1. Conspiracy of Silence

About this Video

Lack of political will and general awareness of this pressing humanitarian cause are blamed for the appalling situation where 80% of all people lack adequate access to essential pain medicines like morphine.

Pain and palliative care activists call for urgent change to this very treatable problem and challenge us to speak up for those less fortunate who have no voice and whose suffering is mute.

Mary Callaway (USA), Dr MR Rajagopal (India), Dr Betty Ferrell (USA) and Dr Henry Ddungu (Uganda) provide notable quotes:

Call to Action

  • Tell several colleagues and friends to watch this video
  • Ask them who often they discuss pain with their patients & families, or with their friends
  • Share your experiences in the comments section below…

Supporting Resources

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Movie Trailer

About this Video

LIFE Before Death is a documentary project comprising a feature film, a one-hour television program and 50 short films about the global crisis in untreated pain and the dramatic life changing affect palliative care services can deliver to patients and their families around the world.

The project is broadly about terminal patients, their families and the remarkable health care professionals fighting to change the culture of medicine to be focused on care, rather than exclusively on cure.

Curative medicine is the cornerstone of national health systems around the world and the primary motivation for many aspiring doctors. While curing patients is unquestionably a key goal, the over-zealous application of cure-based approaches is often at the detriment of patient well being, particularly towards the end of life. For patients with life-limiting illnesses cure is simply not an option.

With skyrocketing numbers of patients suffering from incurable cancer, HIV-AIDS and chronic diseases, a paradigm shift is urgently needed to provide holistic and humane treatment for the world’s dying.
Opiate medications, including morphine, are recognized as the gold standard treatment for moderate to severe pain.

Regrettably 4 of every 5 patients around the world who need these ‘essential’ medicines currently have inadequate access due to international regulatory barriers, counter-productive attitudes towards in both the health and public spheres, lack of relevant medical education, and a shortage of public awareness and political will to do more about this immanently solvable problem.

In addition to effective pain control, studies have shown that the application of palliative care addressing a patient’s ‘total pain’ – be it physical, psychological, social, spiritual or practical struggles – not only improves quality of life and reduces depression but also extends the life spans of patients with life limiting illnesses.

Call to Action

  • Tell your colleagues and friends about this upcoming documentary film
  • Send your colleagues and friends the website for the ‘Treat the Pain / LIFE Before Death’ Overview and Archive videos; encourage them to subscribe to the IPM International Program Mailing list so they receive weekly notifications for the next video

Supporting Resources

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Teaser 2

About this Video

Through the eyes of patients and their families we discover the inherent humanity that empowers the best of us to care for those beyond cure. We uncover hard truths about the torture occurring everyday in hospitals around the world but also of the immense hope that comes from those health care pioneers brave enough to accompany terminal patients on their inevitable journeys to gratifying end-of-life experiences filled with dignity, love and peace. This is a story of living well and dying better, making the most of every moment in our life before death.

Call to Action

  • Tell your colleagues and friends to watch this Teaser Video
  • Send your colleagues and friends the website for the ‘Treat the Pain / LIFE Before Death’ Overview and Archive videos; encourage them to subscribe to the IPM International Program Mailing list so they receive weekly notifications for the next video

Supporting Resources

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Teaser 1

About this Video

LIFE Before Death is a documentary project about the remarkable health professionals battling the sweeping epidemic of pain that threatens to condemn one in every ten of us to an agonizing and shameful death. Their tireless struggle pits them against unfeeling governments, dysfunctional bureaucracies, voracious corporations, over-zealous law enforcement agencies and, above all, the deep-seated attitudes of you and me.

