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Palliative care development in Mongolia.

Palliative care development in Mongolia. Davaasuren Odontuya, M.D., Ph.D., president of Mongolian Palliative Care Society.

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Palliative care development in Mongolia.

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  1. Palliative care development in Mongolia. Davaasuren Odontuya, M.D., Ph.D., president of Mongolian Palliative Care Society

  2. Mongolia is a country with large territory (occupies 1,565 million km 2 of land ) in Asia bordered by Russia to the north, China to the south. Population is very small (2.65 million). One third of the population live in the capital Ulaanbaatar, the rest in 21 provinces.

  3. Cancer is a second course of death in Mongolia

  4. Situation in Mongolia • 166,7 cancer deaths per 10000 population • 65-75 % of cancer patients diagnosed in the late (III-IV) stage of cancer • 64,3% of cancer patents die within first year of diagnoses

  5. Home death rate in Mongolia Diseases Death (%) Cancer 1627 40,9% Hypertension 1097 27,5% Cardiac failure 484 12% Pneumonia 200 5% Hepatitis 111 2,7% Nephritis 106 2,6% Total death 3976 100%

  6. 5 most common cancers in Mongolia leads to death 1. Liver cancer 43% 2. Gastric cancer 15% 3. Lung cancer 10% 4. Esophageal cancer 10% 5. Cervical cancer 5%

  7. Priorities and strategies on 5 common cancer in Mongolia

  8. The wishes of people in the terminal stage of life • Not to suffer from pain and other distressing symptoms • Not to be dependent on others, not to be a burden • Not to be abandoned • To be around the family and close friends • To leave good memories for others

  9. Situation in Mongolia before: • Human rights violation • Equality in health care services • Not accessible for every patients • No hospices or organizations for Palliative care • No education on palliative care • No policy on palliative care • Not available essential drugs for palliative care

  10. Mongolian Palliative Care Society was established in 2000.

  11. Developing palliative care in Mongolia • Main WHO guides on palliative care translated into Mongolian and published in 2000-2002 • First palliative care education material was published for postgraduate education of family doctors in 2000, 2002.

  12. Palliative care development in Mongolia • Inpatient palliative care department with 10 beds was established in the National Cancer Center in 2000 by OSI support

  13. Basic Courses on Palliative Care were organized for 330 medical workers (doctors, nurses, medical teachers) through out the country in 2002 by financial support of OSI

  14. Palliative care development in Mongolia Palliative care teaching programs adapted by National Medical University and 4 medical Colleges of Mongolia (Ulaanbaatar , Darhan, Dornogobi, Gobi Altai Medical colleges) in 2002

  15. Palliative care development in Mongolia First voluntary palliative home hospices established in Zuun Kharaa and Huvsgul Aimags in 2002.

  16. Palliative care development in Mongolia “Hope” home hospice established and officially registered in July 2003 with 5 medical workers

  17. Palliative care development in Mongolia The doctors and nurses of this hospice had more than 1100 home visits to 110 patients within a year

  18. Palliative care development in Mongolia “Green Home Hospice” established in 2002 by financial support of Yonsey University (Korean) and gives home care, outpatient servicers

  19. Leadership Conference for advocacy palliative care organized in 2002 by support of OSI

  20. Participants of the Leadership conference: • 2 Parliament members • Deputy Health Minister • Social Policy Adviser of the President • International consultant • Head of Health Department of all provinces • Directors of Medical schools • Media

  21. Palliative care development in Mongolia Basic and advanced training manuals for palliative care developed in Mongolian language by support of OSI

  22. Palliative care development in Mongolia “Family Medicine” periodical journal published from 2002 in collaboration with MFDA, MPCS, MNU

  23. Palliative care development in Mongolia • Palliative care issues included in the postgraduate training programs and standards of family doctors and oncologists in 2003 • In the Doctors’ category examination tests included Palliative care issues.

  24. Palliative care development in Mongolia 10 courses on palliative care were organized by MPCS in 2003-2004 and 800 doctors and nurses from 5provinces,3 districts of Ulaanbaatar and major Medical Centers participated in these courses.

  25. 4 Decision makers from Mongolia participated in the Palliative Care Policy Development Conference in Budapest in October 2003 by support of OSI

  26. Palliative Care Policy development Conference organized in February 2004 in the Ministry of Health by support of OSI.

  27. Palliative care development in Mongolia Health Minister’s order on establishment of Palliative care policy development with 4 working groups issued in May 2004 : • PC Standard • Financing of PC • Drug availability for palliative care • Undergraduate and postgraduate education programs on PC

  28. Palliative Care Resource Training Center established in March 2004 by support of OSI

  29. Palliative care development in Mongolia Coordination and integration workshop of activities of working groups on policy development organized with technical assistance of international consultant Jan Stjernsward in April 2004.

  30. Palliative care development in Mongolia National trainers are trained from all provinces of Mongolia, from all medical schools and districts of Ulaanbaatar in July 2004 by OSI support.

  31. WHO recommendation for an effective national program on palliative care

  32. Palliative care services in health care system I level (Primary health care) • Family doctors and nurses II level • Home hospices, palliative care team; • Inpatient beds in the Regional or District hospitals III level • Palliative care department in the NCC • home care services;

  33. Drug availability for palliative care • To insure the availability of pain relief drugs for palliative care patients for medical purposes. • To improve essential drug list for palliative care. • To import inexpensive IRMS • To improve prescription right of medical workers to change the law without restriction the amount of drug prescribed or the duration of treatment.

  34. If people were born They will dieThe death is stage of life All people will die, because the death is stage of life. All people don’t like suffer in the terminal stage of life. All people will need palliative care in the terminal stage of life and we have to improve palliative care

  35. Life begins with love and should finish with love

  36. Thank you very much

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