World Hospice and Palliative Care Day will be celebrated on 6 October.

This special day is celebrated all over the world to raise awareness surrounding health care issues relating to pain and symptom management and end of life care.

The facts

Estimates suggest that:

• Around the world, over 50 million people die every year

• There are over 10 million new cases of cancer diagnosed each year

• Cancer causes six million deaths every year

• There will be 15 million new cases of cancer every year by 2020

Many of these people will endure intense and unnecessary suffering and pain with little or no access to appropriate drugs.

The issue

In many developing countries there is limited access to affordable and appropriate treatment for cancer and other diseases. Palliative care is a humane way of relieving pain and distress. Moreover, since access to appropriate medication for pain relief and opportunistic infections is central to palliative care, commitment to its implementation will provide mechanisms for making all kinds of medications available to communities.

Who provides palliative care?

Palliative care is largely provided by non-governmental organisations, community groups and hospices.

In resource-poor countries, where need is greatest, there are many obstacles to overcome. These include: lack of pain-relieving drugs; problems of legislation enabling opiate use; lack of professional and public education; and lack of finance for research and development. Due to palliative care not being part of many governments’ health or national strategic plans, the majority of organisations providing palliative care have limited government support and are highly dependent on donor funding. This creates small pools of excellence which only a few people can access.

What must be done?

Palliative care should be accessible to all and not a luxury for some lucky few. It should be integrated into the continuum of care and management of people with cancer and indeed into all end-of-life care. To achieve this, palliative care needs to be included explicitly in national health policies.

There is little awareness of, and expertise in, palliative care at either policy, health professional or community levels. If provision of palliative care is to be effective, training is needed for policy makers, health professionals, community health workers, patients and their families. Everyone concerned needs to understand the basic principles of palliative care and the way it can be delivered.

What is being done?

It is estimated that between 7,000 and 8,000 hospice and palliative care initiatives have been developed in over 100 countries around the world, adapted to suit local needs and cultures.

What about Malta?

Over the past 18 years, the Malta Hospice Movement, a voluntary organisation inspired by Christian values, has pioneered palliative care services in the Maltese islands, providing home care, day care and practical, psychosocial and spiritual support. In 2006, the movement cared for some 600 patients and their families.

The movement is funded from three sources:

• Annual government grant

• Fundraising

• Voluntary donors

Each source accounts roughly for one-third of the annual financial requirements.

The average annual mortality rate from the most common causes of cancer, in Malta, between 2000 and 2004 is 718. In that same period, the Malta Hospice Movement had an average annual mortality of 240 patients referred to the movement (approximately 30 per cent).

Theresa Naudi is chairperson,

Malta Hospice Movement

Source: World Health Organisation (www.who.int)

Hospice Information Service (www.hospiceinfo/factsandfigures.asp)

National Mortality Registry, Department of Health, Malta