Palliative Care Association "Humanists Union" - Official registration date February 16, 1999

One of the main goals of the organization is to promote development of Palliative Care system and implementation of internationally approved bioethical standards which will provide creation and success of modern Palliative Care Service in Georgia .

Partners, sponsors, collaborators and supporters:

Classical and Traditional Medicine Academy

OSGF

OSI

Hungarian Palliative Care Association and Hospice Foundation

Cancer Prevention Center

Office of the first Lady of Georgia

SOCO Foundation

San Diego Hospice

Hospice of Wake Country

Ministry of Health, Labor and Social Affairs

Parliament of Georgia (Committee of Health Care and Social Affairs)

State United Social Insurance Fund of Georgia

Department of Municipal Health ( Municipality of Tbilisi )

Tbilisi State Medical University

Tbilisi State University

Tbilisi Nursing School N2

Tbilisi Nursing School N3

National Society of  Red Cross

Georgian Public Broadcasting

TV-company "Imedi"

Experts:

Katalin Muszbek - Hungarian Palliative Care Association and Hospice Foundation, Vice President of European Association for Palliative Care

Agnesh Rusha - Hungarian Palliative Care Association and Hospice Foundation

Mary Callaway - International Palliative Care Initiative. Open Society Institute

Franc Ferris - Medical Director, Palliative Care Standards / Outcome Measures, San Diego Hospice and Palliative Care and OSI International Consultant. 
Jan Stjernsward - World Health Organization International Advisor

Lasha Zaalishvili - OSGF

Anda Jansone - Project director of Pediatric Palliative care, Latvia

Accomplished Projects:

2000 - 2001 - Two International meetings - "Integrative Medicine in Palliative Care" (with the collaboration of Classical and Traditional Medicine Academy );

2001 - 2002 - "Creation of specially trained team in Palliative Care" (granting organizations OSI - USA and OSGF). In 2001 the team of doctors, nurses and volunteers has been prepared and trained for the implementation of Palliative Care. In the same year "Humanists Union" with the collaboration of " Cancer Prevention Center " and "Classical and Traditional Medicine Academy" has prepared and published first supplemental handbook "Palliative Care (Medical Aspects)". Both above mentioned activities were supported by leaders of Hungarian Palliative Care Association and Hospice Foundation - Katalin Muszbek (she is also Vice President of European Association for Palliative Care) and Agnesh Rusha

2003 - Organization and leadership of independent section in "USA - Georgia Symposium for Biomedical Collaboration". Preparation and accreditation of two programs (with each duration of 10-hours) in cooperation with "Classical and Traditional Medicine Academy" for continuous post-graduate education of doctors;

2004-2006 - Project "Palliative Care of incurable patients at home by mobile team (home-based hospice)".

First home - based palliative care mobile team was financed in 2004 by humanitarian foundation "SOCO" under the patronage of the First Lady of Georgia.

2004-2005 - Project "Further development of Palliative Care System in Georgia " (granting organization: OSGF);   

During this period of time two handbooks "Palliative Care" for students of Medical Universities and "Palliative Care" for students of Medical Colleges has been prepared and published. Program of Palliative Care for the students of Medical Universities has also been created. From 2006 "Palliative Care" has become an elective discipline at Tbilisi State Medical University . By the end of May 2006, more then 100 students attended the entire course of Palliative Care.

In 2005-06 the components of home-based palliative care is under the financial support of State United Social Insurance Fund of Georgia according to the order of Minister of Health, Labor and Social Affairs.

For the further improvement of health professionals and public awareness of importance of Palliative Care, "Humanists Union" has prepared few publications and 5 TV video advertisements regarding Palliative Care Service of incurable patients in Tbilisi which was presented as a "social advertisement" free of charge 5 times a day during 2 moths in Governmental and private televisions.

For the implementation of internationally approved standards of Pain Relief (management) of patients with cancer (also other chronic incurable diseases), improvement degree of healthcare professional's knowledge, awareness of patients' family members, also for the practical training of medical stuff in the field of Palliative Care, several trainings has been arranged with the participation of foreign experts. For the same purposes training of medical professionals involved in mobile team and Hospice  which is created in the basis of Cancer Prevention Center (Director R. Ghvamichava) has been carried out with the participation of Franc Ferris and Jan Stjernsward (WHO and OSI experts). As a result, report of Jan Stjernsward "National Palliative Care Program" has been created, later published by the office of D. Kordzaia - Palliative Care National Coordinator. The mentioned report was printed and distributed among healthcare professionals and policymakers. The report was issued in both - English and Georgian Languages and its electronic version was presented by internet (also on the web-site of the Parliament of Georgia). The abovementioned document is the most important and basic strategy in further development of modern Palliative Care System in Georgia .

(http://www.parliament.ge/files/619_8111_336972_Paliativi-Eng.pdf)

Election of Dr. Dimitri Kordzaia as a Palliative Care National Coordinator was followed by establishment of the Palliative Care National Coordinator office, which coordinates all the activities of different projects and serves as the educational center for healthcare professionals involved in Palliative Care Service, translates and prepares publications of internationally approved manuals and handbooks in Palliative Care, organizes seminars and workshops,  regulates permanent contacts with old and new partners and experts of Palliative Care in Eastern and Western Europe and USA.

In 2005 "Humanists Union" has prepared translation of WHO document "Achieving balance in National Opioids Control Policy". (It was also published by the office of Palliative Care National Coordinator)

In 2005 by initiative of "Humanists Union" Ministry of Health, Labor and Social Affairs has started discussion to include "Palliative Care" as an independent subcomponent in the list of medical specialties (the discussion is continued).

