Experts call for better care to stop the suffering of critically ill

Palliative care is vital for patients but it is still misunderstood among health professionals, cancer sufferers and the public at large, experts say.

Dr Nehad Nabil Halawa, a specialist in anesthesia in Burjeel Hospital, is one of the doctors calling for better palliative care offerings to relieve and prevent suffering of the chronically ill. Mona Al Marzooqi / The National
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ABU DHABI // Doctors have called for better care to relieve and prevent the suffering of the chronically ill.

Palliative care – treating the pain, symptoms and stress of serious illness – is vital for patients but it is still misunderstood among health professionals, cancer sufferers and the public at large.

This type of treatment is also still not recognised as an essential component of health care and is not just for patients who have terminal illnesses, they say.

The concept of palliative care needs to be an integral part of the curriculum for medical students and health care professionals and the public needs to be trained about the necessity and importance of palliative care, said Dr Falah Al Khatib, an oncologist at Mediclinic City Hospital in Dubai.

“There is absolutely room for improvement,” he said.

“There is not only room but a necessity for it and a demand. It improves the patient’s wellbeing. Controls his pain. Comforts the family. Provides the patient with the best care available.”

According to a World Health Organisation report issued earlier this year, only one in 10 people who need palliative care receive it.

Additionally, only 20 countries worldwide have palliative care well integrated into their healthcare systems – and none are in the GCC or Middle East.

About one third of those needing palliative care suffer from cancer, according to the WHO.

Others needing this type of care have progressive illnesses affecting their heart, lung, liver, kidney, brain, or chronic, life-threatening diseases including HIV and drug-resistant tuberculosis.

Despite the scope for demand, palliative care is often misunderstood, said Dr Al Khatib. Not only by the public but also the medical profession.

“To some, palliative care means you abandon the patient, which is the wrong concept. Palliative care means you provide the patients with whatever medical needs and to keep him comfortable, in good shape, free of pain.”

Palliative care needs to be integrated into the healthcare system, he said. “I would like to see it added to the curriculum of medical schools. I need a proper national educational programme. I would like to see proper government organisation in all the major hospitals,” he said, referring to a uniform programme implementing palliative care in all hospitals.

“We need special doctors, special nurses, better understanding at all levels. We need to see hospices. We need to, of course, get the professionals in that field educated. We need a proper programme for palliative care and rehabilitation in this society.”

Dr Nehad Halawa, a specialist in anaesthesia at Burjeel Hospital, said there is a knowledge gap when it comes to palliative care.

Dr Halawa, who treats patients at the hospital’s long-term care unit, said many people believe palliative care is only for end-of-life patients but that is not always the case.

Unlike hospice care, palliative care is appropriate for patients in all disease stages, including those undergoing treatment for curable illnesses and those living with chronic diseases as well as patients who are nearing the end of life, said the 50-year-old Egyptian.

Palliative care is also known as “comfort care”, he said.

“Palliative care does not mean this is the end. It is the stage in which the patient needs more support to alleviate pain and some psychological support and to teach the family the nature of this disease so they can cope.”

Conrad Williams, a specialist in palliative care at a paediatric centre funded by Abu Dhabi Government, said greater emphasis on palliative care is needed worldwide.

“The basic philosophy of palliative care – easing suffering and optimising quality of life – transcends cultural, political and religious differences around the world,” said Dr Williams, 31, the medical director at the Panda palliative care team at the Children’s National Medical Centre in Washington DC.

He agrees there is a misunderstanding of what palliative care is.

“When the concept of palliative care is explained properly to patients and families, rarely are they sceptical or dismissive of such services.”