Starting palliative care services in Transnistria
Project funded by the European Union, implemented by UNDP
Project duration: March 1, 2018 – August 31, 2018
Palliative care has been recognized in Moldova as part of the health system since 2008. The legislative framework has made significant progress with palliative care services being regulated at primary, secondary and tertiary levels. Palliative care services have not been introduced on the left bank of the Dniester, as this area is new for both medical staff and patients in the region.
According to statistics, 1855 people were diagnosed with cancer in Transnistria in 2016 alone, 212 cases more than in 2015. At the end of 2016, 10 012 people, or 2.1% of the region’s population, were under the care of the Tiraspol Oncology Dispensary. In 2016, the share of people who died during the first year after diagnosis amounted to 27.6%, i.e. all these patients would have needed palliative care.
Following discussions with specialists in Tiraspol, we agreed on the urgent need to take measures in this regard for the benefit of the diagnosed persons and their families. In order to solve this problem, it is necessary to provide oncologists, medical therapists and decision-makers in Transnistria with the documents regulating the palliative care system in the Republic of Moldova (primarily the national clinical protocols in palliative care) in Russian.
Beyond the lack of a legislative framework that would regulate the field, another problem identified is, implicitly, the lack of trained staff to provide palliative care services throughout the entire territory of the left bank of the Dniester.
The main aim of this project is to provide the necessary assistance by the FFMS “Angelus Moldova” to initiate a functioning palliative care system in the Transnistrian region.
The main project activities include:
Training at least 15 specialists in palliative care at the Oncological Dispensary in Tiraspol for 2 weeks (80 academic hours) was carried out by trainers from Chisinau, from the FFMS “Angelus Moldova”: Valerian Isac, expert in palliative care and Natalia Carafizi, physician specialized in palliative care; and by Mrs. Dr. Galina Buta, prof. prof., USMF “N. Testemițanu”.
Translation of the protocols and specialized information (leaflets, information, a palliative care guide, ministerial orders and the 5 clinical protocols for palliative care, approved by the Ministry of Health in 2011), then printing and distribution.
A study visit, lasting at least 2 days, during which the training participants from the Transnistrian region will come to Chisinau to conduct home visits in the Chisinau municipality, together with the staff of Hospice Angelus. On the second day, the participants will visit the Pediatric Palliative Care Center “Casa Angelus” (Isacova village, Orhei district) to observe in practice how pediatric palliative care services are provided in the inpatient care.
The realization of an informative broadcast on a TV channel from the left bank of the Dniester river, dedicated to palliative care and its importance, with the invitation of specialists in the field, competent in the training activity. The program will inform citizens about the opportunities for palliative care. The broadcasting of the program throughout Transnistria will sensitize public opinion on the importance and significance of palliative care in contemporary society.
Following the implementation of this project, we are counting on the introduction of a functioning palliative care system in the Transnistrian region. At the first stage, until the possibilities of establishing a stationary hospice are identified, thanks to trained staff and local political will, the first mobile teams for palliative care services at home will be established, which will be able to serve patients from all over the region. Once introduced, this system will be able to be taken over and monitored by local governing bodies and medical institutions in the region in the long term.
By working together, people on both sides of the Dniester can improve their living conditions.
