Meet the young women providing community palliative care in Bangladesh – Kulsum Akter

Kulsum Akter is part of a group of women working as Palliative Care Assistants (PCAs) in Korail Slum, Bangladesh, taking compassionate care to her neighbours.

Kulsum took part in training provided as part of the Compassionate Korail project, a partnership between the Worldwide Hospice Palliative Care Alliance, and the Centre for Palliative Care, Department of Palliative Medicine, BSMMU.

She says: “During the initial stage of my training, I was a little scared about how to take care of large wounds of seriously ill patients and how to communicate with patients and their families about other family issues.

“But after completing my six months training at the Centre for Palliative Care, I was very happy that my fear had gone and I was empowered to give them the care they need.”

Along with community health workers around the world, Kulsum is at the forefront of providing health care. Along with offering care for pain and symptoms, she is often the first person in her team to recognise and assess psychosocial suffering in the people she sees.

She explains: “Palliative care is the care we give to the patients suffering from life-limiting illness. When we go to the patient’s home, at first, we usually listen about their physical suffering and accordingly we provide care.

“Along with that, we try to find out about other mental and social suffering of patients and their families and try to guide them accordingly.”

Her patients feel comfortable sharing their worries with her as she gives them truly compassionate care. “I provide care to the elderly patients by thinking that they are like my own family,” says Kulsum. “I feel at peace when I provide care to a sick elderly patient rather than helping a healthy person.

“I feel privileged when patients share their innermost feelings which they do not even share with their family members,” she says.

Kulsum and the other PCAs are recognised in the community as a reliable source of assistance. This helps increase referrals to the palliative care service, helping people get the care they need as soon as possible. She says: “Now, people in the community ask for help from us when they see any sick people within the community.”

But Kulsum is concerned about the sustainability of this important work, when the current project ends. She says: “The community feels that Compassionate Korail is a part of them. Since this project has been built up by funds from abroad, I feel insecure what will happen once the funds stop coming. What will happen to the community of Korail and also to my job?”

She is passionate about the importance of palliative care in the Bangladeshi healthcare system and recognises the potential for the government to fund this vital service. She says: “Though we started community based palliative care in Korail slum, in our country there are lots of elderly patients who need palliative care to improve the quality of their life.

“I think if we could let people understand about the importance of palliative care, then it will be easier for us to establish this care throughout Bangladesh.

“The Bangladeshi government can play an important role by building awareness and providing district based training on palliative care for all health care workers.”