease, the high costs of the treatment, the financial strain the treatment will cause to your family? A financial catastrophe can be avoided when one knows the realities of the situation. The huge debts which may have been incurred from the extensive treatments, will leave most families struggling financially. Instead of pursuing futile treatments, pain relief and symptom control are administered to let the patients feel better.

What is palliative care?

Palliative Care aims to improve the quality of life of a patient facing a life-threatening illness and his family. It is an approach of addressing the physical, emotional and spiritual needs and practical concerns of patients. Palliative care also emphasises on pain relief and symptom control, and through that, increases the quality of life for both the patients and care-givers.

 “No one should die alone… each human should die with the sight of a loving face.” – Mother Teresa

Five more days to APHN-LCPC movie Life Asked Death Online Premiere


The Lien Collaborative is a project by the Asia Pacific Hospice Palliative Care Network (APHN) and Lien Foundation to enhance palliative care leadership and capacity in developing countries.

New palliative care services have been started at key government hospitals and cancer centres in Bangladesh, Myanmar and Sri Lanka by participants of the Lien Collaborative.We turned the camera on the remarkable work being undertaken by the International teams and local stakeholders from this initiative.The result is Life Asked Death, a breathtaking documentary film that delves into the world of building palliative care capabilities in Asia.

On 8 October 2016, in conjunction with World Hospice and Palliative Care Day, Life Asked Death will premiere in a free Global Event at

Watch the Life Asked Death trailer now and spread the word about the release of this important film!!



LCPC Myanmar Module 6: It is not the last …………….. It is the beginning

Written by: Dr Wah Wah Myint Zu, Radiation Oncologist, Radiotherapy Department, Yangon General Hospital, Myanmar


Our last module of the Training-of-Trainers in Palliative Care Program for Myanmar is from 11.1.16 to 15.1.16.

It is quite a coincidence!

When we have the very first day of our 6th and last module in Yangon General Hospital, there was also the National Seminar on Comprehensive Oncology Services held at Nay Pyi Daw on 11 Jan 2016. This National Cancer Forum is attended by all  the admin person and policy maker from Ministry of Health, almost all the radiation oncologists and medical oncologists from both government and private hospitals, Academic Institutions involved in training the health professionals, NGO like Shwe Yaung Hnin Si Cancer foundation etc . The Chairperson of APHN and Lead faculty of the Lien Collaborative for Palliative Care project, Prof Cynthia Goh, give a speech on the  Implementation of Palliative Care in Cancer Service. We heard a good news that all the attendee are very much interest in Palliative care and they appreciate the hard work and enthusiasm of APHN for the establishment of Palliative care Service in Myanmar.  The meeting identified as a priority the setting up of Palliative Care services as part of Comprehensive Oncology Services in Myanmar. In addition, the World Health Organisation has identified the setting up of Palliative Care services as part of Universal Health Coverage and Non-Communicable Disease (NCD) management.

At training center, Yangon General Hospital,all the faculty members and the trainee are excited .and active since the very first day. We are thrilled to share knowledge and experience of our palliative practice within previous six months to the faculty members and each other.

During the last module of training of trainers, faculty members encourage and teach us the different methods of teaching like lectures, case-based discussions, large group and small group teaching and usage of role play. I think this is a good topic for the trainees who will become trainers in near future. We also discussed about spiritual care, spirituality, self-care and the ethical dilemma. Our faculty members cover a wide range of Palliative care topics and also revise about many important issues in Palliative care like Difficult Pain, wound care, colostomy care, communication etc. Dr Aye Aye Naing and I shared our learning and experience from the fellowship training program in Division of Palliative Medicine, National Cancer Center of Singapore as part of the Lien Collaborative for Palliative Care project. All the participants are interested to hear about the Palliative care service in Singapore.


Prof Cynthia Goh said that the faculty members are like parents who are excited but concerned for their offspring who will now start to fly out from their nest but they know their children will be fine as their kids are well equipped and trained and parents are always there to support them. These warm words make us teary and touched our hearts.

Professor Myint Thaung , Head and Professor of Orthopedic surgical department and President of Myanmar chapter in ISEAPs, said that he will fully support the establishment of Palliative care service and Palliative care education and encourage us  to try our best in serving our patients with Palliative care.


Upon thanking notes, I said we owe the deep sense of gratitude to the Prof Myint Thaung, Prof Cynthia Goh, all the faculty members and APHN for the difference made by Palliative care TOT program during three years training .We are changed by the knowledge of the value added Palliative care and we want to give Holistic and interdisciplinary Palliative care approach to our patients to promote their quality of life. We also want to share that precious knowledge and experience to all our health care personnel and so we are interested in palliative care education.

