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Children’s palliative care takes root in Bangladesh

Author: Dr Megan Doherty
14 April 2015
  • Dr Megan Doherty, paediatric palliative care physician in Bangladesh
  • Dr Megan Doherty with the parents of one of her patients during a home visit

Dr Megan Doherty, a paediatric palliative care physician living and working in Dakha, Bangladesh, writes about both the encouraging developments and barriers to accessing palliative care for children in that country.

Imagine treating pain in children with advanced cancer using only paracetamol? This was the situation when I first started working on the children’s cancer ward at Bangabandhu Shiekh Mujib Medical University (BSMMU) in Dhaka, Bangladesh. BSMMU is the largest specialist pediatric oncology centre in Bangladesh, providing care to over 1000 children with cancer. Cure rates for children treated at this center are estimated to be around 50%.


Until August 2013, there was no paediatric palliative care service at this hospital, despite the significant need for these services. Recently, with the support of World Child Cancer we have started to develop paediatric palliative care services within the department of Paediatric Haematology and Oncology at BSMMU. Currently the service consists of myself (a paediatric palliative care physician) and an oncology trainee doctor. While providing clinical services, we are gathering data about the palliative care needs of children at BSMMU, in order to advocate to hospital administrators for the provision of more resources to provide these services.

Children's palliative care in Bangladesh is in the early stages of development.  A single hospice, Ashic Foundation, located in the country's capital, Dhaka, provides palliative care for children with cancer, but the need for children's palliative care is overwhelming. Bangladesh has a population of 164 million, and an estimated 64 million are children. Due to a lack of awareness about the signs and symptoms of cancer and the belief that childhood cancer is not curable, many children with cancer are diagnosed very late, when curative treatment is not possible.

Sustained advocacy efforts bring some pain relief for children
A lack of access to opioids has been a significant barrier to providing palliative care in Bangladesh. When I first started working at BSMMU, it was not possible to prescribe morphine or any other strong opioids. The sustained advocacy efforts of several key palliative care physicians in Bangladesh, resulted in oral morphine becoming available. However, initially despite being available, the pharmacy at BSMMU was not allowed to dispense these medications, forcing patients to travel to another hospital on the other side of the city to actually obtain morphine. Starting last week, morphine tablets and syrup are available directly from the dispensary within the children’s cancer department at BSMMU. Finally, rapid and effective pain relief is available for children with cancer at BSMMU.

There are still many children with cancer who will not receive adequate pain control; the availability of morphine is not enough to ensure all children with pain receive adequate treatment. The majority of physicians in Bangladesh remain afraid to prescribe opioids due to widespread misconceptions about the risk of addiction. Clinicians continue to incorrectly believe that opioids should only be used in patients who are dying. Teaching about palliative care and pain management needs to be included in standard medical school curriculum, so that physicians can be trained to safely prescribe opioids and manage pain. With local partners, we are organizing training seminars, workshops and conferences across Bangladesh to educate health care providers about pediatric palliative care and pain management. 

Dr. Megan Doherty is a paediatric palliative care physician living and working in Dhaka, Bangladesh.  She writes about her work in Bangladesh on her blog at 

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Comments | 5 comments


Dr. Shemul

I saw her today at a program in DMCH and i must say that she is an unique lady. Hats off to you madam.

04/06/2016 16:47:19

Samiran Das

I am excited to know all about the treatment facility available a SBBMU, Dhaka. I had my palliative care training as UICC Scholar and had the opportunity to work in Queensland Cancer Fund, Brisbane, Australia, few more palliative care centres in UK such as Royal Marsden Hospital, London. I am also an Alumni of American Cancer Society University, Atlanta.
My association with Bangladesh as I was born there and I am associated with a Cancer Hospital as its Honorary Trustee which has just started its first phase as Preventive Oncology Centre and the hospital is in Beani Bazar, in Sylhet district. The hospital is fully funded by Non Resident Bangladeshis living in different parts of UK.
I visit Bangladesh very often and I will make it a point to see you next time when I will visit Dhaka.
A big applause for the good work you are doing in Bangladesh.
Samiran Das

05/05/2015 12:45:57

Little Flowers of China e.V.

Very important work. There is always so much to do for all children in the world. I am always so happy when I see good People who make a step Forward and help to Change something. Well done and Keep up your good work. Blessings from Germany, Jana Schmidt

23/04/2015 09:49:15

Lynda Gould

well done Megan, a big step forward for the children now and in the future.

21/04/2015 11:24:07

Douglas Showers

Very encouraging work, Megan. Always knew you would find yourself in a place that needs you.
We are proud to see the progress.

17/04/2015 13:13:01

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