As some of you may know, I am part owner of a Home Health Care company is Moscow Russia called First Home Care, I also do some consulting work in Eastern Europe in all areas of hospice and palliative care. My company in Moscow works closely with several hospices because in Moscow, hospices typically only care for cancer patients. So for patients with end of life care needs, with cardiac disease and other illnesses that we can care for we try to assist.
The conflict in the Ukraine caused by Mr. Putin’s quest to re-assemble the old Soviet Union is wreaking havoc on the medical systems both in Russia and Ukraine. The traditional health care systems are funded by government money and with the sanctions the Russia’s are facing from the world, the infrastructure in Russia is starting to crack; including health care. The private health care sector is also suffering as people in these countries are seeing their incomes threatened and causing them to select between basic living and addressing health issues. In short, the health care status continues to decline. One of the consequence being that Global Medical Tourism for people that can afford it continues to grow.
Unfortunately, addressing hospice and palliative care needs in Eastern Europe continue to be a struggle. People are dying in pain; especially those dying from cancer. Most all these people could have experienced a comfortable, peaceful death and, yet, little is done. The good work started in Russia in the early 1990’s by the British Russian Hospice Society and Victor Zorza to develop hospice and palliative care programs is further endangered by the political climate in Russia.
In Ukraine, an organized hospice movement is basically non-existent. I wrote in a past blog that hospice and palliative care is approached as a human rights issues to prevent people from dying in pain. There have been several end of life conferences in Ukraine over the years but unfortunately they did not lead to any sustainable efforts. And with the current conflict occurring in Ukraine I am sad to say I do not see much progress in this area.
The work that Kseniya Shapoval has started in Ukraine in the area of Palliative Care is a solid foundation to build on. Her work to change the use of morphine was one of the largest steps to help improve the quality of life at end of life.
I will be back in Ukraine soon and hope to meet with Ms. Shapoval to further work on ways to improve the delivery of hospice and palliative care. I will also be back in Moscow this summer where my company will continue to work with several hospices in Moscow to seek ways we can collaborate to serve more patients and families in need.