With deep sense of gratitude, we give our remarkable Myanmar traditional souvenirs to all the faculty members and project manager of APHN .The last module of TOT program is successfully concluded by proudly awarding the completion certificates to all the participants.


Although the training is the last module, I think it is the beginning of our Palliative journey. All the participants are excited and thrilled to have empowerment and dedicated for trying our best in establishing Palliative care service in our own hospitals.


Palliative Care Clinic starts in National Cancer Institute, Maharagama, Sri Lanka

Written by: APHN Editorial Team – Sri Lanka (Cancer Care Association, Sri Lanka)

This is a write up on the inauguration of  the Palliative Care Consultative Service & Palliative Care Clinic at the National Cancer Institute, Maharagama (NCIM).

Initial Discussions and Preparations


After the third module of the LIEN Collaborative for Palliative Care Training of Trainers program held in collaboration with the National Cancer Institute Sri Lanka (NCI), National Cancer Control Program Sri Lanka (NCCP) and the Asia Pacific Hospice Palliative Care Network (APHN) held at the NCIM, the participants of the program commenced discussions to establish a Palliative Care Consultative & Palliative Care Clinic at the NCIM.

The articipants of the Training of Trainers Program from NCIM are, Dr Sujeeva Weerasingha, Dr Prasad Abeysinghe, Dr Kanthi Perera, Dr N. Jayakumaran, Dr Lakshman Obeysekara, Dr Sanath Wanigasooriya, Dr Mahanada Udukala , Dr  A. Parthiepan, Dr Samadhi Rajapaksa, Dr Sidath Wijesekara, Dr Ranjan Vidanage, N/O (Nursing Officer) Samindra Ranasinghe, N/O Priyanka kasthuriarachchi, N/O Nirosha Herath.

There was an initial discussion among the resource personnel held at the NCIM counseling center to ensure a wholesome approach towards the initiative. The staff of the NCIM who were supporting the initial preparations were the Director, Consultant Anesthetists NCI, Consultant Physicians NCI, all Other Consultants NCI, Medical Officer (MO) –Nutrition NCI, the speech therapist, counseling Unit, other nursing staff. The staff of Shantha Sevana Hospice also supported the initiative during this stage.


After the discussions held during the initial gatherings, a final discussion was held with the Director, NCIM, Dr. G. Wijesooriya, where procedures and logistics for the establishment and the operations of the Palliative Care Consultative & Palliative Care (PC) Clinic was finalized. The consultant oncologist Dr. Sujeeva Weerasinghe was elected as the Team Lead of the Palliative Care team at the NCIM. The imperative points discussed were as follows:

  • How to establish a PC clinic, PC Unit & other PC facilities
  • To have an internal circular among the Consultants of NCI, regarding PC facilities available at the NCI
  • Circulate the referral form for the PC clinic to all Consultants & Medical Officers (MOs) at NCI and to get them familiarize with the form
  • Circulate an article about Palliative Medicine among MOs of the NCIM
  • Drafted a letter of request to the director NHSL, to get Dr. Hemantha Kumarihami (Consultant Anesthetist) and her team for consultation on Pain Management at the PC clinic
  • Conduct palliative care teaching sessions for the MOs/NOs at NCIM

The Commencement of the Service.


After many rounds of discussions and preparation, the Palliative Care Consultative & Palliative Care Clinic at the NCIM was finally established on 25th August 2015 in Room No. 119 of the NCIM. The unit will be under the leadership of Dr. Sujeeva Weerasinghe. Consultation and registration of the first patient was also done by her as a mark to the opening of the unit.

The first activity of the unit was a visit to the Shantha Sevana Hospice, where most patients will be referred to. It is situated near the NCIM. Dr. G. Wijesooriya (Director, NCI), Dr. Ishani Fernando (Director, NCCP) and other attendees of the Master Trainer program graced this visitation trip.


