When Things Happen - The Story of COVID-19, Palliative Care, and An NGO.

Several natural disasters and the appearance of the coronavirus disease 2019 (COVID-19) pandemic created stressful situations to many health-care workers in the Philippines. New health-related challenges surfaced, and health-care workers felt lost since many of the challenges were either directly or indirectly caused by the fast-spreading coronavirus infections and its variants. Further, the way people die also changed, causing confusion and influencing the Filipino grief and bereavement processes. In response to the need of the health-care workers, a nongovernmental organization (NGO) through its education portal created and offered free webinars, aimed to help health-care workers understand and make sense of what was happening, thus empowering them with knowledge on how to manage the challenges and provide better care to the patients and the community as well. This article relates the process of planning and implementing online webinars during the era of social distancing and COVID-19 pandemic.

Palliative Care: Opportunities for Nursing.

Ayda G. Nambayan, PhD, RN is the Training Consultant for The Ruth Foundation for Palliative and Hospice Care. Prior to this, she held various positions as a Consultant for Advanced Education and Training at Makati Medical Center, Philippines; a curriculum and distance learning developer for www.Cure4Kids.org, the educational website of the International Outreach Program of St. Jude Children's Research Hospital in Memphis, TN. In 2002, she retired from a faculty position from the University of Alabama at Birmingham, where she taught Adult Health Nursing for 25 years. Her nursing degrees were from the University of Santo Tomas, Manila, Philippines, Teacher's College, Columbia University in New York, NY and The University of Alabama at Birmingham, Birmingham, AL. Among her many professional awards include the Oncology Nursing Society's Pearl Moore Making a Difference Award in Oncology Nursing, International Award for Contributions in Cancer Care and the End of Life Nursing Education Consortium award for Pediatric Education.

Availability of palliative care services for children with cancer in economically diverse regions of the world.

PURPOSE: We assessed the availability and quality of palliative care for children with cancer according to national income per capita. METHODS: We surveyed physicians who care for children with cancer using the Cure4Kids website (http://www.cure4kids.org). Queries addressed oncology practice site; reimbursement; specialised palliative care, pain management and bereavement care; location of death; decision-making support and perceived quality of care. Responses were categorised by low-, middle- and high-income country (LIC, MIC and HIC). RESULTS: Of 262 completed questionnaires from 58 countries (response rate, 59.8%), 242 were evaluable (55%). Out-of-pocket payment for oncology (14.8%), palliative care (21.9%) and comfort care medications (24.3%) was most likely to be required in LIC (p<0.001). Availability of specialised palliative care services, pain management, bereavement care and institutional or national decision-making support was inversely related to income level. Availability of high-potency opioids (p=0.018) and adjuvant drugs (p=0.006) was significantly less likely in LIC. Physicians in LIC were significantly less likely than others to report high-quality pain control (p<0.001), non-pain symptom control (p=0.003) and emotional support (p=0.001); bereavement support (p=0.035); interdisciplinary care (p<0.001) and parental participation in decisions (p=0.013). CONCLUSION: Specialised palliative care services are unavailable to children with cancer in economically diverse regions, but particularly in LIC. Access to adequate palliation is associated with national income. Programme development strategies and collaborations less dependent on a single country's economy are suggested.

Cure4Kids - building online learning and collaboration networks.

The International Outreach Program of St. Jude Childrens' Research Hospital has been developing programs to help countries with limited resources develop treatment centers to treat children with catastrophic diseases such as pediatric cancer and AIDS. Cure4Kids (www.cure4kids.org) is the Internet learning network that delivers medical education to doctors and nurses on pediatric cancer and AIDS. The objective of Cure4Kids is not only education, but also to provide tools for communications and collaborations among individuals.