The major innovation in palliative care in Belarus has been in paediatric services; there are no adult palliative care services.
In 1986 the Chernobyl nuclear explosion in the Ukraine affected approximately 70% of Belarus. In 1999, according to data presented by the Belarusian Foreign Affairs Ministry, almost 20% of the population suffered from radiation exposure, including 1,000,000 children and young people. Interest in the hospice concept began as paediatricians became aware that an increasing number of children and young people were presenting with serious oncological/haematological diseases.7
The Belarusian Children's Hospice (BCH) was founded by the child psychologist, Dr Anna Gorchakova, in Minsk in 1993-4. It has received support from OSI, from Tacis (European Expertise Service) and other sponsors including the German and UK embassies; the Belarusian government has provided office accommodation. BCH's annual income rose from US$22,000 to US$88,000 in 1997, though it receives no subsidies from the government.8 The BCH has benefited from close links with the Warsaw Children's Hospice and the expertise and support of Dr Tomasz Dangel, particularly in relation to the education and training of staff and also the evaluation of the service provided, as reported by bereaved parents. BCH staff have also had access to training and conference attendance in other countries.