Lao PDR is a lower middle income group country with 7.1 million population in 2019. It is located in Indochinese Peninsula and is bordered by Myanmar, China, Vietnam, Cambodia, and Thailand. Lao’s healthcare facility has many challenges, the majority of facilities are located in the capital city (Vientiane) and urban centers. Access to healthcare, medical technology, CT scan and cancer diagnostic tests are limited. The health facilities are very crowded and have insufficient equipment to meet the demand. The total number of deaths in 2014 was 46,000 with 4900 deaths resulting from cancer.
The country has no radiotherapy center, chemotherapy is rarely available. Most of the cancer patients visited the hospital at a late stage and only 20% of cases could afford the first dose of chemotherapy, so they need palliation. Palliative care (PC) services need to be established to relieve patients’ suffering. Currently, there is no PC in the country and oral immediate-released morphine is not available.
Karunruk Palliative Care Center (KPC), Srinagarind Hospital, Faculty of Medicine, Khon Kaen University collaborated with between Asia Pacific Hospice Palliative Care Network(APHN), Department of Healthcare and Rehabilitation (DHR), Ministry of Health Lao PDR to organize “Developing Palliative Care Services in Lao PDR” project. The first milestone event was the “First Lao national palliative care conference” on February 20-21, 2023.
Conference topics included; PC in the Asia Pacific Region, WHO public health model for PC, Integrating PC into primary care by dr. Ednin Hamzah, Chair of APHN, Needs of Palliative Care in Lao PDR. by dr. Alongkone Phengsavanh, Vice Dean, of Lao Medical Faculty, Network of PC in Thailand; a prototype drive-by education, Opioid availability, how important? by dr. Srivieng Pairojkul, KPC, Symptom management of palliative patients, Communication in PC by dr. Attakorn Raksasataya, KPC, Managing sufferings: Psychosocial, spiritual and bereavement care by ms. Natchaya Bualakorn, KPC, Advance care planning: what, why, when? by dr. Srivieng Pairojkul, ms. Chalermsri Sorasit, KPC and Next steps for integrating PC service in Lao PDR. by dr. Khamsay Detleuxay, Director-General, Department of Healthcare and Rehabilitation (DHR), Ministry of Health, Lao PDR.
The overall response of the conference was very good, with more than 200 participants; 72% doctors, 11% nurses, 3% pharmacists, and 14% are not specific. More than 85% of the participants rated every conference topic from good to excellent. For the conference evaluation, participants rated good to excellent >90% for session topics, >80% for conference material, an opportunity to network, registration process, and 78.6% for venue, food and beverages. After action review found >90% of participants agree that they became interested in PC, prefer to attend the next PC conference, prefer to train PC further at the hospital level, acknowledge the importance of PC systems in hospitals, wish to have a responsible organization that takes care of the PC and integrates PC into physician and nurse curriculums.
The next activity of this project is an eight week Basic Certificate Course in Palliative Care (BCCPC) for 10 Lao doctors and 10 Lao nurses. This course, supported by the Lien Collaborative for Palliative Care Programme (Lien Collab), will start on 17 April at KPC, Khon Kaen, Thailand 200 kilometers from Vientiane.
We are looking forward to seeing an elegant palliative care development in Lao PDR.
Written by: Dr Attakorn Rakasasataya