Nepal is experiencing a growing burden of non-communicable diseases (NCDs). It is estimated that non-communicable diseases such as cardiovascular disease, chronic respiratory diseases, cancers, diabetes, accounted for 66% of all deaths.
The Palliative Care programme aims to provide holistic care to people with life limiting illnesses, and their families. It includes pain and symptom management as well as end-of-life care. With INF’s focus on the poor and marginalised, we are in a unique position to contribute to palliative care development in Nepal, particularly in the under-resourced Western Regions.
INF’s Palliative Care programme had its origins in 2009 running workshops for both INF and non-INF staff, and from 2013 we were able to start offering a palliative care service at Green Pastures Hospital (GPH) and also a community service. Moreover, GPH now has a 14-bed dedicated Palliative Care and Chronic Disease ward which not only provides inpatient services, day-therapy sessions among others but also acts as a training centre.
The World Health Organisation describes palliative care as “The prevention and relief of suffering by means of early identification and treatment of pain and other problems, physical, psychosocial, and spiritual.” Undertaking these aims is the focus of the Sunita Project in Nepal.
Non-communicable diseases are predicted to be the leading cause of death in Nepal by 2040. Money raised by EMMS International’s donors was match-funded by the UK Government’s UK Aid Match initiative, meaning that Sunita—the name of a three-year project that introduces care for those with non-communicable diseases in hard-to-reach locations in Nepal—launched in partnership with INF Nepal.
The work has recently entered its third year. Since April 2022, Sunita is estimated to have touched the lives of more than 15,000 family members who have a loved one with a non-communicable disease. More than 1,000 individuals have been trained to address unmet palliative care needs in their communities. By setting up and monitoring dedicated services in rural, hard-to-reach areas of western Nepal, INF and EMMS International are building strong evidence to help the country’s Government roll out its national palliative care strategy.
The work also aims to reduce the burden of care on families who are living with a loved one who has a non-communicable disease. This responsibility often falls on girls who, with the support of Sunita-trained specialists, can now instead focus on their education and brighter futures. One hundred percent of children who have a family member receiving palliative care through Sunita are attending school.
EMMS International and the McClay Foundation have also funded a dedicated wing and palliative care centre of excellence at the Green Pastures Hospital in Pokhara, which is run by INF Nepal. As well as a multidisciplinary team of doctors, nurses, physiotherapists, occupational therapists and speech therapists, the Palliative Care Department has dedicated space and trained staff to help palliative care patients and families who are experiencing challenges to their emotional well-being and mental health.
25-year-old Aaditya is from a remote village in northern Nepal. He suffered a high-level spinal cord injury after a motorbike accident. He is bed-bound with severe pressure sores. He and his family are now being cared for by the Palliative Care team at Green Pastures Hospital. His father says:
“With the Palliative Care Multidisciplinary Team’s support, my son can move his hands, sit on a wheelchair, and eat his meal with a smile. He is even enjoying music which has made us think that our son’s overall health condition has changed significantly… His mother’s psychological pain is being addressed by our Palliative Care Counselling Team and this has boosted her confidence. The care providers have increased my son’s and his family’s courage.”
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