After the hospice visit, a week long training session on palliative care was conducted by the unit at the NCIM with the participation of 43 doctors, in order to raise awareness about the importance of palliative care to the medical community. During this training session, the attendees were taught the following:

  • To act as a team leader to provide palliative care in each clinical team /unit/ward under each consultant.
  • To arrange referral to the PC clinic through the consultant in charge
  • How to properly disseminate information across departments using the PC referral form.
  • How to co-ordinate and assist with the work at the PC clinic.
  • Active management of all symptomatic patients with help of other team members to improve the quality of life of each patient
  • How to improve awareness of the concept of palliative care among colleagues and co- workers
  • To continuously update their knowledge in palliative care


This start of this clinic in Sri Lanka’s National Cancer Institute marked an important milestone in the palliative care movement in Sri Lanka. The APHN will also like to congratulate the team for their achievement in setting up the clinic.

Palliative Medicine accepted as a medical specialty in Bangladesh

The University of Bangabandhu Shekh Mujib Medical University (BSMMU) Dhaka in Bangladesh has recently approved the proposal for medical residency programme in Palliative Medicine. This approval was preceded by approvals of the surgical faculty which took the initiative to draft the curriculum. This is an important milestone for the country, as the approval confirms that that palliative medicine has become a recognised specialty in Bangladesh.

Prof Dr Nezamuddin Ahmad from Bangladesh is pleased with this outcome and on behalf of the Univesity she would like to thank everyone for their suggestions and active participation in the development of this curriculum for the medical residency programme in Palliative Medicine. A special thank you is dedicated to the three workshops organized in April, September and December of 2013 with the support of the Higher Education Quality Enhancement Program (HEQEP) of the University Grant Commission (UGC) which greatly helped the development of the curriculum. The valuable suggestions and active participation drafting the curriculum by the attendees greatly helped us complete this task today. The University would like to sincerely thank all of those who participated and contributed to achieving this milestone.

On behalf of the Centre for Palliative Care, the University of Bangabandhu Shekh Mujib Medical University Dhaka look forward to your continued support in the future and  welcoming the first set of M. D Residents in Palliative Medicine.

The ehospice has also published an article on the Palliative Medicine Residency in Bangladesh. In the article, Prof Dr Nezamuddin Ahmad also mentioned that this will be a “turning point for palliative care in Bangladesh”.

The exerpt below originally appeared on ehospice article “WHPCA partner celebrates new Palliative Medicine residency in Bangladesh”


“Specialty recognition can be seen as a turning point in the evolution of the palliative care movement of a country. A residency program will allow us to develop a core group of specialists with expertise in palliative care in Bangladesh. This will raise the profile and awareness among physicians about palliative medicine as an emerging and vital discipline.

Additionally, it is estimated that 600 000 patients in Bangladesh require palliative care at any point in time, so there is an urgent need to train more health care professionals in this field.

These specialists will be the leaders, mentors and trainers for the large number of nurses, support workers and other health care providers who are needed to care for this large number of patients. Besides, this should have an overall impact on other spheres of palliative care development.” more

Quality of Death Index 2015 Released – Need for palliative care outstrips services

QODThe Quality of Death Index, commissioned by the Lien Foundation, a Singaporean philanthropic organisation, is based on extensive research and interviews with over 120 palliative care experts from across the world.

It shows that in general, income levels are a strong indicator of the availability and quality of palliative care, with wealthy countries clustered at the top. The UK is top of the list, as it was in the previous index released in 2010. Australia and New Zealand take second and third place, as they did in 2010, while rich European and Asian countries dominate the top 20, along with the US in ninth place and Canada in 11th.

As expected, many developing countries are still unable to provide basic pain management due to limitations in staff and basic infrastructure. Yet some countries with lower income levels demonstrate the power of innovation and individual initiative.

For example, Panama (31st) is building palliative care into its primary care services, Mongolia (28th) has seen rapid growth in hospice facilities and teaching programmes, and Uganda (35th) has made huge advances in the availability of opioid painkillers.

For the first time The EIU has also compared the supply of palliative care – as revealed in the Index – with the demand for such care.

The demand analysis, based on countries’ demographic profiles and the burden of diseases for which palliative care is necessary, shows China to be among the most vulnerable from population ageing and the rising incidence of conditions such as cardiovascular disease, which accounted for one-third of all deaths in the country in 2012.

Many other developing countries will also need to work hard to meet rising future need as the incidence of non-communicable disease increases and their populations grow older.

David Line, the editor of the report, said: “Since the first Quality of Death Index was published this issue has certainly risen up the global agenda, as shown by the World Health Assembly resolution last year calling for improved standards of palliative care across the world.

“But much more can be done, even in countries that rank highly in the Index. It is an issue that will affect us all – a good quality of death should be regarded as a human right.”

