| Current services in Albania |
| The following palliative care services are known to exist in Albania: |
| |
Existing Services (2002) |
| Adult |
Inpatient - Freestanding |
0 |
| - Hospital Unit |
0 |
| - Hospital mobile team |
0 |
| Nursing Home |
0 |
| Home Care |
3 |
| Day Care |
0 |
| Total |
3 |
| Paediatric |
Inpatient |
0 |
| Home Care |
0 |
| Day Care |
0 |
| Unspecified |
0 |
| Total |
0 |
| Grand Total |
3 |
|
| Current Projects |
| No palliative care projects, not yet operational services, are known to exist in Albania. |
| |
Known hospice/ palliative care projects (2002) |
| Adult |
Inpatient - Hospital |
0 |
| - Hospice |
0 |
| Home Care |
0 |
| Unspecified |
0 |
| Total |
0 |
| Paediatric |
Hospital |
0 |
| Hospice |
0 |
| Home Care |
0 |
| Unspecified |
0 |
| Total |
0 |
| Grand Total |
0 |
|
| There are currently just three palliative care services in Albania, all offering home care: in Tirana and in Durres (Ryder Albania Association) and in Korce (Mary Potter Sisters). |
| The Ryder Albania Association (RAA) seeks to promote 'a better quality of life' for patients in the terminal stages of cancer through the provision of a free home care service which includes medical and psychological support.2 The Tirana team comprises: 4 doctors, 5 nurses, 1 social worker and 1 secretary and had a total budget of US$96,000 in 1999. The head of RAA is chief of the department of radiotherapy in the oncology service in Tirana and the head of anaesthesia in the oncology hospital is also involved in the local palliative care service. |
| The work of RAA in Tirana, Durres and Pristina has been described in detail.3 At Tirana 623 patients were cared from between 1993-2000; at Durres 401 patients were cared for between 1996-2000; and at Pristina 107 patients were cared for in the last nine months of 2000 - making a total of 1,131 patients in all. Pain was the most common problem among these patients (67.7%), followed by dyspnoea (18.8%). Treatment for pain was as follows: NSAIDs+adjuvants (51.1%); NSAIDs+opioids+adjuvants (37.1%); NSAIDs+palliative radiotherapy (11.8%). The average monthly income of the patients cared for was low at US$31 (1998); US$34 (1999) and US$35.3 (2000). Importantly, data have been produced on the cost of the service compared to hospitalisation; the average daily cost of hospital treatment in Albania in 2000 was US$16.6, compared with the average daily cost of the RAA home care service of US$5.3 - a saving of two thirds. Palliative care in the hospital is considered a priority for the country as a whole and RAA has ambitions to create a hospice. . Growing numbers of patients are seeking help, and as some terminally ill patients cannot be maintained at home, there is a perception that without an inpatient facility it is impossible to care for all patients adequately. |
| The Mary Potter Sisters' palliative care centre in Korce operates a home care service and some relatives come direct to the centre, when they need to see the sisters away from the patient's own home. Three sisters (two of whom have worked as Macmillan nurses in the UK and one of whom has palliative care experience in Korea) operate the service along with two local nurses, a part-time qualified volunteer nurse and two volunteer student nurses, plus a secretary. The service has close links with the one oncologist in Korce - the only source of morphine prescribing. The need for the service in the district has been recognised as important by both the Director of Public Health and the Director of Primary Care and it was formally licensed in September 2001, after the production of a detailed business plan and project proposal. Korce has 77,000 inhabitants plus about 150 surrounding villages. Between February and July 2000 the team cared for 58 patients, making 831 home visits; there were 18 deaths and 36 bereavement visits were made. |
| In January 2001 the Malta Hospice Association created a formal 'twinning' arrangement with the Mary Potter Centre for Palliative Care in Korce. This built on existing links, which had already allowed personnel from Albania to go to Malta for training in palliative care. In May 2002 the service moved back into the health clinic originally built in 1996 and an Albanian doctor trained in Malta, will begin work with the sisters in December 2002, under a five year joint project with the Malta Hospice Foundation and SOS Albania. |
| Education and training |
| The Ryder Albania Association (RAA) has funding from the Open Society Foundation in Albania for a two-year programme of National Training Courses in Palliative Care. The project aims are: |
- To update participants on the nature of palliative care and discuss the value of working in this field
- To provide theoretical-practical knowledge and skills in coping with the physical problems of terminally ill patients, with appropriate therapy
- To provide theoretical-practical knowledge and skills in coping with the psychological needs of terminally ill patients
- To identify and understand the role and importance of each individual team member in providing palliative care, as well as the crucial importance of working together
- To clearly identify the role and importance of the volunteer, including recruitment and training.
|
| The grant has also supported translation of two WHO documents on pain and symptom relief. Lobbying by RAA physicians resulted in some specific lectures on palliative care being introduced in 1999 into the teaching of the faculty of medicine in Tirana and into the nursing high school. |
|
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