This is a big step forward for palliative care in Lebanon and opens the door to positive change on many levels. This announcement has many implications for the future: Hospitals will be encouraged to open palliative care centres and education programs, medical students will be able to specialize in this domain, pain control practices are predicted to improve, National Social Security Fund (NSSF) would cover palliative services, and most importantly more patients who need such services will be able to access palliative care around Lebanon.
The Lebanese centre for Palliative Care– Balsam would like to thank the Lebanese Ministry of Public Health, Minister Ali Hasan Khalil, Dr Walid Ammar Director General of Health, and the National Committee of Pain and Palliative Care for their work towards this decree. Balsam with all its staff, supporters and friends is proud to have played a role in advocating for this change, and would like to congratulate all palliative care advocates around Lebanon!
The National Committee of Pain and Palliative Care is a committee established by the Ministry of Public Health. It works on advocating for Palliative care and sets the standards in Lebanon for palliative care practice, education, policies and research. It played a major role in this decree change. But it is important to note that Dr Hibah Osman (Balsam’s medical director) and two other Lebanese physicians certified in palliative care, wrote a letter a few months ago to the Director General of the Ministry of Public Health, Dr Walid Ammar. In the letter they asked for palliative care to be recognized by the Ministry as a medical specialty in Lebanon since such a decision will lead to the advancement of palliative care in Lebanon. All the mentioned activities and many others lead to the Ministry announcing this decree change.
The recognition of Palliative Medicine as a medical specialty by the Lebanese Medical Specialties Committee will lead to the advancement of this much needed medical field in Lebanon. The decree change came into effect on 28 June 2013. It will open the door to positive change on many levels. Of course it will take time, however many changes can now be developed and implemented since palliative care is acknowledged by the government. This also will decrease the toll of the existing barriers on the work of NGOs like Balsam. Palliative care can no longer be considered as a foreign concept to the health sector. It is a medical approach that is now acknowledged by the Ministry of Public Health as any other medical specialty in our healthcare system.
Most students who are interested in this field travel and specialize in other countries and end up working there since palliative care is not a recognized specialty in Lebanon. In a few years medical students will not have to travel abroad to follow this career path. For medical students to specialize in palliative care, training and education programs need to be put in place at hospitals. It will take time to develop these programs. However, this decree will help tremendously in pushing for the development of these programs. Moreover, the fact that palliative care is now a recognized specialty in Lebanon makes it more probable for medical students to choose this field as their specialty. They will also be able to work in palliative care in Lebanon after they graduate.
The American University of Beirut Medical Center (AUBMC) is working on establishing a palliative care team, so palliative care services will be launched on 1 August in the medical center. AUB medical students will be able to train with the team. A specialty palliative care program is in the planning stages.
Hopefully other hospitals and medical schools will follow. Issuing this decree will definitely encourage other schools and hospitals to establish specialty programs in their curriculum. It pushes things to move faster.
This announcement has many implications for the future: As I mentioned, hospitals will be encouraged to open palliative care centers and education programs, medical students will be able to specialize in this domain, and NSSF would cover palliative services. Furthermore, pain control will improve and become accessible on a wider scale since palliative care specialists will be allowed to prescribe opiates which will help in controlling patients’ pain and decreasing their suffering. Finally, hopefully in the near future, patients who are seriously ill and who need palliative care will be able to access such services in hospitals around Lebanon.