Call to Action

  • Tell your colleagues and friends to watch this Teaser Video
  • Send your colleagues and friends the website for the ‘Treat the Pain / LIFE Before Death’ Overview and Archive videos; encourage them to subscribe to the IPM International Program Mailing list so they receive weekly notifications for the next video

Supporting Resources

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Mariam Velijanashvili, Georgia

Mariam Velijanashvili, MD

Mariam Velijanashvili

Palliative Care Physician,
National Cancer Center, Tbilisi, Georgia

Member, Georgian National Association for Palliative Care

Fellow, International Palliative Medicine Fellowship Program, OhioHealth

E-mail: marikaveli@yahoo.com
Skype: marika-veli

Dr. Velijanashvili is a neurologist, providing palliative care in the Palliative Care unit of National Cancer Center. She is a member of the Georgian National Association for Palliative Care involved in the preparation of documents concerning palliative care, website development, the translation of palliative medicine materials, and various other projects. She is also completing her residency course in neurology, monitoring neurological patients with palliative care needs. She plans to expand palliative care capacity in Georgia by increasing access to palliative care by neurological and geriatric patients. Dr. Velijanashvili is also interested in the field of epileptology and EEG monitoring, a field in which she has trained and worked.

Other Appointments

  • Instructor, English and Education in Palliative and End-of-Life Care for Oncology (EPEC-O), consulting physician at Transfiguration Convent Mercy Center, October 2011 – Present;

Key Accomplishments:

  • Translator, “Palliative Care for Neurological Patients” for new edition of Palliative Care textbook in Georgian, 2010
  • Participant in the creation of the Georgian government’s Palliative Care Action Plan for 2011-2015, prepared by the Office of the Coordinator of Palliative Care National Program, Healthcare and Social Issues Committee of the Parliament of Georgia under the leadership of Prof. Dimitri Kordzaia, November, 2010

Education / Honors:

  • Neurology Residency, S. Khechinashvili University Clinic of Tbilisi State Medical University (TSMU), 2007-Present
  • Completion of 6-week practical course in epileptology and EEG monitoring, Nervenklinik Wagner-Jaurreg, Linz, Austria, May-June 2011
  • Medical Degree, Tbilisi State Medical University (TSMU), 2000 – 2006
  • Translator-Interpreter Diploma, Secondary Faculty of Foreign Languages of Tbilisi State Medical University, 2000-2004

Key Presentations:

  • Integration of Palliative Care in Georgian National Health Care System- Past, Present and Future Challenges. Kordzaia, D., Velijanashvili, M., Georgian National Association for Palliative Care GNAPC, Barcelona, May, 2011
  • Implementation of Palliative Care Educational Courses in the Curriculum of Medical School – The First Georgian Experience. Rukhadze, T., Alibegashvili, T., Kezeli, T., Abesadze, I., Velijanashvili, M., Kordzaia, D., 12th Congress of the European Association for Palliative Care (EAPC), Lisbon, Portugal, May 2011
  • Drawing Up a Methodology for Creating a Geriatric Palliative Care Model Tailored to Georgian Reality. Kordzaia, D., Rukhadze, T., Dalakishvili, S., Velijanashvili, M., 12th Congress of the European Association for Palliative Care (EAPC), Lisbon, Portugal, May 2011

Resources


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Sarah Japhet Urasa, Tanzania

Sarah Japhet Urasa, MB ChB, MMed, MSc

Sarah Japhet Urasa, MB ChB, MMed, MSc

Physician, Kilimanjaro Christian Medical Centre, Moshi, Tanzania

Fellow, International Palliative Medicine Fellowship Program, OhioHealth

E-mail: sarah_u76@yahoo.com
Skype: sarah.urasa

Dr. Urasa works as a physician at the Kilimanjaro Christian Medical Centre (KCMC), caring for general internal medicine and neurology patients as well as performing both diagnostic and therapeutic gastro-intestinal endoscopic procedures. KCMC is a consultant referral hospital at the foot of Mount Kilimanjaro, providing services for a catchment area with an approximate population of 12 million people. Dr. Urasa is particularly interested and involved in the care of neurology patients in the African setting, most of who are generally overlooked by the medical practitioners in the area and thus left without diagnoses and care.

