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How the Worldwide Hospice Palliative Care Alliance is improving palliative care in Bangladesh

It’s a key part of what the World Health Organisation (WHO) sees as universal health coverage, but palliative care is a neglected and unequal issue. Globally, 86% of people who need it, are not receiving it. The Worldwide Hospice Palliative Care Alliance (WHPCA) is one organisation looking to change that.

In 2018, the WHPCA, in partnership with the Department of Palliative Medicine at Bangabandhu Sheikh Mujib Medical University (BSMMU), launched a UK Aid Direct-funded project to bring a palliative care service to Narayanganj, Bangladesh. The lack of palliative care service in the region meant that those with serious and life-limiting conditions had high levels of physical pain as well as psychological distress and mounting health costs.

One year on, the project has established a palliative care hub, is providing support to more than 100 patients and has trained 27 nurses and 17 doctors from the Narayanganj public hospital in the basics of palliative care, a subject that does not exist on the medical or nursing curriculum.

To help build awareness and advocate for the service in Narayanganj, WHPCA has enlisted the support of the local community. Local people have been trained as Palliative Care Assistants (PCAs), a new role that has been introduced to the city. PCAs visit patients where they live to minimise travel costs and to encourage the building of a compassionate community around the patient’s home. 93 community volunteers have also been trained to act as ambassadors for palliative care services and support the project by referring potential patients, visiting patients and training other volunteers.

“The community of Narayanganj takes the new concept of palliative care positively. They help me a lot and also respect me,” says Nadia Sultana Nupur, one of the nine new PCAs in the area. “With my work, I can contribute to human life, provide food and nutrition-related advice to the patients and serve the patient’s suffering from life-limiting illness.”

However, one of Nadia’s concerns is whether this service will continue to exist after the project ends.

“I hope that in the future the Narayanganj society will be able to take responsibility,” says Nadia. “The Government can also play an important role to establish palliative care in every district, through funding, raising public awareness and through training healthcare staff.”

WHPCA has already started engaging local authorities to ensure that the momentum gained in Narayanganj is maintained. The organisation has obtained support from Narayanganj City Corporation Mayor, Selina Hayat Ivy, for the project and she has provided a statement of her intention to continue key elements of the project once the international funding comes to an end.

Furthermore, one of WCHPA’s partners – the Department of Palliative Medicine at Bangabandhu Sheikh Mujib Medical University – was involved in the creation of policy and clinical guidelines for palliative care in Bangladesh. A step forward to ensuring that palliative care is available throughout the country.

Supporting female carers in Nepal and Bangladesh this International Women’s Day

It is estimated that 80% of people with disabilities live in the developing world, and while a host of international organisations that are working to support those with disabilities probably spring to mind, it is a challenge to find one that focuses on their unpaid carers who are often equally impoverished, isolated and disproportionately female.

Anil Patil, founder of Carers Worldwide, refers to these carers as an ‘invisible army’ as despite the significant role they play,  recognition and support networks are non-existent.

“All of us will become carers or will have someone caring for us at some point. It does not discriminate whether you are rich or poor. It affects each one of us,” says Anil.

In the UK, unpaid carers save the NHS more than £100 billion a year. Scale the number up to a country the size of Bangladesh and you get an understanding of the contribution carers make. As the only organisation working exclusively with unpaid carers in the developing world, Carers Worldwide is looking to address that imbalance.

Since its establishment in 2012, the organisation has primarily focused its work in South Asia and has received two UK Aid Direct grants for projects in Nepal and Bangladesh. In this region, caring responsibilities are generally undertaken by women; 93% of carers engaged by Carers Worldwide in Bangladesh are women. The lack of support networks combined with the gender inequality present in South Asia – countries in the region rank in the bottom third for women’s economic participation, educational attainment and health – means that female carers are doubly marginalised; excluded from mainstream society due to their gender and role as carers.

Caring responsibilities mean that they often end up impoverished and unable to maintain their own health and wellbeing. During its Nepal project, it was found that 69% of carers had a physical health issue due to the strain of their caring responsibilities.

Carers Worldwide builds support networks and raises awareness of the role of carers by improving the capabilities of local health care systems, providing employment and skills training, establishing respite opportunities and creating carers-only associations and cooperatives.

“By setting up carer organisations, carers are not only able to share their experiences and issues, but they feel empowered and are provided a platform to get recognition for the vital work they undertake,” says Anil.

Carers Worldwide UK Aid Direct-funded project in Nepal was a success. By the end of the project, 75% of the carers engaged had a sustainable, regular income and 100% of young carers had returned to school.

The traction gained by the associations meant that several local communities celebrated a day for carers in 2014. This is a tradition that continues to this day with elected representatives and ministers attending the events.

Next for Carers Worldwide is expanding the model to other countries. Its Small Charities Challenge Fund project in Bangladesh has been live for four months and it has already established 17 carers-only groups; the first of their kind in the country. The organisation is also keen to continue the progress made by building the capacity of the carers associations to increase their political power and ensure nobody is left behind.

“In our first UK Aid Direct project, we ensured 75% of carers had a regular income. But what about the other 25%? How can we improve this? This is our next step,” says Anil.

Find out more about how Carers Worldwide’s work empowers women in South Asia here. 

UK government announce campaign to end period poverty globally by 2030

Ahead of International Women’s Day, Minister for Women and Equalities and Secretary of State for International Development, Penny Mordaunt, today (4 March) announced a new UK government campaign to end period poverty globally by 2030.

In many developing countries, it is estimated that half of all women and girls are forced to use rags, grass and paper to manage their periods. A lack of access to products, and the stigma and taboo that still surrounds periods, can force them to miss school or work, or even to live in isolated huts during their periods each month. In the UK, Girl Guiding UK found that 26% of girls aged 11-21 feel embarrassed talking to people about their period, and 21% had been made to feel ashamed or embarrassed about their period.

Ms Mordaunt’s new campaign pledges up to £2 million in UK aid support, through the Department of International Development (DFID) to help organisations which are already working to stamp out period poverty around the world

The current UK Aid Direct funding round, offering Community Partnership and Impact grants welcomes applications addressing any of the Global Goals. A portion of available funding is already reserved for projects addressing urban poverty, and following Penny Mordaunt’s announcement, projects working to support an end to period poverty globally will also be especially welcome.

Find out if your organisation is eligible to apply by visiting the Community Partnership and Impact sections of the website.