Honduras is a country of 9.5 million inhabitants with a poverty rate of 70 % in 2020, and 53.4 % of extreme poverty. The socio-economic conditions of the country are not unrelated to the plight of paediatric oncology patients. This precarious situation decreases the response of patients to treatment, in a country where 1.12 new patients are detected every day.
The situation is more complex for palliative patients, as the Public Health System prioritises patients with life expectancy, which is why in 2017 the Honduran Foundation for Children with Cancer created a unit for children in need of palliative care in alliance with paediatric oncologists from the Hospital Escuela. This project aims to expand palliative care to the rest of the country through itinerant visits, thus providing medical assistance in hospitals and at home. To this end, a multidisciplinary team was formed, consisting of a palliative doctor, a nurse, a psychologist and a social worker.
The Paediatric Haemato-Oncology Unit of the Teaching Hospital operates with 24 hospital beds. The palliative care beds are located in this unit, which has a room with two beds assigned to terminally ill children. In view of this situation, it was necessary to strengthen the itinerant palliative care programme and a staff member of the Foundation was assigned to monitor the patients through telephone calls and to know the general condition of each one of them using the Lansky Scale to identify their physical, psychological, spiritual and economic needs.
As part of the mission to improve the quality of care for palliative care patients, the Foundation set itself the task of visiting, at home, the child who required attention from the integrated care team according to the findings of the patient monitoring. Due to limited resources and the demand for patients requiring care in hospital wards, the palliative care programme travels to places where it is possible to return to the city the same day.
The Foundation is currently building a new Medical Centre for Children with Cancer in Tegucigalpa, which is expected to increase the capacity for palliative care with 10 palliative care rooms.
- Formation of the oncopediatric palliative care team.
- Medical visits in the different paediatric wards by a palliative oncologist and psychologist.
- Home visits have not been discontinued despite covid-19.
- Through monitoring, 100% of patients who have died have had some intervention by the team.
- Talks on palliative care in the main hospitals in the country.
- Psychological follow-up from diagnosis with or without curative intent, accompaniment during the palliative process.
- Administration of pain medication using an elastomeric pump.
- Each palliative visit, a medication kit, biosafety kit, food, recreational activities near the home, birthday celebrations, wish fulfilment and music therapy are provided.
- The social worker conducts an interview with the family to look for opportunities to improve the environment and the home.
- Our whole life is summed up in a delayed preparation of the truth that we deliver to those who survive us.
Courtesy of Paliativos Sin Fronteras/Palliative Notes Magazine 2021.