Albania News Edition 30 Newsletter A new project in a new country - supporting Ryder Albania Our New Project in Albania by Alex Padureanu Hospices of Hope is extending its work into Albania by supporting existing hospice organisation Ryder Albania. Ryder Albania started work in Tirana in 1993. It was established with support from Sue Ryder and the two organisations still maintain close links. Initially Ryder Albania provided free home care services to terminal cancer patients and to the elderly suffering from chronic illness in the capital city. Then in 1996 it extended its services and opened a home care service in Durres, the second largest city in Albania. For a while the organisation rented space and was able to provide in-patient services. Sadly lack of funds during the recession meant that this service had to come to an end so now Ryder Albania’s multidisciplinary teams offer services in patient’s homes in both Tirana and Durres. The hospice started with two doctors and a nurse in Tirana. It now has two multi-disciplinary teams – one in each location. The team in Tirana has three doctors, four nurses and a social worker and the team in Durres has two doctors, three nurses and a social worker. There is also administrative support in place. Dr Kristo Huta, Durres The teams provide free medical care, psychological counselling and assistance with social service issues to patients and their families. The Tirana team cares for approximately fifty patients and the Durres team looks after forty. The total number of patients helped in the period from 1993 to June 2018 is around 8,400 (4,400 in Tirana and 4,000 in Durres). Ryder Albania has supported 25,200 close family members. As well as caring for patients the organisation provides palliative care training within the country and has taken on a lobbying role to improve hospice services. To date more than 1,200 doctors, nurses and social workers from different areas of the country have been trained by the team. I have visited the Ryder hospices and spent a great deal of time with staff and patients. I was hugely impressed with everything I saw. The staff care deeply about their patients and approach hospice care in an extremely professional manner. However the team faces considerable difficulties working in such a poor country. I was really pleased to have the opportunity to join Dr Ali and Dr Fabian making home visits. I was so impressed with the level of professionalism that I witnessed. It is very frustrating that such a great team does not have the resources to allow all its members to shine. Everyone I spoke to told me how difficult it is to deliver good palliative care when 99.9% of the families will not pass on the real diagnosis to the patient. Educating the population is an absolute must. Dr Fabian explained that not all types of opioids are permitted, making pain management difficult. Paediatric opioids do not exist so the only option is to manually adjust adult doses. Whilst opiate based drugs are available for cancer patients they are not authorised for patients suffering from other chronic illnesses. I was touched by the simple gesture of one of the patients I visited. She kept saying: “thank you for seeing me, thank you so much for caring”. Initially we will be providing advice on issues such as fundraising to the teams. In the longer term we would like to follow our Moldovan model and establish a national network of hospice services in the country. Plans are still at a very early stage, but I am confident we can work with Ryder to achieve this goal and improve the situation for terminally ill patients in Albania.