The release of the report coincides with World Hospice and Palliative Care Day, a unified day of action organised by the Worldwide Hospice Palliative Care Alliance (WHPCA) and the International Children’s Palliative Care Network (ICPCN) to raise awareness of the need for hospice and palliative care worldwide.

Dr Stephen R Connor, WHPCA Senior Fellow, said: “This new report, released ahead of World Hospice and Palliative Care Day, will help highlight the enormous work that still needs to be done to bring palliative care especially to low and middle income countries where lack of education on palliative care, lack of essential medicines, and lack of government support continue to lead to unnecessary suffering.”

The report can be accessed at Besides the full report, it includes bite-sized country profiles and infographics.

Please feel free to share the findings with your stakeholders to further our collective goal of improving palliative care for communities around the world.

Lien Collaborative for Palliative Care Teaching Schedule




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Dates Country Activity
January 2015 Myanmar 4th teaching programme
June 2015 Sri Lanka 3rd teaching programme
July 2015 Myanmar 5th teaching programme
September 2015 Bangladesh 3th teaching programme
January 2016 Myanmar 6th teaching programme
February 2016 Sri Lanka 4th teaching programme
March 2016 Bangladesh 4th teaching programme

Overseas Clinical Attachment program

The inaugural program commences September. Two doctor participants from Myanmar are scheduled to visit Singapore for 3 months, hosted by the Department of Palliative Medicine, National Cancer Centre Singapore. It is envisioned that this program will sharpen their palliative skills and broaden their perspectives through experiencing different care settings.

Please continue to follow us on our website on the latest updates on the Lien Collaborative.

Members who are interest to help us as teaching faculty during this period, kindly email us at or call +65 6235 5166 to find out more.

Palliative Care service starts in Myanmar

By Dr Wah Wah Myint Zu, Palliative Care Clinic, Yangon General Hospital

13 August 2015 was the opening ceremony of the first Palliative Care Clinic in Myanmar, based at the main general hospital, Yangon General Hospital (YGH). I have been so busy and tired with the preparations. But seeing that the opening ceremony was successful, it feels like all my tiredness was gone and I feel refreshed again! I am so excited and looking forward to giving value added Palliative care service to our patients!!

Our multidisciplinary palliative care team comprises of all the participants from YGH who attended the Lien Collaborative for Palliative Care (LCPC)  Training-of-Trainer in Palliative Care program conducted by the Asia Pacific Hospice Palliative Care Network (APHN). The doctors in the team are Dr Khin Thin Mu from the medical oncology specialty, Dr Yin Thu Win, Dr Lin Lin Kyi and myself from the radiotherapy department (RT) , Dr Soe Thant from the orthosurgical unit, Dr Soe Soe Khaing from PM&R department. May Mar Min Aung and Chaw Kalayar are the palliative care trained nurses. We also have two members, Thin Thin Soe and Thin Thin Wai from medical social work. The team will be taking care of patients using the interdisciplinary holistic care approach like symptom management, nursing care, psycho-social care and spiritual care.

I am very thankful to Prof Myint Thaung (Head of Orthopaedic Department and President of Myanmar Chapter in ASEAPS) who gave the speech at our opening ceremony. He presented on how the Palliative care training is established, about the collaboration between Lien Foundation and APHN group. He highlighted our intention of Palliative care training which is to develop champions in Palliative care service and to train other health personnel about Palliative care.

I will also like to thank Prof Khin Myo Hla (President of the Myanmar Chapter of the International Association for the Study of Pain and Head of the Rehabiliation Department) for supporting us; A/Prof Daw Khin Cho Win (Head of the Radiotherapy Department), Prof U Myo Myint Maw (Head of the Medical Oncology Department) and Prof Win Min Thit (Head of Neuro-Medical Department), consultants from our department; Dr Moe Hlaing, Dr Mie Mie Thwe, consultants from Medical Oncology Department; Dr Phyu Phyu Theint , Dr Shwe Sin Win,Dr Zun Thynn , specialist assistant surgeons and post graduate students from RT, Matron, Patron , Sisters and Staff nurses form both OPD and ward and from the Pain treatment centre, physicists from our RT department and medical social officers. They have all taken time to attend the opening ceremony in spite of their busy workload.  Last but not least, I will like to thank Ms Mona and Dr Reddy's company for helping us and those companies who sent us flowers in support of us.

