Page 24 - Sphere No.17 (Sep 2006)

22 SPHERE
programme is leading China into a new era of hospice care.
The 20 hospices employ 140 medical professionals and
are spread across 19 cities in 13 provinces. To date, the
programme has served more than 47,000 patients.
The launch of the National Hospice Care Programme
has attracted extensive media coverage, arousing greater
awareness and interest among the Chinese public, which
in turn has generated more public concern for the physi-
cal pain and psychological trauma suffered by terminal-
stage cancer patients.
Embracing the sunset together
“The work on the hospices will go on beyond my life-
time,” said Mr Li. “I hope members of the hospice staff
will always offer their love and kindness to cancer pa-
tients.” Describing his dedication to the service of impov-
erished cancer patients as “timeless”, Mr Li expressed the
hope that the hospice staff would share his enthusiasm
and carry the torch for this worthy cause.
Despite his hectic work schedule, Mr Li tries to find
time to visit hospice staff members and often writes let-
ters to encourage them.
“Please remember that you never work alone. We are
of the same mind with the same genuine desire to offer
hospice care,” he wrote in one letter. “How noble your
work is, to offer a dose of painkillers, a touch of human
warmth and kindness to a person suffering from illness
and pain, so that the physical torment is immediately as-
suaged and the soul becalmed.
“It is said that after people die, they either ascend to
heaven or descend into hell. However, to terminal-stage
cancer patients in their last days, the immeasurable pain
and torment that they suffer already feels like hell on
earth. To all the medical personnel in the hospices who
NEW FREEDOM FOR THE NEEDY
ONE OFTHE most common problems of terminal-stage
cancer is pain. Pain must first be alleviated before one
can even begin to talk about improving the patient’s
physical and psychological well-being.
World Health Organisation (WHO) studies have shown that
70 per cent of cancer patients suffer pain, of whom 40-50 per
cent suffer moderate and severe pain. In the 1980s the WHO
launched a campaign, Freedom from Cancer Pain by 2000, which
proposed using non-traumatic drug therapy to treat cancer pa-
tients individually according to a scale known as the pain ladder.
Freedom from Cancer Pain, however, remains a distant ideal for
most cancer patients on the Mainland. The majority of terminal-
stage cancer patients suffer excruciating pain.Painkillers can provide
total pain relief for most cancer patients, but because many impov-
erished patients cannot afford basic analgesic treatment, they end
their final days in misery, their bodies wrecked, their spirit broken.
Pain and poverty deny them peace and dignity in their last days.
The 20 hospices set up by the Li Ka Shing Foundation on the
Mainland provide free standardised treatments for cancer pain
and complications arising from terminal-stage cancer. Not only
are they a soothing balm to the destitute patients, they also al-
leviate the mental anguish suffered by patients and their families.
They allow patients to reclaim their dignity and live each day of
their remaining lives in peace.
At the hospice in Shantou, for example, each patient on av-
erage receives a free seven-day course of painkillers that costs
around RMB300. The patient who underwent the longest treat-
ment period was a breast cancer sufferer who, over four years,
received free analgesic drugs that cost around RMB23,000. Two
other cancer patients with bone lesions were each given pain-
killers that cost around RMB12,000 over a period of two years.
For poor families, such medical expenses are astronomical and
completely out of their reach.
To improve the use of resources and lower drug costs, the
Office of the National Hospice Care Programme obtained per-
mission from the State Food and DrugAdministration to reduce
the number of links in the drug supply chain on the Mainland. In
a trial run, six hospices purchased specially approved analgesics
at factory prices, saving up to 38 per cent in costs. Based on the
result of this trial, all 20 hospices on the Mainland would save
RMB7.33 million a year if they used specially approved drugs.
Where the average cost incurred by each patient is RMB1,900,
it would mean that the hospices would be able to serve an ad-
ditional 3,800 patients, or improve the quality of their services.
At the moment, the Office of the National Hospice Care Pro-
gramme is actively seeking approval for the expansion of this
special drug distribution scheme to all 20 hospices by 2007.
At present, the hospices are already providing total pain relief
for 40 per cent of terminal-stage cancer patients under their
care, a figure that is on a par with international standards. The
free analgesic treatment given to cancer patients by the hospices
follows theWHO’s three-step pain ladder.
After a doctor has conducted an evaluation, the pain is clas-
sified as mild, moderate or severe. Different medication is pre-
scribed for each class of pain. Non-opioid +/- Adjuvants are used
for patients with mild pain, while mild opioids +/- anti-inflam-
matory drugs and Adjuvants are prescribed to patients suffering
from moderate pain. For patients in severe pain, strong opioids
+/- anti-inflammatory drugs and Adjuvants are administered.
The 20 hospices set up by the
Li Ka Shing Foundation provide
free standardised treatments.