Partnering to Deliver Palliative Care in Nepal

by Two Worlds Cancer Collaboration Foundation
Partnering to Deliver Palliative Care in Nepal
Partnering to Deliver Palliative Care in Nepal
Partnering to Deliver Palliative Care in Nepal
Partnering to Deliver Palliative Care in Nepal
Partnering to Deliver Palliative Care in Nepal
Partnering to Deliver Palliative Care in Nepal
Partnering to Deliver Palliative Care in Nepal
Partnering to Deliver Palliative Care in Nepal
Partnering to Deliver Palliative Care in Nepal
Partnering to Deliver Palliative Care in Nepal
Partnering to Deliver Palliative Care in Nepal
Partnering to Deliver Palliative Care in Nepal

Dear Friends of TWCC,

We want to share with you what has happened these past months as our programs endured, evolved and expanded throughout this pandemic. 

The unfairness of inequities across the globe remain abundantly clear. Amid personal grief, the loss of friends and colleagues our partners continued to provide the best health, palliative, and end-of-life care possible despite the risks to themselves and their families.
Our volunteer team of healthcare experts expanded the reach of virtual education
As the pandemic started in 2020 and travel was not possible, our international team of volunteers quickly pivoted taking training and mentorship fully online via the Project ECHO model. ECHO stands for Extension for Community Healthcare Outcomes and is based on knowledge-sharing networks, led by expert interdisciplinary teams using video links to develop virtual communities with care providers.
This year in collaboration with our partners in India, Nepal, Bangladesh, Sri Lanka, and the Philippines, Two Worlds Cancer Collaboration has sustained eight separate programs reaching more than 500 participants with 75 video-linked sessions.
The topics included, introductory, intermediate and advanced education in adult and children’s palliative care, responding to the  COVID-19 Pandemic, and palliative and end-of-life care in the Rohingya humanitarian crisis.
Our pediatric program evolves into the Sunflower Children’s Network
What started as a concept to focus on Children’s palliative care with our partners at the Hyderabad Centre for Palliative Care in India developed into the Sunflower Children’s Program. This year that program has expanded and is now the Sunflower Children’s Network.
The Sunflower Children’s Network supports clinical care and education so that children and adolescents with serious illness receive the care they need, no matter where they live.
From Five hubs, in South and Southeast Asia, care will expand to reach 1000s more children and adolescents, and their families.
TWCC launches an expanded one-year Pediatric Palliative Care Fellowship progam
In January 2021, in partnership with the Hyderabad Centre for Palliative Care, the Sunflower Children’s Network launched an innovative training program for physicians. The Pediatric Palliative Care Fellowship focusses on training doctors to become future specialists and leaders in pediatric palliative care in South and Southeast Asia.

Currently there are three pediatricians training in the program: Dr. Lannie Fofue and Dr. Xiohara Gentica, National Children’s Hospital, Philippines, and Dr. Ramesh Dampuri, Niloufer Hospital for Women and Children, Hyderabad, India.

“This fellowship is the best and first opportunity that we have when it comes to the development of pediatric palliative care (PPC) in the Philippines because it saves time, effort, and resources through our direct access to PPC specialists across the globe. Our aim is to produce more PPC specialists in our country and I can see that this fellowship program can guide our team in developing more sustainable training by continuing strong ties, building bigger networks of faculty, and replicating this program’s structure and strategy.”     –   Dr. Xiohara Gentica

TWCC and partners from Nepal and India present virtually at London Global Cancer Week 2021
On November 17th we joined our partners virtually from Nepal and India at London Global Cancer Week which brings together healthcare professionals from across the hemispheres.

Join us today by donating to Two Worlds Cancer Collaboration. Your generous donations will directly impact the care of children and adults facing cancer and other serious illness in South and Southeast Asia.




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This, Giving Tuesday we celebrate the incredible resilience and compassion of our healthcare partners in South and Southeast Asia through an extremely difficult year.

During the height of the COVID-19 crisis this year, our partners showed determination and resolve delivering compassion to patients and their families – helping with pain relief and providing emotional support. For children like Shaik, pictured,  and her mother this meant care at the recently opened Mandara Children’s Hospice in Hyderabad, India.

Partner with us today to celebrate what is possible and Shine Some Light for patients like Shaik and their families.

Please support us this Giving Tuesday.


Thank you!

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Preem being cared for at Thankot Hospice
Preem being cared for at Thankot Hospice

Two Worlds Cancer Collaboration (TWCC) over the past 20 years has been involved in a number of various initiatives in Nepal from cervical screening to palliative care, by means of educational and financial support.  We are now embarking on an innovative program of integrating these initiatives into one ’scaled up’ program that will allow maximum benefit to much greater populations throughout Nepal.  TWCC works in partnership with care providers in Nepal as we strive to build local capacity and sustainable programs with the ultimate goal of helping alleviate pain, distress and suffering due to life-limiting diseases, and to improve quality of life for patients and families experiencing terminal illness and bereavement.  

 Almost 80% of Nepal’s population live in rural/remote areas.  Most cancer/palliative care services are available only in the larger cities (e.g. Kathmandu, Pokhara, Bharatpur, Bhaktapur).  In rural/remote areas of Nepal, access to cancer/palliative care services is extremely limited and requires patients and families to travel long distances over difficult terrain, often resulting in late diagnosis, unnecessary pain and suffering, and limited control of symptoms.  The Closing the Circle Program will help provide services throughout Nepal, including rural/remote areas.  

