The most developed palliative care programmes exist in the main Colombian cities, such as:

• in Bogotá, at the National Cancer Institute. It provides outpatient and inpatient care. Members of the palliative care team also teach the principles of palliative care to undergraduate and postgraduate medical and nursing students at the private University of ‘La Sabana’
• also in Bogotá, at the ‘ Santa Fe’ Foundation that provides outpatient and inpatient care

Both palliative care teams provide training opportunities for physicians and nurses

• in Antioquia, Medellin at the ‘San Vicente de Paul’ Hospital that also provides outpatient and inpatient care. It is linked to the University of Antioquia for academic support
• in Cali, at the Social Security Institute which provides outpatient and inpatient care. This clinic offers teaching and training support to medical students and training doctors

There are other palliative care services at

• the ‘San Ignacio’ Hospital, in Bogotá
• the ‘del Valle’ University Hospital and at FUNDALIVIO, in Cali

All these palliative care programmes operate as hospital palliative care teams (except for FUNDALIVIO that operates as a private clinic for pain control and palliative care).

Most palliative care teams are attached to the hospital pain clinic where palliative care is provided as another specialized service of the pain clinic. Palliative home care may be provided in very particular circumstances, but it is not formally recognized. There are no hospices in Colombia.

Dr Rodriguez describes how a hospital palliative care team works:

“We have not got a specific area for the admission of palliative care patients. Usually, cancer patients are admitted to the internal medicine ward and we are called in to act as advisors; and there are some patients who we follow during all their hospital admissions. Other types of patients are also admitted to the surgical ward, and we also go there to be [palliative care] advisors. But, we do not have a specific palliative care inpatient area”¹⁸

Table 2 shows the ratio palliative care services per million population in cities of Colombia in which the more consolidated palliative care services exist.

 Table 2: Ratio palliative care services per million population

City	Ratio
Bogotá	1:2.279m
Cali	1:1.141m
Medellin	1:1.957m