Olga Berezikova, Chief Physician of the Kemerovo Regional Hospice, Russia
On 10-11 October 2012, the Kemerovo Regional Hospice in South-western Siberia celebrated its 20th anniversary. Created during the economic collapse of the early 1990s, the hospice is one of the oldest palliative care institutions in the Russian Federation.
In 1995, Wendy Jones from the British-Russian Hospice Society taught the first palliative care course for Siberian nurses. Later, Dr Steve Dyer and Maureen Gill from the Oxford International Centre for Palliative Care, with Dr Robert Twycross as director, developed a plan to improve palliative care in the Kemerovo region. British colleagues travelled to Siberia to teach with help from the ‘Know How’ charity fund. Also, several Russian physicians and nurses visited Great Britain to see hospice care first hand.
As a result, Kemerovo Regional Hospice is a recognised palliative care leader in the country. Each year, approximately 600 patients receive inpatient care and more than 300 patients receive care in their homes. Sustained release oral morphine and transdermal fentanyl are widely used for pain management. The average daily dose of opioids is 115.6 morphine equivalence, milligram/person.
Two hundred and seventy-six delegates from ten regions of Russia, Great Britain, and the USA attended the conference, devoted to the hospice’s anniversary. The participants analysed acquired experiences, recognised achievements, diagnosed current problems, and made offers to improve palliative care in Russia.
But despite years of efforts, the conference revealed that palliative care services have not expanded throughout the country. Research has shown that approximately 18 per cent of cancer patients in Russia have access to opioids and fewer than two per cent of patients were treated with non-parenteral opioids. Neglect of palliative care development in the Russian Federation, and misunderstanding of the philosophy of palliative care from Russian authorities, have led to millions of people needlessly suffering and dying in pain. We cannot be happy with limited achievements and need to improve palliative care throughout the country. We must overcome the barriers to benefit our patients.
The delegates approved the resolution of the conference and submitted it to the Ministry of Health of the Russian Federation. Participants stressed that the current working draft of the Palliative Care Order from the Ministry of Health does not meet the philosophy of palliative care. The absence of uniform medico-economic standards, the existing methods of determining the demand in opioids, the absence of short-acting oral morphine, and the lack of sustained release morphine result in inadequate quality of care.
The delegates of the conference recommended the following:
- establish a Palliative Care Department at the Ministry of Health
- create a Palliative Care Order in accordance with the philosophy of palliative care
- approve a new specialty for physicians devoted to palliative care
- design a Palliative Care Program on a national scale for further development:
- a) comply with federal guarantees of rendering services, ensure a drug supply in adequate quantities that includes opioids;
- b) develop an educational policy and a new guideline to calculate the need for opioids.
At the end of the conference, the participants attended a charity concert at the A Bobrov Music Theatre devoted to World Hospice and Palliative Care Day.
Find out more…
Visit the website of the Kemerovo Regional Hospice.