• Alongside the Cancer Care Association of Sri Lanka

For those who are providing hospice or end-of-life care, it’s more than just a job; it’s a commitment to making an impact on the lives of the patients under their care. Palliative care is one of the most impactful, yet least understood branches of medicine. To celebrate some of its unsung heroes and shed light on its core philosophy, we spoke to Cancer Care Association and Palliative Care Trust of Sri Lanka Founder and College of Palliative Medicine in Sri Lanka President-elect Dr. Samadhi Rajapaksa.  What is palliative care? Palliative care is an interdisciplinary coordinated delivery approach for individuals with life-limiting illnesses. According to the World Health Organization (WHO), palliative care is defined as “an approach that improves the quality of life of patients and their families facing any problems associated with life-threatening illnesses through prevention and relief of suffering. Delivered through early identification, impeccable assessment, and treatment of pain and other problems such as physical ailments, psychological and spiritual difficulties that they may encounter.”  [caption id="attachment_185561" align="alignleft" width="378"] Pictures from the celebration held in honour of the Birth Centenary of the Father of the Nation of Bangladesh – Bangabandhu Sheikh Mujibur Rahman and the Golden Jubilee of the Independence of Bangladesh at the Institute of Palliative Medicine[/caption] Research has shown that palliative care can improve the quality of life and at times survival in patients with life-limiting illnesses. Consequently, because of the rapid increase in population, epidemiologic transition, and increase in life-limiting diseases across the world, an immense need for palliative care development has risen. Every year approximately 20 million people rely on palliative care and among them, 6% are children and others are at the end stage of their lives.  However, according to global estimates, one-third of people with terminal illnesses have no access to palliative care. According to the WHO the goal of palliative care is achieving the best quality of life for patients and their families. Many aspects of palliative care are also applicable earlier in the course of the illness in conjunction with other treatments. Management of pain and other symptoms and provision of psychological, social, and spiritual support is paramount, stated Dr. Rajapaksa.  What are the available palliative care services?  The worldwide Palliative Care Alliance emphasises that palliative care services are being developed all over the world in many different settings which can be delivered in a hospital, at home, in a hospice, in an outpatient clinic, in a local health centre, in a mobile clinic, or a daycare centre.  [caption id="attachment_185563" align="aligncenter" width="419"] Some of the recipients of the ‘Golden Jubilee Scholarships for Blooming Flowers’[/caption] Community-based palliative care includes a variety of models of care designed to meet the needs of terminally ill individuals and their families outside of the hospital setting. There are eight aspects of care governing the delivery of these services, which include physical, psychological, psychiatric, social, spiritual, religious, existential, and cultural care of the patients at the end of life. This also includes ethical and legal aspects of care. It is proven that many dying people would prefer to remain at home, but many of them die in the hospital. Even though most of them spend their final years of life at home, many are admitted to the hospital before they die.  “Home is the place that reminds us of living as well as dying and it is where we feel more fully ourselves” – Oxford Handbook of Palliative Care Birth Centenary of Father of the Nation and Golden Jubilee of Bangladesh celebrated with Cancer Care Association of Sri Lanka [caption id="attachment_185562" align="alignright" width="402"] Pictures from the celebration held in honour of the Birth Centenary of the Father of the Nation of Bangladesh – Bangabandhu Sheikh Mujibur Rahman and the Golden Jubilee of the Independence of Bangladesh at the Institute of Palliative Medicine[/caption] Bangladesh High Commission in Colombo, in association with the Palliative Care Trust and Cancer Care Association of Sri Lanka, celebrated the Birth Centenary of the Father of the Nation of Bangladesh – Bangabandhu Sheikh Mujibur Rahman and the Golden Jubilee of the Independence of Bangladesh at the Institute of Palliative Medicine (IPM) in Matara on 12 December 2021. With this programme, the Bangladesh High Commission has awarded the ‘Bangabandhu Memorial Grant for Palliative Care Services’ to the Palliative Care Trust of Sri Lanka and ‘Golden Jubilee Scholarships for Blooming Flowers’ to the Cancer Care Association of Sri Lanka for supporting 50 children who are cancer victims around the country.   