Although the health system in Tunisia is increasingly promoting screening and seeking to raise awareness, many diseases, particularly cancers, are not diagnosed until they are so advanced they can no longer be cured. This happens in over a quarter of patient cases. Many cancer patients and families have to travel long distances for consultation and treatment in Tunis, Sousse or Sfax, at great financial cost. Patients are very often marginalized through poverty, the financial strain of job loss and paying for ongoing medication or dressings. Separation from family support can be frightening, as is the taboo nature of a life-threatening illness. Pain and suffering are frequently experienced by many. Some patients are rejected by their families as they feel unable to cope with distressing symptoms and unpleasant wounds.
It is into this situation that ACT sought the development of a Palliative Care and Supportive network. A palliative care support and education centre has been opened opposite the local hospital and regional cancer centre in Gabès. Patients and families are visited in the hospital and followed up by telephone support at home. Group sessions are held and home visits are made for further support. This has been a 4-year pilot project. There are now additional centres treating cancer in Tunis, Sousse and Sfax. The education arm of this project aimed to demonstrate the practical ways in which patients and their families can still be supported to have the best possible quality of life for the rest of their diagnosis.