10 hours of lectures and 12 hours of seminars in palliative care are provided for students at the Medical Academy in Bishkek, and the Russian journal Palliativnaya Medicina & Reabilitatsiya is available. With support from the Soros Foundation, palliative care courses in Switzerland and Hungary have been attended, and two oncologists from Bishkek have received training at the Kansas City Hospice.¹⁶

Mary Lou Hathaway, the American hospice nurse who conducted two travelling fellowships to Kyrgyzstan, in 1999 and 2000 reports on education and training amongst nurses:

‘Nurses are very interested in collaborating with other countries. I believe it would be beneficial for a palliative care physician to collaborate regarding pain management, barriers to narcotic use, ethics, and communication with patients regarding diagnosis. A visit by a social worker to determine psychosocial needs and interventions would help. Nurses are needed to demonstrate the palliative care philosophy. Collaboration with funding organisations such as Soros Foundation and Carelift International is needed. I believe methadone would be a good alternative medication in this setting given the patients’ limited ability to pay for medications. Good teaching would be needed to introduce this medication for pain control. Support for families and home care needs to be developed.’¹⁷