A Comparative Review of Palliative Care Development in Six Countries Represented by the Middle East Cancer Consortium (MECC)

Palliative rare development and services were reviewed in the region represented by the six members of the Middle East Cancer consortium: Cyprus, Egypt, Israel, Jordan, the Palestinian Authority, and Turkey. The multimethod review synthesized evidence from ethnographic field visits to impatient units, home care hospice teams and free-standing hospices, including interviews with hospice and palliative care clinicians, administrations, volunteers, policy makers and academic researches. Public health data and relevant literature were collated together with internet-accessed information on services and health care systems. A total of 69 services were located; two country members have a history of relatively sustained development of hospice and palliative care bot provision across the Middle East Cancer Consortium reo-ion is highly variable at a local level. Considerable barriers to service development were identified in a region already struggling with many military and political conflicts. Key problems are a lack of secure funds and government support, inadequate professional training programs, opioid phobia in professionals and the public, and lack of awareness and understanding of palliative care needs at public government, and professional levels. Key areas for further attention were increasing national and international professional training and public education programs, improving opioid legislation and health care Policies, government or health insurance funding provision, raising awareness about the need for pediatric services and for patients with other illnesses, as well as for those with cancer, and working to integrate palliative care into mainstream health service provision and education. J Pain Symptom Manage 2009;37:287-296. (C) 2009 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.