Caring communities in Nepal: How EMMS International have supported thousands with compassionate palliative care
As EMMS International’s three-year UK Aid Match project in Nepal comes to a close, people with life-limiting illnesses and conditions are receiving the support they need, and long-held stigma around palliative care is starting to shift.
In Nepal, the concept of palliative care is still very new, and people are often unable to access the services they need to live comfortably and manage their illnesses or conditions, which can be extremely isolating. As well as this, children often take on extra household chores, as the work in the household expands when one family member needs the others to care for them.
With funds raised through their UK Aid Match appeal, EMMS International’s Sunita project is changing this, developing caring communities in partnership with healthcare professionals, teachers, and community groups.
The Sunita project offers a holistic approach to palliative care through cost-effective and sustainable health and social care services. Healthcare professionals and community workers have been trained to recognise the needs of those requiring palliative care, ensuring people can get the right support sooner and more effectively. This mix of community and healthcare training ensures people living in remote areas – who are unable to access a hospital – can still be supported within the community. For people who are able to travel for care, a dedicated wing at Green Pastures Hospital (GPH) in Pokhara is available where patients can receive specialised treatment and access vital pain relief and resources such as counselling.
Stories of change
When Ramesh was 17, he suffered a life-changing fall that left him very sick and feeling hopeless. His mother Lakshmi became his main carer. Through the Sunita project, Ramesh and Lakshmi now have a growing community of support around them. They receive home visits from community nurses and doctors so they are less isolated, and travel to GPH for specialised treatment and essential medicine.
Photograph: Ramesh at home
83-year-old Jit was born with no legs below his knees, affecting his ability to walk. His son Dal works as a builder and is proud to take care of his father, albeit he did this alone. Now, they are both supported by Ganga, a Female Community Health Volunteer who lives nearby in their community. After receiving training through the Sunita project, Ganga visits Jit around four times a week, and guides him on better sleeping positions so he is comfortable, supports his care needs, and provides crucial updates to his medical team in Sahodar so they can keep track of his progress.
Photograph: Ganga, Jit’s Female Community Health Volunteer
Advocacy, community support and caring societies
One of the most powerful aspects of the Sunita project has been its focus on the holistic, human side of healthcare. Dr Dan Munday, palliative care consultant at GPH and adviser to the Sunita project, explains how palliative care training goes beyond end-of-life support, shaping compassionate communication skills that can enhance other areas of health care too. “We are now gaining pretty good evidence that palliative care is a way of enabling people to develop those interpersonal skills, which then go across the whole practice. And they’re not just to do with end of life care or people with advanced illnesses but actually it’s something that strengthens your work with anybody.”
Empathy, compassion, and advocacy are central to this approach, supporting not only healthcare professionals, but volunteers and teachers. By centring local voices and investing in community volunteers, the project demonstrates that palliative care can be both accessible and deeply meaningful, even in remote regions. As palliative care becomes more recognised and accepted, teachers trained through the project are now able to provide child carers with additional support so they can continue with their studies.
“So that’s what we need, to actually work on all the aspects…. not just the physical aspects of things, but the social, the spiritual aspects and psychological aspects. You need a person who’s empathetic to cater to the needs of the patient or their family.” Dr. Amrita Shrestha, paediatrician and palliative care physician at GPH.
Photograph: Outskirts of Pokhara in Nepal, where Ramesh (mentioned above) lives
The legacy of the Sunita project
The project’s strong emphasis on holistic approaches and breaking stigma around palliative care is key to building evidence to support the Government of Nepal’s national care strategy, laying the groundwork for future policy and government action.
Not only is immediate impact from the project clear to see, but a rise in female leadership in palliative care in Nepal is also providing hope for a long-lasting future.
Take Dr. Amrita for example (quoted above). Encouraged by the success of the Sunita project, she has pursued specialised training and completed a fellowship in palliative care. On top of being a skilled clinician she has become a passionate advocate for children’s palliative care, an area that is critically underserved in Nepal.
And it is not just health care professionals. Arati has always been drawn to research and found herself leading a team of researchers under the Sunita project. Their work has contributed to multiple palliative care studies, with findings shared at national and international conferences, giving vital voices to patients and caregivers through data and evidence.
Dr. Bishnu Dutta Paudel Bucha, Professor of Medical Oncology and President of the Nepalese Association of Palliative Care is certain that the work of the Sunita project is shaping the way for palliative care across the whole of Nepal. “This finding of the Sunita project is very, very helpful if we really can use it to amplify in other districts of Nepal”.
These initiatives show that the Sunita project has not only paved the way for creating sustainable change, but with continued momentum palliative care in Nepal and beyond can be given the attention it deserves.
Read more about EMMS International and the Sunita project.
And follow them on social media to learn more from health care professionals involved in the project.
