Georgia is the country, where number of pediatric patients with cancer and other chronic incurable diseases is statistically high. According to the information of the Department of Statistics, in 2004 total amount of pediatric patients with cancer was about 250. The total amount of hospitalizations for this period of time was about 650. In 38% of cases, cancer was first diagnosed and in 43% of cases it was stage IV cancer. Thus, it is necessary to emphasize the importance of increasing the efforts of cancer prevention from one hand, and creation of Palliative Care Service for children from other hand. In the same 2004, 1885 patients with Cerebral Palsy were registered in Department of Statistics. With the international experience 50% of patients with cerebral palsy need palliative care activities. In 2004 about 18 children was diagnosed to have AIDS, which is really 3 times less when compared with the real statistics received from the estimation of experts.

According to the international experience (recommendations of WHO - Palliative Care: Symptom Management and End-of-life Care, 2004), it is advisable to involve the child in society activities, it is essential for children to be able to play every day (drawings, stories, games, favorite toys), encourage siblings and friends to play with child, continue schooling where appropriate, use language appropriate to age, get down to level of the child, involve child in decision on care, according to age, allow children to ask questions about their health, because they often know far more then we think. Thus, the team of Palliative Care for children should include physicians, nurses, social workers, chaplain, psychologist and teacher. Where necessary, a physiotherapist, a dietician or other specialists can also become involved in the care program.

It should be emphasized, that well co-ordinate and successful work of multidisciplinary team is based on the level of training and preparation (right vision of the problem) of main components of the group - physician and nurse.

Main targets of the project:

• 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;
• Preparation and publication of internationally approved recommendations and instructions (guidelines) in Georgian language;
• Improvement of legislative normative basis, which regulates Paediatric Palliative Care and drug availability (pain management).

WHO Recommendations

Palliative Care: symptom management and end-of-life care WHO/CDS/IMAI/2004.4