Background and Context:
Pediatric palliative care (PPC) was new to oncology practices in Thailand, where 1000 new cancer children each year are cared for by 60 pediatric hematologist-oncologists in 25 centers, around 500 will relapse and need palliative care annually. Busy oncologists and overworked nurses are not always interested in psychosocial issues which are the integral part of PPC.
Aim: To build and expand a network of pediatric palliative care services for children with cancer to cover the entire country.
Strategy/Tactics: The wishing well foundation offered children's activity events to each hospital, followed by educational conferences on PPC for nurses, and finally site visits to empower each local center.
Programme/Policy Process: From the inception (2005) the foundation offered children's cancer camp twice a year, where 20-40 children from 4-8 hospitals participated at each camp. In addition, we organized 10-12 day-trips a year for children from 10 participating treatment centers. We fulfill wishes for any children with terminal cancer from the network of treatment centers. These activities improves quality of life for children and were welcomed by hospital personnels. With UICC's My Child Matters program support (2009-12), we organized 2 ELNEC conferences for pediatric nurses and an international pediatric palliative care congress for pediatricians to get the PPC service established in their center. In the recent years (2012-14), we visited each treatment centers to empower and provide PPC education for each local team.
Outcomes/What was learned: We have created a network of PPC services in Thailand, expanding from 2 centers in 2005 to 20 in 2014, improving access to pediatric palliative care for cancer children by this approach. The children's activities were completely supported by public donations. While education was efficiently introduced through conference, busy physicians often cannot attend and local empowerment was vital.