Establishing Pediatric Palliative Care in Armenia
26.02.2015
13:30
The concept of introducing pediatric palliative care appears to be gradually shaping in Armenia while palliative care for adults is becoming more available through availability of medicine and improvement regarding the policy, legislation and public awareness campaign, Armenian and foreign experts stated at the Media Center panel discussion.

The 2009-2010 preliminary assessment shows nearly 18 thousand people in Armenia need palliative care. The data concerning children will be summed up by the end of 2015.

Ara Babloyan, Chairman of the National Assembly’s Standing Committee on Healthcare, Maternity and Childhood, said an estimated number of children needing palliative care in Armenia makes 6000- 8000 though these figures are not confirmed yet.

“Palliative care gets more advanced worldwide. Certain illnesses are impossible to be treated fully and the patient’s health cannot be restored. Whatever the period - months or years - the patient has to live sick, it is vital to provide relief and psychological and social services to ensure their decent life and not a life full of sufferings,” Babloyan said. 

He added corresponding legislative regulations are drafted and after the second reading at the National Assembly the Law on Medical Care and Service will be adopted. Concurrently, the Law on Health will be amended and a special chapter on palliative care will be added to the law.

“We intend to ensure palliative care for both adults and children. Adults need relief in case of cancer, for example, whereas children may need relief from the symptoms of inborn anomalies or illnesses and we must relieve their pain, sufferings and ensure better living conditions,” Babloyan emphasized.

Stephen R. Connor, PhD., expert, Worldwide Palliative Care Alliance, said cooperating with the Open Society Foundations-Armenia, they have worked to create preconditions for the establishment of palliative care in Armenia for recent five years.

“We have developed standards for delivering palliative care in the country; we began working on clinical guidelines on how to deliver clinical palliative care. We have an approval for a concept note for palliative care by the Government and we have a national strategy almost ready for approval,” Connor said.

In Armenia four pilot projects have operated delivering palliative care mostly at home. Besides, a few training programs for health professionals have been conducted but now Armenia is still missing doctors, nurses, psychologists and social workers for delivering palliative care, Connor added.

“Armenia still lacks some of the essential medicines for delivering palliative care, particularly oral morphine to be used for pain management with many patients. Too many people are still dying without an access to pain relief. We have a good cooperation from the government but we need at this stage for the government to step up and begin to provide resources to deliver palliative care. And we need to develop palliative care for children which is not available yet.”

With respect to public awareness, Davit Amiryan, Deputy Director for Programs at Open Society Foundations-Armenia, noted health specialists are rather informed.

“Both the Health Ministry and Government have quickly responded. The bill was drafted more rapidly than strategies. This field requires comprehensive approach and mere improvement of building conditions and training of the staff are not enough. Medicine is not available yet and the issue needs legislative regulation. Besides, there is an education component. Palliative care needs the involvement of the whole society in the country,” Amiryan said.

Armenia must adopt the international practice, Amiryan added, thus, Yerevan will host a two-day international working scientific conference during which experts will share and discuss the opportunities, experience, obstacles and advantages various countries had when establishing palliative care.

Karina Vartanova, head of the Children’s Palliative Care Foundation, noted Russia is also at the first stage of establishing palliative care for children. “The national advocacy strategy specifies the establishment of palliative care and services. Evidently, the Government has recognized the importance of palliative care. It is time to go from words to deeds. In Russia an estimated number of children needing palliative care is 287 thousands.”

According to Andrey Penkov, doctor at the Hospital for Children with Disabilities, Ukraine, the first pediatric hospice was opened three years ago. The challenges regarding infrastructure, building conditions and facilities, as well as professional training, however, are a major concern.

“The problem is that we do not understand that palliative care, in general, is not absolutely a philosophy but it is a spiritual, psychological, social daily support to patients,” Penkov said.

Mihaela Dumitrache, head of Casa Lumina Hospice, Romania, spoke on the practice of palliative care in her country which has adopted a law on opioid treatment and presently people in Romania have an access to opioid treatment. “All doctors with practice can prescribe morphine or opioid medicine. Our Government has a strategy for palliative care and program. Despite these opportunities, just six percent of people with life-limiting diseases have an access to palliative care in the country,” Dumitrache said.

The speakers stressed their determination to make palliative care available in Armenia and take practical actions aimed with respect to medicine availability, legislation and increase of public awareness.

Lilit Arakelyan, Editor-Coordinator

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