Page 0054

REGIONAL PERSPECTIVES

54 CANCER CONTROL 2021

of Health Sciences (Figure 1). There

is presently an 8 bed in-patient unit, a

home based community programme in

Kathmandu and a rural programme in

the Makwanpur área (Table 3).

The hospice is run as a non-profit,

non-governmental organization (NGO)

registered with the Social Welfare

Council in Lainchaur, Kathmandu. It

is a registered charity overseen by a

Board of Trustees. All NGOs in Nepal

have to get certification from the Social

Welfare Council which is subject to an

annual audit and verification by the Tax

Division of the Finance Ministry.

Aims

With the current demand for palliative

care in Nepal outstripping the capacity

of the present services, there is an

urgent need to expand Hospice Nepal

and include facilities for the care of

children. Eighty percent of Nepal's

population live rurally where transport

links to Kathmandu and other major

centres are often difficult decreasing

access to central services. The need

to expand Hospice Nepal's current

successful outreach programmes into more rural areas will

thus be a major focus of the new hospice.

In particular, the provision for healthcare training and

telementoring facilities are key to enable the leveraging

of palliative care expertise across a wide population. It is

planned to utilize the ECHO Programme which is a worldwide

telementoring movement dedicated to the democratization

of specialist knowledge which will enable clinicians to gain

the expertise required to provide palliative care services and

support (4,5). The ECHO network participants are able to learn

new approaches for applying their knowledge across diverse

cultural and geographical contexts (Figure 2). Patan University,

The Vision: Building a new Hospice Nepal and

Palliative Care Education Centre in Kathmandu

Background:

Twenty years ago, four former Nepali schoolfriends got

together and started the country's first hospice in Kathmandu.

Today, from those very humble beginnings, Hospice Nepal

has become an important centre for palliative care under

the guidance of one of those four friends, Professor Rajesh

Gongal, who is now the Vice-Chancellor of Patan Academy

Table 1: Number of cervical cancer Incidences and deaths per Commonwealth region

Population

Number of new cancer cases

Age-standardized incidence rate (world)

Risk of developing cancer before the age

of 75 (%)

Number of cancer deaths

Age-standardized mortality rate (world)

Risk of dying from cancer before the age of

75 (%)

5-year prevalent cases

Top 5 most frequent cancers excluding nonmelanoma skin cancer (ranked

by cases)

Males

13 348 435

8 943

78.6

8.1

6 244

56.1

6.0

15 073

Lung Stomach

Colorectal

Oral Cavity

Thyroid

Females

15 788 373

11 565

82.6

8.6

7 385

53.9

5.8

21 833

Cervix uteri

Breast

Lung

Gallbladder

Ovary

Both genders

29 136 808

20 508

80.9

8.4

13 629

54.8

5.9

36 906

Lung

Cervix uteri

Breast

Stomach

Colorectal

Table 2: Palliative care in the United Kingdom versus Nepal

United Kingdom Nepal

Population 66,650,000 29,136.000

Those in receipt of palliative care in hospice each year 48,000 700

Those in receipt of palliative care at home each year 225,000 500

Number of adult hospice beds available 2,760 25

Total number of hospices 220 6

Number of dedicated children's hospices 58 0

Number of terminally ill patients with access to opioids 100% 9%

Figure 1: Inside the existing hospice in Kathmandu

Table 3: Number of annual admissions to current hospice services

Year In Patients Kathmandu (urban Rural

community care) Community

(in the

Makwanpur

area)

2017-2018 133 105 111

2018-2019 160 104 213

2019-2020 76 94 274

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