Other Appointments:

  • Lecturer, Kilimanjaro Christian Medical College, Moshi, Tanzania

Education / Honors:

  • MSc Clinical Neurology, University College London at the National Hospital for Neurology and Neurosurgery, Queen Square, London, UK, 2010
  • Master of Medicine, MMed, Internal Medicine, Kilimanjaro Christian Medical College of Tumaini University, Moshi, Tanzania, 2007
  • Postgraduate training, Gastro-Intestinal Endoscopy, Radboud University, Nijmegen, Netherlands, 2006
    Medical Degree, MB ChB, Makerere University Medical School, Kampala, Uganda, 2001

Resources:


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Kyriakos Stylianides, Cyprus

Kyriakos Stylianides, Cyprus

Kyriakos Stylianides, Cyprus

Doctor at the Supportive Care Unit Bank Of Cyprus Oncology Center

Fellow, International Palliative Medicine Fellowship Program, OhioHealth

E-mail: kyriakos.stylianides@bococ.org.cy
Skype: kyriakoss22

Palliative care in Cyprus is taking its first steps. Dr Kyriakos Stylianides is already part of this big step, and his main interest is to provide the best care for the patients not only at the end of their life, but also during their treatment. Dr. Stylianides has worked in the Supportive Care Unit of the Bank of Cyprus Oncology Center in Nicosia, Cyprus, since 2001.

Education / Honors

  • Sergeant, Army of Cyprus, 1990-1992
  • Medical Doctor, Ovidius University of Constanta, Romania, 1999
  • Pre-Registration at Larnaca General Hospital, Larnaca, Cyprus, 2000
  • Essential Palliative Care (Princess Alice Hospice, London), Nicosia, Cyprus, 2009
  • Advanced Communication Skills Workshop, Larnaca, Cyprus, 2011
  • Advanced Life Support course, Nicosia, Cyprus, 2011
  • Present: Lieutenant, Army of Cyprus

Resources


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Claudia Petrou, Cyprus

Claudia Petrou, MD

Claudia Petrou, MD

Medical Officer, Anticancer Society

Fellow, International Palliative Medicine Fellowship Program, OhioHealth

Email:claudia.petrou@anticancersociety.org.cy
Skype: claudia.petrou

Dr. Petrou is the Medical Officer responsible for homecare and day care at the Evagorio Center for Palliative Care, Anticancer Society in Limassol, Cyprus. The Anticancer Society is a non profit organization which provides palliative care to cancer patients and their families through homecare and day care. Dr. Petrou is interested in making the goals and philosophy of palliative care more known and accepted by colleagues, nursing staff and families.

Other Appointments

  • General Practitioner (part-time), Chrisovalantou Hospice, Limassol

Education / Honors

  • Subspecialty Palliative Medicine, German Medical Association, 2011
  • Specialty General Medicine, Cyprus Medical Association, 2007
  • Medical Degree, University of Berlin, Berlin, Germany, 1991

Key Presentations

  • Constipation as a symptom in palliative care, European University, Nicosia Cyprus, March 2012

Resources


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Christian R. Ntizimira, Rwanda

Christian R. Ntizimira, MD

Christian R. Ntizimira, MD

Medical Officer, Department of Internal Medicine, Palliative Care Educator and Trainer of Trainers, Coordinator of First Pediatric Palliative Care Center in Rwanda, Medical Director, Kibagabaga Hospital

Fellow, International Palliative Medicine Fellowship Program, OhioHealth

E-mail: ntiheritier@yahoo.fr, ntiheritier@gmail.com

Dr. Christian R. Ntizimira is Medical Director at Kibagabaga Hospital in Kigali City, Rwanda. He was Coordinator of the first Pediatric Palliative Care Center in Rwanda, and Educator and Trainer of Palliative Care at the national level. His decision to pursue a fellowship in Palliative Medicine was fueled by his passion for a holistic approach and the high rate of chronic disease in his country. Dr. Ntizimira is proud of his hospital and staff who have begun to offer palliative care at Kibagabaga Hospital, the milestone of a holistic approach in Rwanda.

Dr. Ntizimira grew up living in several different places, including the Democratic Republic of Congo. He speaks six languages: Kinyarwanda (mother tongue), Swahili, Lingala, French, English and some Spanish.

