Professor David Oliver, University of Kent, UK, and a board member of the European Association for Palliative Care, explains the background to a longer article published in the July/August of the European Journal of Palliative Care.
Professor Anica Jušić has been pressing to develop palliative care in Croatia for more than 30 years. As a neurologist and one of the first professors of neurology in Croatia, she had been unhappy that she could not offer the best care for patients who were deteriorating and dying – particularly those with amyotrophic lateral sclerosis (motor neurone disease). Rather than accept the restrictions of care she wanted to do more and in the early 1980s started to hear more about palliative care and its role in the care of people with neurological and other advancing diseases.
Her travels took her to St Christopher’s Hospice in London and the opportunity to meet Dame Cicely Saunders where her enthusiasm for palliative care grew. This enabled her to start to develop the Croatian Association for Palliative and Hospice Care and education for professionals and volunteers. Within Zagreb, a Palliative Care Centre provided support for patients and families. However, there were continual changes in government plans and policies and it was not possible to sustain a volunteer-based approach.
Ban Jelačić Square in Zagreb, named in honour of Ban Josip Jelačić, Governor of Croatia in the 19th century
Although Professor Jušić’s ideals and plans were difficult to bring to fruition, the concepts of palliative care are still developing in Croatia. With a population of four million, 25 percent of whom are in the Zagreb area, and a complex history, especially resulting from the conflict that ensued when Yugoslavia broke up, there are now increasing signs of palliative care developments – with new home care teams, several small hospices and a new National Plan.
Professor Jušić has continued to fight for palliative care and has recently published her autobiography, entitled ‘The Two Lives of Anica Jušić’, reflecting on her career as a neurologist and then within palliative care. Although the slow development has been frustrating the signs of progress can be seen.
I have had the privilege of working in Croatia for more than 15 years – leading courses on palliative care with a team from the University of Kent, supporting students and helping to advise and support the emerging services. The hope for the future is the fuller development of an integrated palliative care plan across Croatia and improved care for the people with advancing disease.
This post relates to a longer article, ‘The early days of the hospice movement in Croatia’ by Anica Jušić and David Oliver, published in the July/August 2016 edition of the European Journal of Palliative Care (EJPC). (vol. 23.4).
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