In the programme, Foreign Minister of Bangladesh Dr. A.K. Abdul Momen joined through a video message wherein he highlighted humanism and political ideals of Bangabandhu Sheikh Mujibur Rahman, the Father of the Nation of Bangladesh which motivated Bangladesh to uphold his legacy and to work for the cause of humanity at large. He also coined the programme as a fitting tribute to Bangabandhu and a remarkable demonstration of the warmth and depth of Bangladesh-Sri Lanka bilateral relations. Bangladesh High Commissioner to Sri Lanka Tareq Md Ariful Islam in his remarks appreciated the noble humanitarian endeavors of the Cancer Care Association and Palliative Care Trust of Sri Lanka. He expressed hope that as a representative of a humanitarian nation and in the pursuit of Bangabandhu’s ideals, the Bangladesh High Commission in Sri Lanka will continue to render humanitarian support to  Sri Lanka. Cancer Care Association and Palliative Care Trust of Sri Lanka Founder Dr. Samadhi Rajapaksa highlighted present activities and shared future aspirations of the institutions. He thanked the Bangladesh High Commission for its continued support for good causes.  [caption id="attachment_185560" align="alignleft" width="410"] Pictures from the celebration held in honour of the Birth Centenary of the Father of the Nation of Bangladesh – Bangabandhu Sheikh Mujibur Rahman and the Golden Jubilee of the Independence of Bangladesh at the Institute of Palliative Medicine[/caption] The programme was attended by hundreds of doctors, health workers, students, and patients and many were connected virtually. At the end of the programme, High Commissioner Tareq Md Ariful Islam presented the ‘Bangabandhu Memorial Grant for Palliative Care Services’ and ‘Golden Jubilee Scholarships for Blooming Flowers’ for the children of cancer victims.   Speaking to us further on the importance of establishing palliative care services in the country, Dr. Rajapaksa stated that the Institute of Palliative Medicine was the first institute dedicated to palliative medicine in Sri Lanka. It has a full-fledged hospice, research and training centre for palliative medicine situated in Nupe, Matara. The hospice has a capacity of 21 beds, including two small hospital wards with a five-bed capacity separately for males and females, 11 individual rooms (six for males, five for females) with attached bathrooms and air conditioning facilities, five rooms for staff accommodation, fully equipped kitchen and dining area for 21 persons, two consultation rooms and waiting area with a beautiful gallery environment and parking space for 30 vehicles. The research and training centre includes six rooms for accommodation, office, and an auditorium with a seating capacity of 125. This project is worth approximately $ 1.2 million, and it was another step forward in their long-term thought of establishing hospice care in each district. “Presently we have received land donations in Ampara, Ratnapura and in Galle districts to continue our hospice care in the future,” stated Dr. Rajapaksa. Furthermore, the IPM research and training centre has trained 375 home carers and 21 nurses up to today. By 2021, the IPM hospice had provided palliative care/terminal care/respite care for 118 patients and 17,105 free meals were provided. Out of 118 patients admitted to IPM, 56 patients were non-malignant.   Doing voluntary social service is not always about impressive development; at times it is solely doing the work with pure dedication with tremendous patience. Even the smallest work with precise intention will take us one step closer towards Dr. Rajapaksa’s endeavour. Recognitions and awards Some of the awards and memberships secured during the past few years in recognition of the humanitarian endeavours are as follows.

• Asia-Pacific Cancer Society Training Grant (APCASOT) award Mumbai, India. 2013
• Asia-Pacific Cancer Society Training Grant (APCASOT) award Brisbane, Australia. 2016
• Member of the Asia Pacific Hospice and Palliative Care Network (APHN)
• Member of the European Association for Palliative Care (EAPC)
• Member of American Academy of Hospice and Palliative Medicine (AAHPM) 
• Best Social Impact Award 2018 – Good Market 
• Bango Bandu Memorial Grant 2019 – Bangladesh 
• Cancer Care Association of Sri Lanka received the title of ‘Approved Charity’ from the Ministry of Finance 2019
• Bangabandhu Memorial Grant for Palliative Care Services 2021 – Bangladesh
• Golden Jubilee Scholarships for Blooming Flowers 2021 – Bangladesh

“In palliative care, we never say, ‘there’s nothing we can do.’ In a nutshell, palliative care is about living well and dying well. That is why it is an essential human right of each terminally ill person to receive proper palliative care wherever they are, and it is a prime duty of every healthcare person to put into practice the palliative care as terminally ill patients need, irrespective of their illnesses,” concluded Dr. Rajapaksa.