As this phase of our training program is slowly drawing closer to an end, I will really miss the other palliative care participants. We have a bulletin board showing photos of our Palliative Care Training activities by the APHN, right from the first module which started in Dec 2012 to the fifth module which ended in July 2015. They showed our hardwork, role playing and team spirit building activities, group presentations and at one occasion, a remarkable relaxing dinner. Our 6th and last module will be in Jan 2016.

To all the other participants of the LCPC program, we welcome you anytime to visit our clinic and any help you offer to us will be very much appreciated.

If you are interested to find out more about the Lien Collaborative for Palliative Care or contribute articles on palliative care services in your country, please contact Joyce at or +65 6235 5166.


Lien Collaborative for Sri Lanka Module 3 of 6 – The trip report

Large group discussions
Bedside teaching in Oncology ward at National Cancer Institute, Maharagama
Group photo at Distric Hospital in Vauniya, Northern province of Sri Lanka
Visiting a ward in District Hospital, Vauvniya
Palliative Care Unit and referral centre at District Hospital, Vauvniya

Case discussion with visiting faculty

New hospice at Cheddikulam, Northern province to open in August 2015

Patients gathering at the prayer area to fold lantern wicks at Cancer Care Hospice in Kurundankulama, Anuradhapura, Northern Province

The 3rd module of the Lien Collaborative for Palliative Care – Training of Trainers in Palliative Care Programme for Sri Lanka took place from 29th June to 3rd July this year at the National Cancer Institute, Maharagama in Colombo. The faculty comprise of 4 doctors and 2 nurses from Singapore and Australia. They are Associate Professor Cynthia Goh (Project Lead), Associate Professor Ghauri Aggarwal (Country Lead), Dr Allyn Hum, Dr Suharsha Kanathigoda, Mr Joshua Cohen, and Ms Peggy Chen.

The key topics covered in the teaching included service development, care for non-cancer patients, ethical issues in palliative care, symptom management and scope of palliative care.

The teaching model consists of large group and small group discussions, lectures, case discussions and ward rounds. In addition to those, a brainstorming session on the last day was added into this module to discuss learning points of the programme and for participants to provide feedback and ask questions. Many questions were raised and everyone wished that this session could have been even longer. The participants were interested for more information on the issues facing them in providing care and to discuss the challenges when starting palliative care services in Sri Lanka.

We had the opportunity during this module to visit the newly set up hospices and palliative care services around Sri Lanka. On the 4th of July, the team went to the District Hospital in Vavuniya, located in the Northern Province of Sri Lanka. There are currently no separate palliative care unit with full time doctors and nurses in the hospital. However, one of our module participants, Dr Ranjan Mallawaarachchi, an oral and maxillofacial (OMF) surgeon at the hospital, has established a team within the OMF unit to care for patients who needs palliative care. He has also founded the Regional Association for Palliative Care – Northern Province to work on developing palliative care services in Sri Lanka.

The team also went to visit a hospice set up by Dr Ranjan and his team in Cheddikulam, the Northern province of Sri Lanka. According to Dr Ranjan, the service will open in August this year. We are all excited and looking forward to it. As palliative care is something new to many in Sri Lanka, creating awareness and trust among healthcare professionals is important to get referrals for admission to the hospice.

Another hospice which we visited is the Cancer Care Hospice. According to Dr Samadhi W.Rajapaksa, director of the Cancer Care Association, there was no doctor willing to refer their patients to the hospice until the director of a hospital was convinced by him and came personally to admit the first patient.

As the palliative landscape in Sri Lanka continues to develop, both the government and non-profit organizations are working hard to increase awareness of palliative care among the healthcare workers and members of the public. Relative to the need, there are only a few institutions providing palliative care or hospice services in the country. Palliative Care is not yet an established medical or nursing specialty in Sri Lanka.  The APHN hopes to continue to engage and support the various initiatives to strengthen the development of palliative care in Sri Lanka.

If you will like to contribute to the Lien Collaborative for Palliative Care, we welcome you to email us at and visit our website to find out more.

Sri Lanka – Training program on integrating the services of hospices for provision of community based palliative care for cancer patients.

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Dr. Samadhi Rajapaksa delivering the lecture

The above mentioned training program organized by the National Cancer Control Program of the Ministry of Health & Indigenous Medicine, Sri Lanka, with the intention of strengthening the partnership between organizations providing palliative care in Sri Lanka for further expansion of community based palliative care, was held in Shantha Sevana Hospice Colombo, on 17th March 2015.

