FUNDACION CUDECA, Benalmádena, Málaga, Spain. Since 1991.
Cudeca is the acronym of Care for Cancer, whose logo shows a person with their arms wide open offering help and whose slogan is “A Special Way to Care”. This NGO aids patients with cancer and other pathologies and is based in Arroyo de la Miel (Málaga, Costa del Sol). The mission of CUDECA is to care for, alleviate pain and keep patients company, offering specialized palliative care to residents in the province of Málaga who suffer from cancer in an advanced or terminal phase, and to offer support and counseling to their families.
CUDECA possesses multidisciplinary teams formed of doctors, nurses, social workers, psychologists, physiotherapists and qualified volunteers. The programmes offered by CUDECA are completely free for patients and their families. They are known for their flexibility and ease of adaptation to the specific needs that arise, responding to patients’ problems by means of medical attention and home-based palliative care, external consultations, and assistance with the rehabilitation of patients either in the Day Centre or in the foundation’s hospital.
Patients may be referred to the CUDECA foundation by their medical specilialist, family doctor, or any other health professional. If they are suffering from cancer in an advanced phase or a terminal illness, CUDECA offers both the patient and their family assessment and specialized, holistic care.
More information on the CUDECA foundation on www.cudeca.org
Paediatric Palliative Care: FUNDACION ALBERGUE SAN GABRIEL, San José, Costa Rica. Since 1990.
The mission of Albergue San Gabriel is to facilitate the personnel, materials and knowledge necessary to give efficient and timely attention to children and teenagers who are in a condition of terminal illness or limited life expectancy so that, together with their families they can benefit from the principles, teachings and philosophy of Palliative Care.
The Albergue San Gabriel attends to two types of paediatric patients: 1) those in a condition of limited life expectancy, who have been diagnosed with illnesses in an advanced stage where there exists no reasonable possibility of a favourable response to curative treatment; and 2) palliative patients, who present numerous problems or intense, multiple, multifactorial and changeable symptoms; and in both cases whose prognosis of life expectancy is limited.
In the history of the Albergue San Gabriel, on 1st October 1990 Doctor Lisbeth Quesada Tristan founded the Paediatric Palliative Care Unit in the National Children’s Hospital, this establishing the first such unit in Costa Rica and Latin America, providing in-home and hospital care to its patients. The original impulse for the creation of the unit came from a legal appeal presented by a patient who was suffering intense pain due to terminal cancer and who was being denied the morphine which she had been prescribed by her doctor, Dra Quesada Tristán. Allied to the scarcity of morphine in the country the denial was motivated by several medical professionals who, lacking up-to-date knowledge in pain therapy, regarded the levels of dosage as unscientific. The verdict of the Constitutional Court was that “Every citizen of Costa Rica has the right to a dignified death without pain”.
This verdict marks a landmark in the history of Palliative Care in Costa Rica, to the extent that it can be said to mark a turning point. It served to foster awareness in the civil population that families with a member suffering pain from a terminal illness could demand from their doctors or the Social Security an adequate attention and control of this pain.
In the year 2006 the Foundation launched a doctorate programme in Palliative Care at the Catholic University of Costa Rica. The aim of the programme is to formally train health professionals not only in Costa Rica but also in all the other Central American countries.
Those children who may require Palliative Care are those suffering from: 1) conditions for which curative care is possible but which may well fail; 2) illnesses which could lead to a premature death, but where an intensive treatment could extend a good quality of life; 3) progressive conditions where the treatment is exclusively palliative and which may go on for several years; and 4) conditions with neurological damage leading to weakness and susceptibility to complications. For more information about paediatric Palliative Care in Costa Rica, visit Paediatric Palliative Care in Costa Rica
HOSPITAL DIVINA PROVIDENCIA, San Salvador, El Salvador. Since 1966.
The mission of the Hospital Divina Providencia is to provide Palliative Care attention to patients with cancer and to their families, who are generally referred from the Hospital Nacional Rosales and the Institute of Cancer and who are people lacking economic means and who suffer on account of the pain of the cancer. The institution relies on charitable donations from benefactors and Divine Providence, and it is the only organization offering this service in El Salvador. The Director-General of the institution tells us: “The Hospital Divina Providencia over these last eleven years has become a sanctuary from pain, where on a daily basis we live through experiences which strengthen our lives. Through Palliative Care we have provided quality of life in terminal situations, we have supported families who themselves suffer alongside the patient, and we too have suffered and shed tears with them. We know that our task is not easy but God gives us the grace and strength to carry on.”
The Hospital Divina Providencia arose from the original idea of the Carmelite missionary nun of Santa Teresa, Sister Luz Isabel Cuevas, who wished to offer a place of rest for patients of the Institute of Cancer who had travelled from far afield to San Salvador to receive radiotherapy and who, due to their limited economic means, had no option but to sleep rough near the installations of said institution. The plans of Sister Luz were blessed by God’s Providence in the form of Mrs Bertha Rivas de Albiñana who, as well as donating land for the building, also challenged the nun to create a hospital where cancer patients could receive an integral treatment. In the decades of the seventies and eighties the elected Bishop of San Salvador, Monseñor Óscar Arnulfo Romero, found supporters in these nuns and set up his house in the Carmelite community, living in close contact with the patients and living fraternally with the nuns. His assassination on 24th March 1980, in the chapel of the hospital, provoked diverging reactions in the different sectors of society. On the one hand, the chapel and house of Moseñor Romero became places of pilgrimage for many people, while on the other his assassination and his criticisms were a motive for abandoning charitable donations to the hospital.
In the last decade the Hospital Divina Providencia has dedicated itself to professionalizing and improving its service, in accordance with the principles of Palliative Care. In spite of the limitations, it has been possible to treat over two hundred new patients every year, supporting their families in addition. Nowadays the hospital has doctors, nursing teams, physiotherapists and nutritionists. Aided by volunteers they are able to provide psychological attention and emotional support to patients. Learn more about the work of this historic hospital at http://hospitaldivinaprovidencia.org