Bringing End-of-Life Care to Parts of Bangladesh

In the past 30 years, the world has made phenomenal progress in terms of ensuring more new-borns and infants survive the first few years of life.

Between 1990 and 2019 the global mortality rate for children under the age of five declined by 59%, according to UNICEF, representing millions of children’s lives saved. Supporting those early, vulnerable years remain a global health issue of utmost priority, as mortality rates for children in the world’s poorest countries are still shockingly high compared to wealthier nations.

But many low-income countries have limited health care support for people dealing with health issues towards the end of their life as well — and universal health coverage means health care at every life stage.

Whether it's supporting people who are elderly or living with life-limiting illnesses and disabilities, without appropriate care, so many people end up suffering unnecessarily and experiencing very poor quality of life.

This is something that the Worldwide Hospice and Palliative Care Alliance (WHPCA), an international NGO, is working to address — with a little help from the British public.

A UK-aid backed project that WHPCA has been running, in partnership with the Bangabandhu Sheikh Mujib Medical University (BSMMU), in Bangladesh since April 2018 has brought palliative care to Narayanganj City Corporation. The city of about 2 million people, 10 miles south of the capital Dhaka, had no existing services available.

“In Bangladesh people are living and dying with serious pain and suffering because there are so few hospice and palliative care services and essential palliative care,” WHCPA explains. The organisation estimates that “256,000 people die each year from life-limiting illnesses in Bangladesh”, and most do not have access to specialist health services that support them through that.

It’s a sensitive area of work, involving vulnerable patients, so WHCPA and BSMMU decided to build a compassionate palliative care community in the city, involving both medics and members of the public.

In the first two years of the project, which started in April 2018 and will end in June this year, they reached hundreds of people through their work by setting up a Palliative Care Hub.

They fully trained nine local residents to be palliative care assistants (eight women, one man) to deliver home-based care. They also trained 72 nurses and 34 doctors on the basics of palliative care and held meetings to alert local leaders and residents to the issue too.

Through this work they supported 275 patients, 70% of whom had a serious disability, and directly supported almost 1,000 families members of those patients too.