Dr. Samadhi Rajapaksa as one of the main resource personal specializing in the development of Home Based Palliative Care in Sri Lanka, delivered a highly informative lecture addressing the importance and the value of such an initiative in uplifting palliative care in Sri Lanka. The practical challenges that arise when implementing it at ground level, was also highlighted based on the experiences the CCASL has had when conducting home visits in remote areas of Gall, Anuradhapura and Colombo. Dr. Suharsha Kanathigoda (a palliative care specialist from Sydney, Australia and also founder of the Shanti Foundation) and Dr. Suraj Perera (Consultant Community Physician) also participated in this event.

From APHN Sri Lanka News Team – Cancer Care Association of Sri Lanka


Commencement of Home Base Palliative Care Service in Colombo and Anuradhapura, Sri Lanka

Written by Cancer Care Association Sri Lanka (CCASL) – APHN Editorial Team (Sri Lanka)

In commemoration of the World Cancer Day which falls on 4th February of every year, Cancer Care Association Sri Lanka (CCASL) expanded its Home Based Palliative Care Service (HBPCS), first of its kind to treat Sri Lankan underprivileged cancer patients, to the districts of Colombo and Anuradhapura.

This service was first inaugurated in the district of Gall, in southern Sri Lanka, by the Karapitiya branch of CCASL under the guidance of Dr. Samadhi Rajapaksa (current president of CCASL) and Dr. Iresh Jayaweera (then president of the Karapitiya branch). The objective of HBPCS is to treat palliative cancer patients in the comfort of their own home and amongst loved ones.

A team of volunteers comprising of a medical doctor, a nurse and trained palliative care practitioners from CCASL visit the homes of cancer patients in need of palliative treatments, mostly in remote areas. They engage in activities such as pain management, treating cancer related wounds and bed sores, monitoring the vital signs of patients such as blood pressure, blood glucose level etc., administering relevant drugs (done by the medical practitioner accompanied by the team) and most importantly religious activities such as meditation, counseling etc., to uplift the spiritual well being of the patient (which is of utmost importance, at the palliative care stage).

Hence on 4th February 2015 (World Cancer Day), the CCASL Home Based Palliative Care team visited pre-identified patients in the districts of Colombo and Anuradhapura to inaugurate the expansion of its services to the above mentioned districts. A total of four patients were visited within two days and the patient feedback was immensely positive and highly commendable. CCASL will continue to provide similar services to the underprivileged cancer patients of Sri Lanka, in months to come.

Given below are some pictures of the event.

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Dr. Iresh Jayaweera and Dr. Samadhi Rajapaksa treating the patients









Home Base Palliative Care Team during a home visit in Anuradhapura

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Patient monitoring and counselling 

Brought to you by APHN Editorial Team (Sri Lanka) : Dr. Samadhi Rajapaksa (President, CCASL); Mr. Hasitha Premathilake (Secretary, CCASL); Dr. Iresh Jayaweera (Chief Organizer, CCASL)

Lien Collaborative builds palliative care capacity in Myanmar

IMG_2584 ver3January 2015 saw the 4th instalment of the training-of-trainers in palliative care program at Yangon General Hospital, Myanmar.

The training was implemented by a volunteer faculty of doctors and nurses from the Asia Pacific Hospice Palliative Care Network (APHN) coming from Australia, Malaysia and Singapore.

As part of the Lien Collaborative for Palliative Care initiative, the program aims to develop palliative care leadership and capacity in the mainstream government health system.

Small group discussions, case-based learning and teaching on the wards by interacting with patients featured prominently throughout the teaching week.

The in-country training is complemented by overseas clinical attachments for selected participants. This is planned to start from September 2015, with the first batch visiting Singapore for a 3 month-long attachment which aims to enhance each recipient’s understanding of running a palliative care service as well as clinical skills.

The APHN team also supports its local partners, such as the Myanmar Medical Association (MMA) in their efforts to engage the Health Ministry.

This advocacy is aimed at better access to essential pain medications, the introduction of palliative medicine into the medical and nursing curriculum, and the establishment of palliative care services at the principal tertiary hospitals.

The MMA has just ratified the creation of a Palliative Medicine special interest group to advance the development of this area of healthcare in Myanmar, including the intention for this group to spearhead the formation of a national strategy for palliative care.

Local media organisations have also been helpful in raising the awareness of hospice and palliative care, read this related article by Mizzima Media.

The Lien Collaborative is also active in Bangladesh and Sri Lanka with several more in-country training programs scheduled over the course of the year.

If you or your organisation would like to be a partner in the Lien Collaborative, please contact the APHN at

From ehospice