A Phnom Penh-based Portuguese photographer is working with the NGO Douleurs Sans Frontieres (DSF) to organise an exhibition at the French Institute of Language in order to raise awareness about palliative care for patients in Cambodia.
Palliative care is specialised medical care that focuses on providing patients relief from pain and other symptoms of a serious illness, no matter the diagnosis or stage of disease, though it is most often employed for patients with terminal illnesses.
“Recently we marked international cancer day and this NGO [DSF] is doing important work in this field by providing a more dignified end of life to people without means,” said photographer Miguel Lopes Jeronimo. “I feel this is a topic worth discussing and having more people, especially medical students, become interested in a more holistic approach to care.”
The “Palliative Care in Cambodia” photo exhibition opens on March 9 and is aimed at raising awareness about what palliative care is and how to access it in Cambodia.
“It’s a photography exhibition of portraits of four cancer patients who are followed at home by our medical-psychological teams,” said Frederic Garcia, country director of DSF in Cambodia.
He said that Jeronimo took many pictures of the patients during visits to the patients’ homes and in the hospitals of Phnom Penh.
DSF provides resources and help with the management of pain and additional follow-up for patients who are at the end of their lives due to terminal illness and who are among the most vulnerable populations in Cambodia.
Created by doctors in France, the NGO relies on both volunteer health professionals and salaried professionals in project management, according to Garcia.
DSF has been working in Cambodia for more than 25 years and has developed expertise and a network of partners adapted to the development of palliative care and end-of-life issues within hospitals, at DSF’s facility and at home, mainly, for cancer patients.
“The goal is to promote palliative care in Cambodia, especially among the authorities and medical students,” said Garcia, adding that it’s a three-year project funded by the French Development Agency, Etypharm, under a partnership agreement with the Cambodian Ministry of Health.
Palliative care aims to relieve the physical, emotional and psychological suffering of terminally ill patients and their families, according to Garcia, who also said that it is a relatively new concept of care in Cambodia with few specialists.
Garcia said that palliative care is holistic care for individuals across all ages with health-related suffering due to severe illness, especially those near the end of life, that aims to improve the quality of life of patients, their families and their caregivers.
He said palliative care was first introduced in Cambodia during the AIDS epidemic of the 1990s, when hospices, clinics, and pagodas began offering care to those dying of the disease who had been rejected by their families.
“Most of the patients of DSF in Cambodia have cancers and they provide care at home due to cultural and religious beliefs here. The majority of patients do not wish to die in the hospital and choose to go home with their loved ones to spend their last moments,” Garcia told The Post.
Every year, 15,000 new cases of cancer are diagnosed in Cambodia, and more than 13,000 people die from it, according to Garcia.
He said that the health ministry recognises that if it is not possible to treat the majority of cancers in the medium term, it is possible to reduce the number of cancer patients who are suffering.
It is estimated that in Cambodia, 80 per cent of cancer patients die without relief from their suffering, Garcia says.
This alarming figure is likely an underestimate, however, because it refers to patients treated in Phnom Penh, where the only two hospitals with oncology services are located.
“We must also consider patients in the provinces who do not have access to care and appropriate medicines. That is why we provide palliative care in 11 provinces of Cambodia,” said Garcia.
DSF improves access to care and follow-up of patients, appropriate pain management and the implementation of palliative care through the implementation of an integrated home health service to allow isolated populations to access care adapted to their pathology and the degree of progression of the disease.
“It’s not only about pain management but also about helping the patients with more psychosocial needs and giving support to the family,” Jeronimo told The Post.
To implement its project, Garcia says, DSF is successfully working in partnership with government institutions in the two countries concerned and civil society actors for the recognition and development of pain management and palliative care and that the strategy focuses on long-term action through capacity building and support to institutional and civil society health actors.
“Practitioners say that barriers to Western-style care for the dying include dependence on family caregivers, the reluctance of some health professionals to change their practices and deliver bad news to patients, and, as in all sectors in Cambodia, a lack of money,” said Garcia, adding that his organisation is determined to keep working to overcome these obstacles.
The palliative care photo exhibition opened on March 3 and is currently running at the French Institute of Language.