Irena Laska, Executive Director of Qendra E Kujdesit Paliativ ‘Mary Potter’, Korça, Albania, and General Secretary of the Albanian National Palliative Care Association.
Although Albania did not officially sign up to the Budapest Commitments in 2007, our National Palliative Care Association has certainly taken up the challenge to define our priorities and goals for the coming years. Launched in 2001 by The Little Company of Mary, SOS Malta (Claudia Taylor) and Sue Ryder Albania our national palliative care association has been working hard ever since, with the help of international experts, to build a national action plan for palliative care and other projects to develop our services. The National Palliative Care Working Group operates as part of the organisation and is making strong efforts to ensure the development and integration of palliative care. I describe below how our efforts are beginning to make a real difference to the way in which palliative is delivered in our country.
Albania is a small country in Southeastern Europe with a population of about three million. Palliative Care in Albania started in 1993. In Korça, it was introduced at the initiative of ‘Mary Potter’ Catholic sisters (Little Company of Mary) from London, UK, who continue to be the main donors of palliative care for the southeastern part of the country. Today, palliative care is also available in Tirana and Durrës where Sue Ryder Albania provides services to the patients from the central regions of the country.
My own journey into palliative care began when, as a student at the school of nursing, I volunteered with the ‘Mary Potter’ missionary nurses. After finishing my studies I was delighted to accept an offer to join them as a member of staff. Alongside my role at ‘Mary Potter’ I became involved from the beginning with our National Palliative Care Association and am passionate about my duties.
What we have achieved…
In the early days, palliative care was offered only by nurses but today it is provided by a multidisciplinary team of doctors, nurses, social worker and volunteers.
As a result of our continued lobbying efforts, doctors have now signed agreements with the National Health Insurance Institute allowing them to prescribe unlimited opiates for cancer patients. From 33 essential drugs for palliative care (according to the World Health Organization) only 26 are available in Albania. Fifteen of these drugs are reimbursed only for cancer patients living in the cities where palliative care is available.
Education and training
We have succeeded in producing the National Palliative Care Standards and a Palliative Care Training Manual, which is used during the training of health professionals.
Palliative care is now included as a subject in some nursing schools and we are striving to get it included as a separate subject in the curricula of all nursing and medical faculties and postgraduate studies in this field.
Basic, post-basic and advanced level training has been delivered to health professionals across the entire country. The training sessions have lasted three to five days as residential courses, including lectures and practical experience. The goal of this training has been to deliver knowledge on palliative care to all doctors and nurses, especially family doctors, so that the number of beneficiaries of this service would increase.
Information and publications
We have also translated important publications on palliative care into Albanian including the ‘Recommendations of the European Union on palliative care’ and a range of topics such as symptom control, oncology, communication, morphine and pain management and ‘Chemotherapy: a guide for patients and caregivers’. All these materials are very useful to health specialists in a terrain where there is a lack of publications on these issues. Meanwhile, we shall continue our efforts to increase the capacities of the staff who provide palliative care and to improve the quality of service.
Research into the palliative care needs in Albania is our challenge for the future; we hope that research can be undertaken but this will depend on the support of donors.
Share your story…
We’d like to hear how other national organisations are implementing the goals they set themselves back in 2007. Dr David Oliver (UK) and Dr Michaela Bercowitz (Israel), board members of the EAPC, are currently collating information about the Budapest Commitments and urgently need your help. Information will be published as an editorial summary in the European Journal of Palliative Care, on the EAPC blog, and for the 13th World Congress of the European Association for Palliative Care in Prague 2013.
To contribute, or for more information, please contact Dr David Oliver.
In the coming weeks we hope to see how other countries have kept their promises to the Budapest Commitments.