In October 2015, the World Health Organization Eastern Mediterranean Region (WHO EMRO) organized the third ‘Train the Trainers’ workshop about palliative care. As a special adviser to the WHO EMRO, Professor Sheila Payne met leaders in palliative care from the region and invited them to contribute to this special series on palliative care in North Africa and the Middle East.
Omar Shamieh, MD, MBA, Consultant, Hospice & Palliative Medicine, Chairman of Palliative & Home Care Services at King Hussein Cancer Center, and Chairman of the Jordan National Palliative Care Committee, Ministry of Health, Jordan, concludes the series.
A question we are often asked is about the applicability of hospice and palliative care principles in Jordan and barriers to implementation. From the perspective of a palliative care physician trained in North America I have found no major difference in practising and applying palliative care principles in Jordan. Jordanians may have different cultural values and preferences; however, they are no different from any other population in their reaction to terminal illness and their experience of suffering. Patients are in need of effective communication skills, effective symptom and pain management and effective end-of-life care.
Jordan is a Middle Eastern Country with a population of 9.5 million in 2015. The predominant religion is Islam, Muslims make up 97.2 % of the population and 2.2 % are Christians. The country is classified as upper-middle income and the predominant language is Arabic. Health care in Jordan is considered one of the best in the region; in 2014 the estimated annual cancer burden was 6,000 new cases and around 50% present in the advanced stages. Hospice and palliative care started in Jordan in the early 1990s with a stand-alone, not-for-profit home hospice, named Al-Malath. In 2001, the Jordan Palliative Care Initiative emerged, and a National Palliative Care Committee was created under the Ministry of Health to oversee the development of palliative care in the country. The National Palliative Care Initiative and the National Palliative Care Committee are led by King Hussein Cancer Center (KHCC) in collaboration with the Ministry of Health, the World Health Organization and key stakeholders from governmental and non-governmental organisations. The main objectives are to increase opioid availability and access, build capacity of palliative care by increasing educational and training opportunities and encourage healthcare services to incorporate palliative care.
Currently, King Hussein Cancer Center is leading the largest comprehensive hospice, palliative, and home care services and serving more than 50% of cancer cases in the country. KHCC palliative care team treated more than 10,000 patients in the past decade and trained more than 2,000 healthcare professionals. In addition, palliative care services are currently starting in other large government and private hospitals. Educational opportunities have increased from basic and advanced courses to the availability of various palliative care diplomas, a palliative care master’s degree, and palliative care fellowships. Palliative care education is being incorporated into the curricula of major medical and nursing schools. Palliative care is incorporated in the Jordanian National Cancer Control plan. A new national home care initiative is emerging to build capacity and improve access to home care and promote palliative community services. The national strategic goal is to make palliative care affordable and accessible to all Jordanians.
There are remaining challenges to overcome, including the accreditation of a palliative care fellowship by the Jordan Medical Council, the formation of the Jordanian palliative care board certification to increase specialty recognition and improvements to provider reimbursement. Further challenges are to increase opioid availability and access in the peripheral governorates of Jordan, to increase the number of palliative care services in all healthcare settings and to create a hospice and home care national insurance plan to improve access and make these service affordable to all.
All Jordanians deserve to receive the best health care possible when they are suffering from a terminal illness. They deserve optimal treatment for their pain and other symptoms regardless of their age, sex, religion, or where they reside.
- A Comprehensive Palliative Care Program at a Tertiary Cancer Center in Jordan, American Journal of Hospice & Palliative Medicine, 2015, Vol. 32 (2) 238-242.
- Innovation Can Improve and Expand Aspects of End-of-Life Care in Low and Middle-Income Countries Health Affairs 33, 9 (2014): 1612-1619.
- Omran S, Obeidat R, Palliative Care Nursing in Jordan. J Palliat Care Med 2015, S4: 1.
Read more about Palliative Care in North Africa and the Middle East on the EAPC Blog . . .
If you missed any of the previously published posts in this series you can read contributions from Djibouti, Egypt, Sudan and Saudia Arabia.
With special thanks to all the contributors to this series and Prof. Sheila Payne.