Palliative Care Treatment is a developing area of healthcare that focuses on relieving the suffering of terminally ill patients. In 2005, ASHIC, Foundation Serving Childhood Cancer, was the only parent-run organization out of 14 global projects to receive a grant for establishing the first Palliative Care Unit (PCU) in Bangladesh, from UICC/sanofi-aventis initiative titled “My Child Matters”. Then the International Union Against Cancer (UICC) has now become Union for International Cancer Control.
In developing countries, where opportunities for curative treatment are often severely limited, the ASHIC PCU has been under the spotlight as a replicable model for other developing nations. Operating since May 2006, the ASHIC PCU provides end-of-life care for terminally ill children suffering from cancer.
One of the greatest challenges in a developing country like Bangladesh is that many underprivileged families hailing from far-flung villages have to travel to Dhaka, the Capital, for availing specialized treatment for a childhood cancer. However, due to the high cost and or late diagnosis, many parents often discontinue the treatment of their helpless child and go back home, thus contributing to the previously high “Drop-Out Rate” as well as the poor “Survival Rate”.
For many heartbroken parents of these terminally ill children, often, their first consideration is to give up then drop out of the tertiary care services, and return to their village so that they may bury their child close to their home once the child succumbs to cancer. The cost of transporting a child to a rural village after s/he had passed away in Dhaka is significantly more expensive than the costs of transporting a critically ill child to and from Dhaka. This imposes an excruciating dilemma on the parents, many of whom often have no option but to deny the suffering child of Palliative Care in Dhaka. As such, the doctors and nurses of ASHIC PCU have designed a program, recognizing the necessity of teaching parents effective methods of Palliative and Hospice Care, thus enabling parents to continue to care for the dying child in the comfort of their village home during the last days of their beloved child’s life.
Once a family returns home, the parents can be in touch with the medical staff of ASHIC PCU via phone. They are always welcome to re-visit the PCU for follow-up. Any child seeking admission in the ASHIC PCU receives free services for a minimum of 5 days, depending on the availability of donation. The cost of going back home after a follow up is free for the patient, provided that ASHIC has adequate funds from donors. This model is quite different from the Western model where a Symptom Care Team or a Hospice Team will go over to the patient’s home if the patient wishes to stay at home for their end of life care.
The PCU has a high operating cost as it is staffed by round the clock doctors and nurses, with necessary medication for pain management and equipment’s to help patients who are about to breath their last.In 2007, the ASHIC PCU received permission from the Narcotics Dept. of the Government of Bangladesh to administer morphine for adequate pain management of the terminally ill children. In the last 12 years, the PCU has helped thousands of terminally ill children under treatment as well as patients seeking Out-Patient Services. Till May 2018, 461 brave children have had the opportunity for a significantly peaceful and more comfortable end to their lives than they would have otherwise had at home. Their families subsequently received Ambulance services from ASHIC to carry the body of the angel back to their home.