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101 A simple act of kindness can do more than medicine: palliative care training for community health workers in rural myanmar
  1. Kerry E Waterfield
  1. Health Education England North East


Introduction Chin State, a very remote and mountainous state, is the most impoverished in Myanmar. Health and Hope has trained 834 community health care workers (CHWs) from over 550 villages across Chin and neighbouring Rakhine state to address basic healthcare needs in their communities. The current project involves the selection and training of Area Coordinators (ACs) to provide support, ongoing training and supplies to a group of CHWs in their geographical area. Palliative Care is underdeveloped and resourced in Myanmar, which ranked 76th out of 80 countries in the Economist ‘Quality of death’ index. There is no known provision in Chin State.

Method A half day workshop was delivered to 23 ACs which aimed

  • To improve understanding of issues facing patients at the end of life

  • To introduce palliative care and a holistic approach

  • To improve confidence in looking after patients at the end of life

Results None of the participants had previously heard of palliative care. ACs reported that most had looked after patients at the end of their lives with many difficult and distressing stories involving huge suffering. Verbal feedback at the end of the workshop demonstrated that they had acquired a good understanding of palliative care and a holistic approach in several key areas and had improved in their confidence of caring for patients at the end of their lives.

Conclusion There is a significant need for palliative care in Myanmar, due to a high level of serious health related suffering and poor current provision. A short training package delivered to CHWs improved understanding of palliative care and confidence in looking after dying patients. Additional education, training and resources could further equip the team with the potential to make a significant impact on the lives and deaths of those in Chin and neighbouring states in Myanmar.

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