Activists launch campaign aimed at raising public awareness on access to painkillers for palliative care patients. Both bottlenecks and solutions are at the local level.
Activists launched the awareness campaign #ЗнімайРожевіОкуляри – Take Off Your Rose-Colored Glasses. Its aim is to present the actual situation with the access palliative care patients have to painkillers. Official data usually says that all such patients have the access, they are provided with the necessary amount of medicine while the doctors are using correct treatment protocols. The actual state of play is different though. It was stated by Kseniia Shapoval, Manager of the Public Health Program Initiative of the International Renaissance Foundation speaking at a press-briefing at Ukraine Crisis Media Center. “In Ukraine 500 thousand patients annually require palliative care. Seventeen and a half thousand of them are children, they are lacking the special form of morphine. Provision with painkillers depends on regional-level healthcare departments and on the doctors,” Shapoval said. “In Dnipro for example out of the 11 primary health care centers there’s only one that supplies adequate painkillers. It means that there’s just one clinic in which the doctors are aware of the protocols used to treat the pain and of the pain evaluation scale, the clinic where seriously ill patients may receive prescriptions that offer discounts and painkillers are applied in a correct way,” the Public Health Program Initiative Manager said.
The worst situation is observed in Kyiv. Medics are using outdated legislation, it has a negative impact on patients. “Medics are still using outdated practices and legislation. Since 2013 the decision of one doctor is being considered sufficient to prescribe painkillers. However Kyiv has been using a commission to make such prescriptions even though this requirement has been suspended. Morphine injections are not being prescribed. There is a myth saying that ampoules require a different form of control. Patients entitled to free medicine supply often cannot get it. Their families have thus to purchase it at their own cost,” Shapoval said.
According to the World Health Organization if painkillers are applied correctly the patient may completely get rid of the pain and achieve the normal quality of life. “In Ukraine five to 14 per cent of patients have achieved the state of life without pain. They have not managed to get rid of pain sensations completely, however in comparison to other people their state is acceptable. If asked the chief medic at a clinic whether all the patients are provided with painkillers, they would say ‘yes certainly’. In Ukraine’s information space it’s easy to put this problem out of the public eyesight,” said Andriy Rokhanskyi, director of the NGO Institute of Legal Research and Strategies.
Outdated methods of treatment and resistance to the new protocols are frequent exactly at the local level. It’s at the local level that management of medical institutions does not let the doctors work based on the new standards. “Medics at local level are ready to work based on the new standards but their managers will not let them. The fear and the rigid way of thinking leads to the situation when the doctor fearing to get fired does not stick to the rules,” said Oleksandra Bratsiun, advisor to the acting Healthcare Minister of Ukraine on palliative care.
In case painkillers are denied to the patient, experts advise to insist that their rights are preserved and file complaints to the chief medic with a copy to the local state healthcare office, the Healthcare Ministry and the Ombudsman on human rights. As a rule, the issue is resolved at the level of the chief medic.
More information on palliative care in Ukraine is available from the Facebook page as well as during the public events in Sumy on April 19 and in Rivne on April 26.