Other Appointments:

  • Member of the steering committee for implementation the National Policy of PC at the MoH
  • Vice-Chairman of steering committee in charge of Health at District level (Gasabo)
  • Member of Board committee of District Pharmacy (Gasabo)
  • Vice-Chairman of Committee for fight against HIV/AIDS at District Level (Gasabo)
  • Member of steering committee at Kigali city in Charge of Hygiene, Health Sector and Environemental Health
  • Member of steering committee in charge of Implementation tools for Palliative Care at the MoH
  • Member of steering committee in charge of NCDs (Cancer & Palliative Care)
  • Member of board committee in Charge of Health at Sector level (Kimironko)
  • Coordinator of all programs and activities in health sector at District Level (Gasabo)

Key Accomplishments:

  • Trained around 240 people at health center, District Hospitals, National level & Students from Family Medicine.
  • Start the First Palliative Care for Adult in 2010
  • Integrate Palliative Care as part of the routine activities in all services
  • Avail Morphine IV or Oral for all patients with Moderate/Severe pain
  • Set up a linkage in the community for continuum care for patients discharged from the Hospital by the PCAR
  • Coordinator of the first Pediatric Palliative Care Center in Rwanda in 2009

Education / Honors:

  • Medical Degree, National University of Rwanda 2010, 1996-2007
  • Medical Internship in four main departments: Surgery, Internal Medicine, Pediatrics and Ob/Gyn at Teaching Hospitals (CHUK&CHUB), 2007-2008
  • Harvard Medical School of Medicine Palliative Care Education & Practice Courses, 2011
  • Certificate of Awards for Developing countries from the AAHPM at New Orleans, 2013

Key Publications:

  • Title:”Neonatal Mortality in District hospital. A retrospective and descriptive study on 114 Cases in Ruhengeri hospital. September 2007″

Key abstracts:

  • Co-Authors: [New guidelines, promising outcomes: prevention of mother-to-child transmission (PMTCT) results over two years in Rwanda] to the XIX International AIDS Conference (AIDS 2012), which was taken place from 22-27 July, 2012 in Washington D.C., United States. Abstract #: A-452-0187-15985.

Key Presentations:

  • New beginnings: Rwanda’s first pediatric palliative care center at Kibagabaga Hospital
    The situation of Palliative Care in Rwanda, Achievements&Challenges.

Resources:


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Eddie Mwebesa, Uganda

Eddie Mwebesa, MB CHB, MMed

Eddie Mwebasa

Clinical Director, Hospice Africa Uganda, Kampala, Uganda

Fellow, International Palliative Medicine Fellowship Program, OhioHealth

E-mail: emwebesa@hospiceafrica.or.ug

Eddie Mwebesa, MD is Clinical Director at Hospice Africa Uganda in Kampala, Uganda. He provides clinical care to patients and provides mentoring and support to members of the palliative care team. Eddie is involved in efforts to increase morphine production within his organization and in Uganda, and has a special interest in furthering the philosophy and practice of palliative care in Uganda and Africa.

Other Appointments:

  • Honorary Lecturer, Makerere University,Kampala, Uganda
  • Honorary Lecturer, Mbarara University,Mbarara, Uganda
  • Instructor, BSc Degree in Palliative Care, Institute for Palliative Medicine for Africa
  • Senior Management Team, Hospice Africa Uganda
  • International Programs Directorate, Hospice Africa Uganda

Key Accomplishments:

  • Eddie is championing operational research projects through Hospice Africa Uganda’s Research Agenda Initiative.

Education / Honors:

  • Master of Science, Public Health, International Health Sciences University, Kampala, Uganda, expected 2012
  • International Visiting Scholar, Institute for Palliative Medicine at San Diego Hospice, 2010
  • Master of Medicine, Internal Medicine, Makerere University, Kampala, Uganda, 2009
  • Bachelor of Surgery, Makerere University, Kampala, Uganda, 2002
  • Bachelor of Medicine, Makerere University, Kampala, Uganda, 2002

Key Presentations:

  • Mwebesa, E. 2011, “Difficult Clinical Situations”, Palliative Care Association of Uganda Conference.

Resources:


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