Reports from IAHPC Traveling Scholars: Lebanon, Egypt, Russia, and Albania

From Lebanon

I would like to thank IAHPC for providing support for my travel to the EAPC Congress in Vienna. As a family physician looking to enter the field of palliative care, I have much to learn. I have been trying to figure out what my needs are for additional training and the best ways to access the training. I have also been trying to determine the best course of action for developing palliative care in Lebanon. The EAPC meeting in Vienna exposed me to people working in palliative care in a variety of settings. Exposure to their experiences and the programs they are developing gave me many ideas about how to move forward in my own setting.

Based on the many things that I learned during the EAPC meeting, I have developed a plan of action related to my roles as a physician, a faculty member, and a researcher.

Clinical practice: I have been working with a number of non-medical people who are interested in developing a home-based hospice service. We are establishing an NGO that will provide hospice services and will work on changing the restrictive morphine laws in our country. The conference provided me the opportunity to clarify where to seek funding for our NGO, what we should consider when developing the structure of the organization, how we should reach out to the public, and it pointed out the value of twinning with other hospices. We are using this information as we develop the organizational structure.

Capacity building: Currently in Lebanon, we don’t have any physicians who have specialized training in palliative care. One of the most important barriers to develop palliative care in the country will be to find and train physicians to provide this care. I attended a session on primary palliative care where the presenters argued that the primary care physician can deliver good palliative care given the proper tools and education. I believe this is a wonderful approach and quite feasible in our setting. I have already approached the Lebanese Society of Family Medicine to discuss the possibility of making palliative care the focus of their annual meeting in 2010 - their response has been very encouraging. This could be an important step in getting more family physicians comfortable with the principles and practice of good palliative care.

The conference also exposed me to several courses that can be additional sources for training of myself, or others, such as the Multiprofessional Week at St. Christopher’s Hospice, the Liverpool Care Pathway’s course and others.

Medical education: There were several presentations about integrating palliative care into medical education. I am on faculty at the American University of Beirut which graduates about 80 medical students each year. I also teach in the Family Medicine residency program. The information I gained through this conference has given me many new ideas about how to introduce students and residents to palliative care. As a first step, I plan to offer a lecture on palliative care for the fourth year medical students. In the future, I hope to experiment with some of the teaching techniques that were mentioned in the conference such as the “goldfish bowl”, and writing parallel notes in patient’s charts that address the patient’s experience with their illness.

Advocacy: I learned about organizations that are working on advocating for paons, oral presentations and workshops. I learned a great deal from listening to othin and palliative care as human rights and the different initiatives that have helped change morphine laws. I hope to work on developing these connections in order to change the morphine laws in Lebanon.

The scholarship program worked very well for me. The prospect of developing palliative care in a setting where it doesn’t exist can be extremely overwhelming. The lack of human and financial resources, lack of knowledge about palliative care, and the current morphine laws are only some of the barriers that we will have to overcome. Attending the EAPC meeting allowed me to network with people who have worked in palliative care for many years. They shared their experiences, successes and challenges in informal discussions, poster presentations, oral presentations and workshops. I learned a great deal from listening to others who shared their experiences and I hope to put this new knowledge to good use in my country.

The conference was also a great opportunity to network. I have made connections with wonderful people who I feel I can turn to for support and guidance. This makes the prospect of developing a new program in palliative care much less daunting.

Thank you for giving me this opportunity.

Hibah Osman, MD, MPH
Assistant Professor of Family Medicine
Department of Family Medicine
Assistant Professor of Public Health
Department of Health Behavior and Education
American University of Beirut
Beirut, Lebanon

From Egypt

I would like to express my sincere thanks to the IAHPC for sponsoring me to attend the 11th European Association for Palliative Care (EAPC) Congress in Vienna.

The congress was a very rich experience for me and in many ways the knowledge I gained will help me to advance palliative care in Egypt, which is in an early stage of development.

I attended the Congress representing the first university hospital-based palliative care program in Egypt, the Palliative Care Medicine Unit in Kasr Al-Aini School of Medicine – Cairo University.

I had three aims for this congress:

First, I wanted to share the results our research using two posters. Research is essential to illustrate the need for palliative care in Egypt and to find a suitable model for our resources and culture. One of our posters with the title “Symptom prevalence in cancer patients referred to the first specialist palliative care clinic in Egypt.” It illustrated how much advanced cancer patients in Egypt are suffering physically and it also highlighted the need for palliative care. Our team won the “Special Poster Award” of the EAPC. This international recognition and appreciation of our palliative care initiative is a major step forward in the development of palliative care in our institution and country.

