Perspectives of Former International Pain Policy Fellows

International Pain Policy Fellowship

Training ProgramMadison, Wisconsin, USA

6 August 2012

Bishnu D. Paudel, MD2008 Fellow

Nepal

Mount Everest : 8,848m (29,029ft)

Nepalese Situation

• Most of the cancer patients were diagnosed in advanced stage.

• Pain was most commonly associated symptom in cancer patients.

• Pain was not treated optimally.

Breast cancer lady with severe pain

Drug availability

Expensive chemotherapy & targeted therapy were available.

Cheap opioid like oral morphine was difficult to get.

International Pain Policy Fellowship?

• Why opioids like oral morphine availability is problem in Nepal?

• Something more than routine work!

International Pain Policy Fellowship

The Fellowship is intended for health professionals from developing countries who have an interest to improve availability of opioid analgesics.

International Pain Policy Fellowship

• Training program in June 2008 for fellow and ministry representative

• In country Project & Action Plan

• Mentorship

• Financial support

IPPF Fellow, Mentors & Ministry representative

Training Program

1) Policy level

2) Drug Distribution System

3) Cost of Opioid Analgesics

4) Knowledge & Attitudes

Barriers of opioid availability

Action Plan

Problems;-Irregular supply of opioids .

-Dependent on foreign drug companies .

-Multiple groups working

-Lack of knowledge & attitude

Action PlanActions:

Importers to report regularly. Production in Nepal

An Association of Palliative Care.Educational activitiesPain Management Protocol

Oral morphine production in Nepal

• Morphine syrup in 2009

Morphine tab 10 mg 2011

Morphine Tab(10mg) PR 2012

Morphine Tab 30mg (PR)2012

Nepalese Association of Palliative Care(NAPCare)

Nepalese Association of Palliative Care Officially registered 16th December, 2009 and 11 member body was formed.

Dr. Eric, Mentor, visit

Educational Activities

• One month palliative care training

• Pain and Palliative care training in National Academy of Medical Sciences in March 2011. Dr. Eric resource person.

Educational activities

American Academy Hospice Palliative Medicine Annual Meeting 2011

Indian Cancer Aid Society Palliative Care Award 2012

INTERNATIONAL LEADERSHIP IN PALLIATIVE CARE

Conclusion

At the end of my fellowship I am proud to say because of IPPF I could bring some changes in my country to help people who are suffering from pain .

I enjoyed working as International Pain Policy Fellow and have 100% satisfaction.