Lukas Radbruch, Coordinator of the EU-funded ATOME project, and Saskia Jünger, project coordinator of ATOME
“In Turkey we wait for a long time, but then we move very quickly.” Murat Gültekin, Director of the Cancer Control Programme of the Turkish Ministry of Health, summarises palliative care development in Turkey in one sentence. Whereas just a few years ago there was almost no interest in palliative care and only patchy provision of pain management in Turkey, the situation has changed considerably more recently.
Speaking today (2 May 2012) at the ATOME (Access to Opioid Medication In Europe) conference in Ankara, Gültekin reported the important stepping stones of the Pallia-Turk project initiated in 2009. Using a population- and community-based model of care, the project focuses on the education of more than 23,000 family physicians in Turkey, and on more than 500 home care services, with nurse, physician and driver, that will visit palliative care patients daily and provide financial support, as well as medical and nursing support to patients and families. This primary level care will be supported by secondary and tertiary centres, culminating in the development of a specific Turkish inpatient hospice model, which is currently piloted in three cities, including Ankara where the ATOME conference is being held. These hospices will provide not only accommodation for family members, but also rooms to support family activities, acknowledging the traditional family model in Turkey.
The Pallia-Turk project is supported by a growing recognition of the importance of palliative care in the Ministry of Health (MoH) and accompanying changes in regulations and legislation. Fifty percent of legal opioids used worldwide are produced in Turkey, but the use of opioids in the country is still inadequate. There is a lack of interest in the production of morphine tablets of the pharmaceutical companies, as morphine is cheap and only little profit is to be expected. The MoH in collaboration with WHO is thinking about regional production of opioids in order to overcome this problem. The MoH has also worked on the definition of palliative care, and now uses a very broad definition that includes curable as well as non-curable diseases, cancer and non-cancer, and ranges from acute and subacute to chronic diseases. Using this broad definition will ensure that all patients who need palliative care will be able to access it.
As Murat Gültekin clarified in his lecture, palliative care is not only cheap and easy to perform; it is also a human right. The ATOME conference proceeded with workgroups that identified gaps in the regulations and legislations that guide the provision of palliative care, and discussed action steps that will be needed to close these gaps. Seeing how quickly Turkey is moving, hopefully it will only be a short time until these steps are taken and opioids are available, accessible and affordable for all those who need them in Turkey.
To find out more…
More information on the conference and on ATOME can be found at www.atome-project.eu