My second aim was to meet palliative care experts from around the world and to discuss with them the problems facing the development of palliative care in Egypt. Their input was very helpful to me as I plan to optimize cancer pain control using the current resources in Egypt, how we should approach advocating for palliative care and ways to secure funding.

The third aim was to meet palliative care professionals from countries that have similar resources and culture as we do. It was interesting to learn about very successful advanced palliative care programs in settings similar to ours in terms of resources and barriers. I realized that it might be more useful to send Egyptian professionals who are interested in starting palliative care programs to established programs rather than sending them to advanced western educational programs. It is very important to learn from the experience of those with similar resources who faced the same barriers we anticipate.

Although it may be beyond our resources, it was interesting to learn about advances in symptom management, particularly pain and constipation. David Oliviere’s presentation on “Narrative and Stories in Palliative Care” illustrated an effective tool for the development of palliative care that we are missing very much in our setting.

The IAHPC Traveling Scholarship was very successful for me and I look forward for further support and cooperation with the IAHPC and other international organizations to help us promote palliative care in Egypt.

Samy Alsirafy, MBBCh, MSc, MD, ABHPM, Dip. Pall. Med.
Palliative Care Medicine Unit
Kasr Al-Aini Center of Clinical Oncology & Nuclear Medicine
Kasr Al-Aini School of Medicine,
Cairo University, Cairo, Egypt

From Russia

Thanks to the generous support of the IAHPC Traveling Scholarship Program I was able to participate in the 11th Congress of the European Association of Palliative Care in Vienna.

This Congress was very useful as I learned a lot about different palliative care experiences, achievements, and challenges from my colleagues in other countries.

My participation in the Congress was very fruitful. I had the opportunity to present the Russian Palliative/Hospice Care Information and Resource website (supported by Help the Hospices) while presenting my paper at the “Committed to People” session where I also was the Co-chair of the “Policy” session.

I appreciate very much the trust of the congress secretariat for providing me with this opportunity.

This experience was very enriching and I am sure it will contribute significantly to the development of palliative care in one of the largest regions in Russia. I will do my best to use the knowledge I gained to work with our team to advance palliative care advocacy.

I had an opportunity and great pleasure to meet old friends and many extraordinary people who are involved in palliative care development and clinical work with patients all over the world. This was an experience that will enrich my everyday work.

I would like to express my sincere gratitude to the IAHPC for providing me with the opportunity to take part in the congress.

I also appreciate the support and assistance of Ms Heidi Blumhuber and Ms Dorothea Marks who have done a lot to help me in arranging my travel.

Thank you very much indeed.

With very best wishes,

Sincerely yours,

Dr. Elena Vvedenskaya, M.D., Ph.D.
The Nizhny Novgorod Society for Palliative Care,
Nizhny Novgorod, Russia

From Albania

I had the opportunity and pleasure to participate in the 11th European Conference of Palliative Care. I represented the National Albanian Association for Palliative Care as its General Secretary and palliative care in the southeast region of Albania. My participation in this event was made possible by a grant from IAHPC.

The participants came from many countries but we have common goals and objectives. I was privileged to be among colleagues in a wonderful opening ceremony where the Queen of Sweden, one of the guests, who is involved in supporting palliative care development.

I was really impressed with the participation and interest of professionals regarding the new developments in pain control.

I was able to share our experiences with my colleagues, learn about their efforts, challenges and achievements in the development of palliative care as a human right. I had the opportunity to learn how to lobby and to become a part of an international network that advocates for patients.

This congress demonstrated the worldwide affirmation of palliative care. The oral presentations and posters represent the efforts, achievements, challenges and research performed in various fields related to palliative care and gave me new ideas for future improvements.

It was very important to learn about innovative ways of control pain with analgesics. I am frustrated that in my country, patients presently do not have access to their use.

As an active participant in the development of palliative care in my country, I have been involved in many meetings with the Ministry of Health, policymakers, directors of healthcare institutions, directors of Medicine and Nursing Faculties in order to introduce the importance of developing palliative care in our country, and also to emphasize the importance of making palliative care part of the governmental health policies.

I will now be able to strongly influence these developments.

I am very grateful and would like to thank the IAHPC for giving me the opportunity to attend this congress. I feel privileged, but also responsible to do the best for the development of palliative care in Albania. I hope opportunities like this will be available in the future, not only for me, but also for my colleagues who play an active role in the development of palliative care in Albania.

Thank you.

Irena Laska, RN
General Secretary
National Albanian Association for Palliative Care
Korce, Albania