Transitions in End of Life Care: Hospice and Related Developments in Eastern Europe and Central Asia

By David Clark; Michael Wright et al. | Go to book overview

3
Palliative care developments
across the region

In the years prior to the collapse of communism, across the countries of Central and Eastern Europe and of Central Asia, undoubtedly there were groups of clinicians, concerned citizens and others interested in making improvements to end of life care. Yet it is clear from the material presented in this chapter, that with few exceptions the aspirations of these individuals and groups could not be mobilized with much effect until the ideological, political, and social circumstances had changed. Poland is a partial exception, for here there is evidence at Nowa Huta, near Kracow, of hospice innovations led by Halina Bortnowska, as far back as the mid-1970s. In Russia too, a decade later, some attempts to establish hospice were getting underway, spear-headed by the emigre Victor Zorza albeit assisted by the atmosphere of glasnost and perestroika. Elsewhere it is difficult to tell what may have been occurring during the communist era. What is clear is that, from the early 1990s, as the transition to democratic forms of government, to market economies, and to reformed systems of welfare got underway, so too - among many other examples of social renewal - there occurred a volley of initiatives aimed at promoting hospice and palliative care. These, we see, are patchily distributed across different parts of this huge and varied region, but with only a small number of exceptions, we have been able to find examples of hospice and palliative care development taking place in most countries.

In this chapter we attempt to capture that history, to document achievements and innovations, and also to identify barriers and difficulties, as well as aspirations and perceived solutions for future development. We do this descriptively, country by country. The reader will therefore find here a fairly comprehensive overview of palliative care development and current provision across 28 individual countries, of hugely varying size,

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Transitions in End of Life Care: Hospice and Related Developments in Eastern Europe and Central Asia
Table of contents

Table of contents

  • Title Page iii
  • Contents v
  • Series Editor’s Preface vii
  • Foreword ix
  • Acknowledgements xi
  • 1 - Introduction- Background, Aims and Methods of the Review 1
  • 2 - Epidemiological and Policy Considerations 11
  • 3 - Palliative Care Developments across the Region 18
  • 4 - Palliative Care Beacons 176
  • 5 - Conclusions and Recommendations 269
  • Index 292
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