 The COVID pandemic has added additional challenges as already scarce resources continue to be stretched to the limit in Nepal.  One of our most recent initiatives is to provide education/support through the use of the Project ECHO (Extension for Community Based Outcomes) education model which is ZOOM based and allows us to share knowledge and collaboratively discuss complex cases regardless of distance, geography, travel or convenience, and facilitate multiple education sessions with local healthcare providers across Nepal.  

 The ‘Closing the Circle Program’ is comprised of the following key initiatives:

  • Cancer prevention through education, esp. regarding risk factors (smoking, alcohol/substance misuse, importance of vaccinations) 
  • Screening & early detection, esp. for cervical and oral cavity cancer
  • Education & training through fellowship programs, esp. related to cancer/palliative care and oral cavity cancer screening
  • Rural/Remote outreach & expansion of pain and palliative care services to those areas of Nepal where services are currently very limited or non-existent
  • Purchase of equipment and facility improvement to facilitate provision of cancer and palliative care throughout Nepal
  • Purchase of medications, most notably Morphine, to help alleviate pain and distress

 By bringing together these elements, we will ‘Close the Circle’, creating a model program that can be replicated elsewhere.  

 The time is right to move forward with these initiatives!  This past year, Dr. Bishnu Paudel, a medical oncologist, has been appointed as Executive Director, Bhaktapur Cancer Care Hospital, Nepal with responsibility for the coordination and implementation of population-based cancer control, including a government approved national palliative care program for Nepal.  TWCC has a strong, long-standing relationship with Dr. Bishnu and he and his colleagues in Nepal are very keen and ready to move these initiatives forward.  

 After months of visits to different hospitals, Preem (above) was diagnosed with late-stage, male breast cancer. He and his family lived in a remote region of Nepal with no access to healthcare without a days of travel. The months of hospital visits and tests exhausted the family's finances leading them to sell their farm to pay for treatment. Eventually he was referred for palliative care  at a hospice in Thankot – 15 kms west of Kathmandu.  Preems' circumstances are common in Nepal

 Please help us ‘Close the Circle’.  Your funding support is needed!

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Two Worlds Cancer Collaboration (TWCC)’s work in Nepal has focused to date on developing palliative care within two urban hospitals - the Bhaktapur Cancer Care Hospital (Kathmandu valley) and Bharatpur Hospital in Chitwan. This year, Dr. Bishnu D. Paudel, a medical oncologist, has been appointed as Executive Director, Bhaktapur Cancer Care Hospital, with responsibility for the coordination and implementation of population-based cancer control, including a government-approved national palliative care program for Nepal.

TWCC partnership with Nepal involves building capacity for palliative and end-of-life care, requiring attention to funding for:

- education, including educational materials, for palliative care nurses, physicians and health care providers.

- equipment and facility improvement to facilitate care

- medications, most notably morphine to relieve pain and distress.

The pandemic challenges us daily, as patients, families and health care providers, placing constant pressure on providing services whilst securing the resources necessary to grow sustainable palliative and end-of-life care. Our volunteers have adapted by expanding mentorship and training online, using Zoom (? internet) and the Project ECHO education model, thereby allowing us to share knowledge regardless of distance, geography, travel or convenience, and facilitate multiple sessions with local healthcare providers across Nepal.

COVID-19 has changed the circumstances of individuals facing life-limiting illnesses, their families, and their caregivers.

Please help TWCC provide more and better care for those with life-limiting illnesses in Nepal during these uncertain times.

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Dear Project Supporter,

2020 has been a difficult year for everyone - uncertainty, social disruption, changes to our work and social routines, and for many, financial distress. 

But, because of the support of generous donors, Two Worlds Cancer Collaboration has been able to continue with it’s Project ECHO – an online, virtual educational model that connects community-level health care providers with volunteer Two Worlds Cancer Collaboration specialists.

ECHO has been particularly effective in South Asia, since it emphasizes moving knowledge not people, and having the training Two Worlds Cancer Collaboration provides reach healthcare professionals where they are, instead of requiring them or their patients the cost and inconvenience of long journeys to specialist centres to receive training or care.

Because of donor support during the pandemic, we have held successful ECHO sessions for multiple different learners across different groups of learners across South Asia (India and Nepal), and for humanitarian health workers addressing palliative care support for Rohingya refugees in Bangladesh. 

For those facing life-limiting illness in the lesser-resourced world, often in pain, distressed, stigmatized and alone, the holiday season offers little to celebrate, and, with the added burden of the pandemic, much to grieve. Even though our personal celebrations are more constrained this year, let our motivation to support those less fortunate, continue to grow in the future. 

"Shining Some Light” can bring comfort, dignity and inspiration to us all.


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Organization Information

Two Worlds Cancer Collaboration Foundation

Location: KELOWNA, BC - Canada
Facebook: Facebook Page
Twitter: @twoworldscancer
Project Leader:
Sandra Broughton
$1,127 raised of $36,105 goal
42 donations
$34,978 to go
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