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 aphn@aphn.org and visit our website http://aphn.org/lien-collaborative-for-palliative-care/ to find out more.

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