In October 1993 a two-day seminar was held at Kaunus University organised by the Norwegian palliative care workers Steinar Bjorgo, Lorents Gran and Tor Jacob Moe. The event proved to be a turning point for wider palliative care development in Lithuania.9 The driving force for palliative care innovation in the country so far has been in the non-governmental sector and there have been difficulties in establishing palliative care within the broader structure of health care services, with a perceived lack of co-operation from the health authorities in starting this process.10 Good progress has been made with educational work and initiatives designed to raise awareness and understanding. The national societies for palliative medicine and for pain have organised a variety of courses and conferences and have translated a number of key palliative care works into Lithuanian. A pain clinic opened in 1994 in the department of anaesthesiology of the University Hospital of Vilnius. The idea for a Lithuanian-Polish symposium of palliative care was devised by Professor Jacek Luczak (Poznan) and Dr Jane Baubliene (Vilnius) and was attended by over 200 participants (from Latvia and Belarus as well as Lithuania) when it took place with Open Society Institute support in April 1996. The symposium led both to a meeting with the Minister of Health (one of eight Ministers over a ten-year period) in a bid to highlight the need for palliative care and also to subsequent attendances by Lithuanian health care workers at the Puszczykowo Advanced Course in Palliative Medicine.11
In 2001 Dr Arunas Sciupokas of the Kaunus University of Medicine received an Open Society Institute grant for a project on the development of national policies for palliative care in the three Baltic countries of Lithuania, Latvia and Estonia. The core work of the project is based around regional meetings held in Palanga, Lithuania (May 2001); Riga, Latvia (October 2001); and Tallinn, Estonia (May 2002).
In 2002 Dr Raimonde Ulianskiene, working with nursing colleagues from Doncaster, UK, began a palliative care education and strategy development programme within Panevezys County Governor’s Administration, with a primary aim to educate in palliative care 50% of family doctors and 80% of relevant specialists.12
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