Palliative Care is still relatively new for Nepal and most of the limited services are cancer-focused and located only in the central region. Nepal faces a rapid increase in non-communicable diseases, with high levels of hypertension (often undiagnosed or poorly managed), stroke, diabetes, and poorly-managed lung diseases. Chronic disease management including end-stage care is an escalating need.

COVID-19, with a central clinical requirement for palliative care has only increased the numbers of people in need.

INF’s Green Pastures Hospital [GPH] is pioneering an “all-disease-inclusive” comprehensive palliative care service, based on an innovative model integrating chronic disease management with palliative care for both adults and children. GPH is in a unique position to pioneer this integrated model, with its palliative service and well-established chronic disease services caring for both adults and children, including cerebral palsy.

The model includes a continuum of inpatient and community services, day therapy and clinics. A lovely new building funded through partners EMMSI and INFUK will be completed by August 2020, and provides 14 inpatient beds (10 adults, 4 children); a Day Therapy service incorporating clinical, educational, social, and skill transfer activities and a volunteer program; the community service base; and clinics. As well as holistic clinical care, the palliative care service has a long-term focus on training, education, and research.
Completion of construction is an absolute miracle in the context of strict lockdown since March.

We are incredibly grateful to our INF engineering team for their perseverance and hard work. Completion of the internal work is underway – final painting, laying of floor coverings and installation of doors, windows, and cupboards.

Remaining work includes sourcing the needed equipment – a big challenge during lockdown and border closures – and establishing the peaceful sensory garden with creative features that will be inclusive for people with disabilities.

Our palliative care team has been busy. COVID-19 has “fast-tracked” palliative care development with preparing an end of life isolation unit; need for resources, and increased palliative care trainings for GPH staff. We have recently provided sessions on the safe care of deceased bodies for 35 health workers plus via multiple Zoom sessions, for 65 leaders from different churches.

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