When Nepal is mentioned, our recent thoughts have been about the consequences of the earthquakes and the need to support and help people and institutions recover from them. There is still a need for this but as well there is a need for palliative care services so that people at the end of life can have their symptoms controlled as far as possible and die with dignity.
Palliative care in a developing country looks very different than in the UK; it’s about making sure the most basic of pain relief can be obtained, and that physical and spiritual support is provided. Palliative care in this context is about rudimentary care –better sanitation and nutrition practices, the provision of oral morphine and basic pain killers, and affording patients the respect and dignity that they deserve.
In Nepal there is a culture of not telling people that they have an incurable disease or are dying, so that money is often wasted on the costs of traditional healers, homeopathic treatments and home remedies. Those living above the poverty line may be able to afford some paracetamol or basic pain relief but the 6 million rural poor, living a subsistence lifestyle will not be able to afford this.
EMMS International is working with partners in Nepal to improve palliative care in Nepal, especially for the poorest.
Manju, is being supported in her training to become Nepal's first palliative care nurse specialist. Recently returned from training in Hyderabad, India, she reported that she learned many things really applicable in her setting – the full assessment and proper management of pain control; cancer wound management; lymphoedema management and the importance of good communication.
Gary Brough, EMMS' communications manager, leaves for Nepal on 5th November with Susan Ripoll of STV News joining him a week later. They’ll be visiting Kathmandu, Pokhara, Tansen and Lamjung to see the early progress in bringing palliative care and meeting people affected by the earthquakes.