Using Technology to Connect Health Care Providers with Experts in Bangladesh

Each year, around 220,000  children in Bangladesh experience serious health-related suffering. Children’s Palliative Care is a holistic  approach to managing that suffering. It is still in its infancy in Bangladesh and palliative care training is  yet to be included in undergraduate nursing and medical education, limiting access to services at a primary and secondary health care levels.

The only clinical children’s palliative care programmes are located in the capital city of Dhaka. This means that there is a serious lack of palliative care services and trained health care workers resulting in<10% of the children in need of services being able to accessing palliative care and pain management. From an equity standpoint, this lack of services disproportionately effects children in rural areas, as well as the women and girls who take on caregiving roles, limiting their educational and economic opportunities.

In collaboration with The SickKids Centre for Global Child Health, Dhaka Medical College Hospital and Two Worlds Cancer Collaboration (Canada), a groundbreaking online learning initiative has been launched to connect doctors, nurses and allied health professionals working in the departments of paediatrics of three Medical Colleges in Khulna Sylhet and Rangpur, with international and national palliative care experts and mentors.

The course was launched on May 8, 2024, with an opening ceremony. During the ceremony, Dr. Megan Doherty, Paediatric Palliative Director at Two Worlds Cancer Collaboration, extended a warm welcome to the participants and faculty. Dr. Gayatri Palat, Head of Palliative Medicine at the MNJ Institute of Oncology and Regional Cancer Centre in Hyderabad, commended Bangladesh for its outstanding efforts towards increasing palliative care provision. She highlighted that palliative care services need to reach the more rural and remote areas of the country, which is essential to ensure quality care for all.

Professor Titu Miah, the Director General of Medical Education in Bangladesh, emphasised the significance of improving access to palliative care across the country. He noted that palliative care is an essential element that needs to be included in nursing and undergraduate medical curricula. Professor Zohora Jameela Khan, Head of Paediatric Hematology and Oncology, Dhaka Medical College Hospital, expressing optimism about the 6-week ECHO programme’s potential to greatly benefit participants and faculty.

After the opening ceremony, participants began their training, with an interactive lecture from Dr. Sabitha Binu, a paediatric palliative care consultant from Chennai, India. Dr Sabitha discussed the holistic approach of children’s palliative care, and the conditions that necessitate its provision.

Over the next 6 weeks, this innovative training programme will use the Project ECHO model, featuring lectures from local and global experts, along with case discussions from the participants. It aims to empower healthcare professionals to address the comprehensive needs of children with life-limiting illnesses and their families, covering physical, emotional, social, and spiritual sources of suffering.

The course boasts a diverse and experienced faculty from Bangladesh, India, Kuwait, and Canada, united to foster connections among healthcare professionals and offer ongoing mentorship.

Key course topics include:

• Overview of Children’s Palliative Care and which conditions need palliative care
• Opioids and Pain Management in Children and Infants, local opioid availability
• Symptoms other than Pain
• Supportive Communication with Parents, Breaking Bad News
• End of Life Care
• Grief and Bereavement – Adults and Children

Upon successful completion of the course, participants will be awarded an official certificate, marking a significant milestone in advancing healthcare for children with serious illnesses in Bangladesh. This initiative represents a crucial stride towards establishing a comprehensive health system that caters to the needs of all children across the nation.