In 2005 International Palliative Care Development Course for Caucasian Countries was organized in Georgia with the participation of Palliative Care Association "Humanists Union" and " Cancer Prevention Center" under the support of Hungarian Hospice Foundation and sponsorship of OSI.

From 2006 Palliative Care State programs also have increased. The municipal Palliative Care Sub-Program (as a small component of Out-Patient Program) was initiated. This sub-program now finances the second Palliative Care Mobile Team and two additional beds in Hospice (at the National Cancer Centre) in Tbilisi from July 2006; (in 2004 we had only one mobile team financed by the First lady's Foundation in 2004-2005 and by government budget - from 2005. So, for today Palliative Care Service in Tbilisi consists of one hospice for 15 patients, organized by "Cancer Prevention Centre" at NCC and two Home-based Palliative Care teams organized by Association"
"Humanists' Union". All activities are financed by government (by State United Social Insurance Fund of Georgia and by Tbilisi Municipal program budgets). Palliative Care each mobile team includes 1 general practitioner and 3 nurses, also group of consultants: surgeons, oncologists, hematologists, immunologists, endocrinologists, neurologists and etc. Mobile team provides medical and nursing care (home visits) of incurable patients with cancer and other chronic diseases, also provides them with different medications and medical supplies. Both mobile teams (physicians and nurses) permanently takes care of about 70 patients, carries out about 4-6 visits daily. Each patient is visited once during the week by physician and 3 times a week by a nurse.  All mentioned activities are realized by the motor vehicle "SUBARU", which Palliative Care Association "Humanists Union" has purchased by the financial support of the Humanitarian foundation "SOCO", leaded by first Lady of Georgia .  The car also serves for transportation of patients from home-hospice to stationary hospice and backwards (if necessary) and organizational activities of Association and PC National Coordinator's office as well.

Permanent training system of physicians and nurses working in home care mobile teams is established at the hospice. According to active participation and contribution of Palliative Care National Coordinator, the attempts are conducted to include also the Primary Health Care Network Oncologists in this system.

Two nursing schools are ready to begin the elective course in "Palliative Care" from November, 2006

In 2006 Association "Humanists Union" has been awarded for the project: Implementation of Palliative Care Service for children. The goal of the project is promotion of Palliative Care for children and professional education of healthcare resources through:

1. Creation (selection) of the team from interested professionals to work in the field of   Palliative Care and promotion of theoretical and practical training with participation of invited experts;

2. Preparation and publication of internationally approved recommendations and instructions (guidelines) in Georgian language;

3. Improvement of  legislative normative base, which regulates Pediatric Palliative Care and drug availability (pain management).

In April 19, 2006 Association "Humanists Union" and Palliative Care National Coordinator Office supported arrangement of special meeting for creation of working group (commission by 17 members) for preparation of suggestions of harmonized integration of palliative care into the national health care plans and improvement of legislative-normative basis of End-of-life Care and drug availability. The same meeting Committee of Health Care and Social Affairs of Parliament of Georgia has approved the office of Palliative Care National Coordinator and its strategy plan.

Palliative Care National Coordinator has arranged detailed discussion with the leaders of Ministry of Health, Parliament Health and Social Committee and State United Social Insurance Fund regarding development and distribution of home based Palliative Care Services throughout Georgia via the 5 centres (Tbilisi and 4 regional centres) and 12-15 mobile teams. From November, 2006 PC National Coordinator's office (within the OSI (OSGF) financed project - Law and Health) is planning the tours in the regions. The mentioned activity consists of holding (organization) of informational lectures in Tbilisi and regions of Georgia for all those healthcare professionals, who are involved in relationship with patients in need of Palliative Care (4 lectures in Tbilisi and 8 in different regions). Lectures should contain complete information about manufacture (or delivery), administration, prescription, issuance and consumption of different forms of pain relief drugs worldwide, also pharmacology and pharmacokinetics of different forms of narcotic pain relief drugs, legal and ethical aspects of importance of pain relief.

Association "Humanists Union" in cooperation with International Society of  Red Cross involves volunteers in Palliative Care mobile teams.

Association with the financial support of OSGF and other humanitarian organizations permanently participates in International trainings and conferences.

Palliative care has not been included yet in the National AIDS Management system. But in last months resulted from the recommendations and advices of the Director of Public Health Program at OSGF, First Lady of Georgia and Director of AIDS Centre every effort was done for suitably inclusion of large component of  "Palliative Care in AIDS patients" in united proposal applied from Georgia to "Global Fund". The component aims at development of Palliative Care service for AIDS patients through creation and development of both - institutional and home-based - Palliative Care services and provision of these services to 10% of patients with HIV/AIDS in the hospice and to 15% of patients - through home palliative care, support of their family members. This means improvement of quality of life of patients and their family members, support, moral and psycho-social assistance. This also means development of a family support system in case of patient's death.

Last activity of Palliative Care National Coordinator is establishment of department of Gerontology and Palliative Medicine. This department is financed by governmental budget. At present it works as an organizational center of Home based Palliative Care Mobile Teams (2 teams). This Department should become a future center for Continuous Medical Education and Professional Development of physicians involved in provision of Palliative Care Service, theoretical training of nurses and other healthcare professionals. Department of Gerontology and Palliative Medicine should realize the out-patient management of children, adults and elders, who are in need of Palliative Care. It is also planned to arrange the educational center for the students of Tbilisi State medical University and at least 2 medical colleges.