Implementation of Palliative Care in Palestine: Cultural and Religious Perspectives

The care of terminally ill cancer patients poses a significant global public health problem.1 Populations are growing older as healthcare interventions become increasingly more effective in the management of chronic diseases.2 Care of the terminally ill patients has evolved significantly over the centuries in the developed countries from Hospice services to highly specialized palliative care programs and facilities. In the Middle East, the progress in this area has been very slow over the last two decades which could be attributed to several reasons including the lack of education, training, budgets and several other barriers.3 Although age projection for Palestinians does not indicate generational transition toward an older population,4 yet the increasing incidence of cancer cases and other chronic diseases that need palliation, alerts the policy makers to the crucial need of introducing and developing palliative care services. Thus, the aim of this paper is to: 1) Reflect on the need and access of the Palestinians living in the West Bank and Gaza Strip to palliative care; 2) Define the factors that might interfere with the proper introduction of palliative care; and 3) Focus on the positive compensatory effect of religion and culture on palliative care. The Palestinian population in the West Bank and Gaza Strip at the end of 2016 was 4.88 million (61% and 39%, respectively.4 Palestinians live in refugee camps were about 41.9% distributed between the West Bank and Gaza strip, and 16.7% live in rural areas (2.7% in Gaza Strip compared to 25.6% in the West Bank.4 The Palestinian population is a young generation, though it has been gradually aging; birth, fertility, and death rates have been dropping. In fact, the median age of the Palestinians was 16.4 years in 2000 and increased to 20 years in 2016, with 39.1% of the population under 15 years old compared to 2.9% over 65 years of age. The life expectancy of the population was 73.7 years in 2016 compared to 72.4 years in 2011.4,5 The Palestinian population has low income, and the majority do not have health insurance and cannot afford to seek medical care