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Doctor: CNMI lacking hospice, palliative care
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Posted on Sep 09 2008
Without hospice care, some terminally ill patients in the CNMI are not able to spend their last moments the way they want to, a Commonwealth Health Center doctor said yesterday.
Dr. Divya Sharma, who joined CHC in 2006, spoke to members of the Rotary Club at their weekly meeting about palliative care and hospice care.
Palliative care focuses on providing comfort to a patient. Hospice care is a branch of palliative care that focuses on terminally ill patients.
There are no resources in the CNMI to provide for hospice care, Sharma said.
“That’s where we have a huge gap in our ability to provide care in the CNMI,” she said.
CNMI Medicaid is severely underfunded compared to other states, she said. In the U.S., hospice and palliative care are covered under Medicaid and Medicare.
Sharma said the Commonwealth also needs a law that allows patients to die at home in peace. Currently, patients that die at home must be taken by ambulance to the hospital in order to be pronounced dead.
“If everything we’re working toward is to give the highest quality of care, they need to be able to die in peace and go straight to the funeral home,” she added.
Sharma said a bill, based on a similar one passed in Guam, is currently being drafted to allow patients to die at home.
Another deficiency in the CNMI health care system, she told the Rotary members, is cancer detection.
“Unfortunately on Saipan, we detect [cancer] later than you would in the U.S.,” she said.
Treatment is slower, she said, and there is not adequate health insurance for most individuals.
“I think there are a lot of barriers to health care that you don’t have in the U.S.,” she added. “People in the CNMI are disadvantaged.”
For example, Sharma said, girls in the U.S. receive pap smears earlier. Pap smears detect cervical cancer, which is treatable if caught early. One in six women with cervical cancer in the CNMI die. The cancer is a Third World illness because it can be prevented, but the resources must be available, she said.
“We call ourselves the United States, but we have one of the highest rates [of cervical cancer],” she added.
