Thousands of patients deprived of palliative care in Armenia

An average of 3,370 terminally ill patients in Armenian provinces have no access to palliative care and are struggling with pain every day.

“Palliative care is a human right to live a dignified life without pain until the end. Its primary purpose is the management of pain and other distressing symptoms, qualitative care, as well as social, psychological and spiritual support for the patient and his or her relatives. However, palliative care is not available to everyone in Armenia,” Sputnik Armenia writes.

According to the article, in two regions - Shirak and Lori - such services are not provided at all; in several other regions, some mentioned services are chargeable.

According to Hripsime Martirosyan, founder of the Henaran Foundation (cancer patient advocacy in Armenia), which defends the interests and rights of cancer patients and has also run a public awareness campaign on palliative care, there are 31 institutions and services in Armenia that provide such services on a paid and free basis.

"Considering the population of these two areas [Shirak is 230,500 and Lori is 211,600], one wonders what is preventing them from helping terminally ill people there. Either the local health centres don't want to do it, or the problem is the difficulties associated with licensing. The latter is unlikely, as other regions provide this care," she said.

Armen Khachatryan, head doctor of the Gyumri Medical Center, told Sputnik Armenia that the hospital cannot provide this service at the moment, as it does not and has never had the necessary staff or infrastructure.

"First of all, we need to solve the issue of premises, we also need to obtain a license and train personnel. This is very difficult and costly," he said.

Sputnik Armenia asked the Ministry of Health for data on which oblasts are eligible for palliative care, which services are provided under a state order and how many people need this care, but the ministry did not provide the data, noting that no such statistics are kept.

But data is available from the Henaran Foundation, which estimates that there are 3,600 patients in need of palliative care in Armenia every day. Around 40 per cent (1,440 people) are cancer patients, and only 500 of them live in Yerevan, while the rest live in the provinces, which complicates access to palliative care. On average, 3,370 people (93.7 per cent of those in need of palliative care) are in pain every day.

"Many people in Armenia believe that if an illness is incurable, it must be accompanied by unbearable pain and suffering. However, thanks to effective pain management and palliative care, it is possible to live without such suffering," said Hripsime Martirosyan, head of the Foundation.

According to her, modern palliative care offers a wide range of pain medications, but often opioids are needed to control pain. But, as it turns out, the problem in Armenia is not so much related to their availability, but rather to the lack of awareness of the population. Many people refuse to take medication for fear of becoming addicted.

Martirosyan's words are confirmed by data received from the Ministry of Health. The Ministry told Sputnik Armenia that last year, the UN International Narcotics Control Board (INCB) approved a quota of 12.5 kilogrammes of opioids for Armenia, but only 2 kilos were used.

Apart from numbers, there is a living example. L.K., an 80-year-old resident of Gyumri, who recently passed away, had been in pain for months but was not taking any medication or receiving the care she needed.

"Her family members live abroad and they organised her care. However, the woman was not so much in need of care as she was in need of pain relief, she literally could not be touched. If there had been a palliative care centre, her care would definitely have been less painful," said Karine Karapetyan, a relative of the deceased.