Specific care for cancer patients at the end of their life started to be established in the mid 1970s, initiated by the Cyprus Anti-Cancer Society, whose founder members recognised a need for support in the population. As Neophyta Kouppi, now the Matron at the Arodaphnousa Hospice, Nicosia, explains, in the early days:

‘Few people in Cyprus knew about hospice and palliative care. We started because we wanted to help the cancer patients to have somebody to care about them. Because after the Turkish invasion and all the problems we’d had in the general hospital with refugees with cancer and nobody to look after them and all those problems, we thought we needed to build a home for them and take care for them. But we didn’t know about hospice philosophy. Later on, we heard about hospice care and that was after, I think, the second meeting in London with Cicely Saunders. One of our members, Dr. Soulitis, an oncologist, heard about St. Christopher’s, so he went there to visit and he when he returned with many ideas about hospice care and how to control pain and symptoms. So we started to do more things actually about pain, with medicine; for example, to give medications regularly, so as not to be in pain. After a few years we helped the families to spend time with the patients, and encouraged them to go home on weekends, you know, to spend time with their family. But we didn’t know that this kind of care is hospice care.’³⁴

By the beginning of the 1990s, there was increasing awareness of the concepts of palliative care. Both organizations, Cyprus Anti-Cancer Society and The Cyprus Association of Cancer Patients and Friends (PASYKAF), independently recognized the need to develop home care services. Neophyta Kouppi describes her early work setting up the home care service as part of her work in Arodaphnousa Hospice:

‘From the end of 1991 in November, I started to visit the Oncology Department in the general hospital and meet the patients who had finished their treatments and were going home. I used to visit the Oncology Department twice a week in cooperation with the oncologist to meet the patients and their families. I gave them information about the home care we could offer them. After their agreement we would start visiting them at home.’ ³⁵

Within a year she had started to enlist more help from two other nurses at the Arodaphnousa Hospice and had engaged medical support from the hospital oncologists, who prescribed medication to be taken at home. She encouraged the Society to develop services in more districts of the island, initially in Limassol. By the end of the 1990s, services had been extended to 4 of the 5 Greek Cypriot administrative districts.

In 1992, Jane Kakas, had started to set up the first independent home care team, at the instigation of PA.SY.KAF, in Nicosia. Since this time both NGOs have developed teams in all 5 Greek Cypriot districts. One important innovation developed by PASYKAF has been the ‘DITIS’ computerised patient record system, which allows the home care team to access a central patient record by internet or mobile. Although, still in early stages of implementation the aim is for all members of the team to be able to share and communicate with each other anywhere on the island and adjust records or discuss problems as needed.³⁶

About 35% of cancer patients now die at home with support from home care teams provided by either Cyprus Anti-Cancer Society or PA.SY.KAF.

Since the late 1990s, both NGOs responded to the need to have dedicated full time physicians in their services, by funding specialist training, For instance, in PA.SY.KAF one part time physicians has completed a Masters in Palliative Care and another part time physician has completed a Diploma in Palliative Care. In the Cyprus Anti-Cancer Society two full time physicians have completed Masters in Palliative Medicine in the UK .

Psycho-social support has been increasingly prioritised by both NGOs. In 1996 the hospice staff requested that the Cyprus Anti-Cancer Society employ their first social worker. In 1999 the Society appointed its first full time psychologist Maria-Christina Tchopourian. She explains the kind of ways the psycho-social staff work:

‘We are 2 full-time psychologists and 5 part-time, covering all the Greek Cypriot districts. The hospice I would say is about 30% of my work. The Oncology Centers in Cyprus don’t have a position for a psychologist, so the voluntary organizations cover the patients’ needs. In the hospice, if the team and the doctor feels it would be beneficial, we meet with the patient or their family. At the beginning, there were only a few referrals, but now it’s the majority of the patients we have here. We also do home visits, working with patients cared for by the home care teams, other nurses, and the oncology centres, so a patient can meet with us at any point in their treatment, either at home, in the hospice, the oncology centres or at our offices. The same psychologist will stay with the patient throughout the different stages of their disease.’³⁷