Developing Palliative Care in Asia - Short Film

More than half of all patients with cancer experience pain. In advanced disease, close to two thirds of patients report pain, about half of whom suffer pain of moderate-to-severe intensity. If cancer pain is not adequately treated, it can have devastating consequences that affect the quality of life of patients and their families. Palliative care improves the lives of patients and their families.  Watch ‘Life asked Death’ now and learn how palliative care services can be developed in ALL countries.

Pain, including beyond cancer pain

Living and dying in pain: It doesn’t have to happen.

Oral morphine is the gold standard essential medication for pain relief according to the WHO.  It typically costs several times less than other medications. However, insufficient knowledge, unfounded fears, over-regulation and commercial interests means that this pain medication is not available and accessible to the majority of patients.

Total Pain

Cancer pain encompasses more than physical pain and may include psychological, social and spiritual suffering. Physical pain is often made worse by other worries, by fear and by anxiety.  Sometimes physical pain cannot be relieved until the emotional, social or spiritual distress has been addressed.

Total pain can be addressed through:

  • Nursing care – Good nursing care can be provided by the family and in the community with the right training
  • Community – Gathering the community to give support will alleviate much of the social need.
  • Empowerment of the family – Families can be empowered to give the best care to the patient. Not only does this contribute to the patient’s welfare but knowing they have done their best supports the family in their bereavement.
  • Truthful, Honest Communication – Knowing the truth of the situation will allow people to plan for the future, express their wishes, and pave the way for reconciliation
  • A Listening Ear – Just allowing people to express their suffering goes a long way to sharing the burden.

Oral morphine

Oral morphine is the gold standard essential medication for pain relief according to the WHO. It should be made available to the patient wherever he is – in hospital, at home or in any other setting. Both immediate and slow release morphine and other analgesics need to be available.

Morphine is affordable

All countries can afford oral morphine.
But pharmaceutical companies do not promote it because the profit margins are too low.
Instead, expensive alternatives are often marketed.

Living and dying in pain: It doesn’t have to happen

Collectively, we need to do away with unnecessary suffering by breaking down the barriers to good pain relief. These barriers include:

  • Unfounded fears about morphine in patients, family members.
  • Fear & ignorance of doctors in prescribing morphine.
    • Opiophobia is a situation in which exaggerated concern about the risks associated with opioids prevent appropriate medical use of opioid pain medications such as morphine. Healthcare staff, policy makers, as well as patients, family members, and members of the public, can have these exaggerated concerns.
  • Over-restrictive rules governing the prescribing and dispensing of morphine
    • Oral morphine and other essential medications should be made legally available and accessible in all countries.
  • Over-regulation and unfounded fears resulting in most hospitals and pharmacies not stocking morphine. This leads to patients having to travel long distances in order to obtain their supplies of morphine.


New Palliative Care services have been started at key government hospitals and cancer centres in Bangladesh, Myanmar and Sri Lanka by participants of the Lien Collaborative.
Oral morphine is being made available by the government of Myanmar.
Is your country implementing policies to provide palliative care as part of the healthcare system?
Are essential medications available to treat pain?

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