IAHPC Traveling Scholar's Report

Because of a Traveling Scholarship I received from IAHPC, I was able to travel to Barcelona, Spain where palliative care standards continue to expand. This grant was a collaborative effort between the Spanish Society of Palliative Care (Sociedad Española de Cuidados Paliativos – SECPAL), the Latin American Association for Palliative Care (Asociacion Latinoamericana de Cuidados Paliativos – ALCP) and the IAHPC. I spent a month working at the Catalan Institute of Oncology (ICO) in Barcelona, Spain, under Dr Josep Porta-Sales; the WHO Collaborating Centre for Public Health Palliative Care Programs and The "Qualy" End of Life Observatory under Dr. Xavier Gómez-Batiste.

I work in a palliative care (PC) program in a large hospital in Buenos Aires, Argentina. My country has a clear need for developing palliative care. Problems in the healthcare system include fragmentation of the system; unsuitable treatment prioritization; inequalities in healthcare provision; outsourcing of management responsibilities; inadequate legal framework; inadequate policies for the provision of drugs; limited public healthcare promotion and disease prevention policies; lack of universal healthcare insurance coverage; and inadequate quality control policies. Most of these problems are prevalent in other South American countries. PC services are still unable to reach the vast majority of patients who might benefit from them.

On the other hand, with life expectancy increasing, cardiovascular and malignant diseases are now evident. Today, more than two thirds of all reported mortality is due to chronic diseases and external causes. The rise in the incidence of neoplasm is significant, but there is insufficient collaboration and coordination among various programs. Despite these limitations, it is highly probable that most of the positive changes observed in clinical practice policies have their origins in the educational efforts of a few health workers who deserve strong encouragement and much support.

I lack the words to describe the amazing experience I had. I mainly worked with Dr. Gomez Batiste on how to ensure good quality palliative care based on a Spanish model of how to implement Public Health Palliative Care Programs. The model has been used for years at the Public Health Catalan system, at Catalonia, Spain, but is suitable for any healthcare system that deals with patients with advanced terminal illness and their families. I will continue to build my professional relationships. I have now received the education needed to be able to contribute to the development of a public palliative care program in my country.

Finally, I had the opportunity to participate in the 8 th Congreso Nacional de Cuidados Paliativos (La Coruña, 5-8 de mayo de 2010) of SECPAL thanks to its organization committee. This experience was very valuable for me and was a great opportunity to meet colleagues and share professional experiences in palliative care.

I wish to express my deepest gratitude to IAHPC, Doctor Roberto Wenk and Liliana De Lima for the Traveling Scholarship. I also wish to thank Dr. Javier Rocafort, Dr Rafael Mota Vargas and Nurse Lourdes Guanter Peris from SECPAL, Dr Jordi Trelis, Dr. Porta-Sales and his team from the ICO, and Dr Gómez Batiste from Qualy for making this learning opportunity possible and also for enabling me to participate in the SECPAL congress.

Vilma A. Tripodoro, MD
Coordinator Palliative Care Team and Home Care Unit
Instituto de Investigaciones Médicas Alfredo Lanari
University of Buenos Aires, Argentina