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Where there is no law, but every man does what is right in his own eyes, there is the least of real liberty
Henry M. Robert

Refuges for suffering people

Thousands of Ukrainians need palliative care
27 February, 2007 - 00:00

Nearly 12 million elderly people, veterans and invalids, live in Ukraine. Many of them are seriously ill and need palliative care in the final stages of their lives. The idea is to save patients from terrible suffering and create maximally possible comfort for them. This type of care is available at specialized medical institutions called hospices. However, this service is underdeveloped in Ukraine.

“The problem of introducing palliative care is urgent because 160,000 people are diagnosed with cancer every year,” says Olha Koliakova, representative of the Department for Organizing and Developing Medical Care. “More than 100,000 incurably ill patients die in terrible torments. The creation of a system of hospices will help protect the rights of these patients to live freely, without pain and discomfort, and to guarantee respect for the individual and his or her last will.”

According to Minister of Labor and Social Policy Mykhailo Papiiev, this problem is complex because to resolve it several departments must be involved - the labor and health ministries as well as parliament. “The first problem that we encountered is the lack of experience in Ukraine with regard to this issue. Thus, the main thing is for us to develop the European standard of hospice services with the help of foreign experts. At the moment we are cooperating with prominent experts from Romania, Moldova, and Great Britain.” According to the labor minister, among the problems hindering the development of a palliative care system in Ukraine are the lack of a necessary normative-legal base, disregard for monitoring medical law, insufficient financing of this sphere, and lack of social workers. Koliakova says that not only elderly people need palliative care but also young patients and children with a limited lifetime prognosis, who need extended medical and social care, moral, psychological, and spiritual support together with effective painkilling treatment. “The health care system in Ukraine still cannot guarantee accessibility to palliative care for the majority of people who need it. Our country only has 11 hospices, and 457 new hospice beds have been created.” According to Koliakova, “palliative care was recently introduced in Kharkiv, which received three million hryvnias for 2007 from the Municipal Council - a first for Ukraine. However, the material-technical base of active hospices does not meet international standards, and the living conditions of people living in these institutions are not always satisfactory.” The vice-president of the National Council for the Protection of and Security of Patients’ Rights, Viktor Serdiuk, thinks that Ukraine should set out on the path of humane development by implementing the palliative care system instead of resorting to euthanasia as they do in many European countries. “One of the tasks of social policy should be the creation of an institute of medical-social and palliative care, which is possible when social protection is enhanced. In order to satisfy the needs of an individual under complex care, doctors, nurses, social workers, psychologists, lawyers, and other experts must be involved in palliative care. Essential help may be provided by the families of patients and volunteers with special training,” Serdiuk thinks.

The president of the National Palliative Care Association, Svitlana Martyniuk- Hres, says that the allotment of beds for palliative care, the conversion of vacant buildings into hospices, creation of a list of people who need care, assurance of a lengthy stay for patients with mental disorders, and the adoption of a state policy concept will fundamentally improve the development of hospice care in Ukraine.

By Inna FILIPENKO
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