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