Care Beyond Cure
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! April 2019 !
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April 1, 2019
MEDICAL COUNCIL OF INDIA INCLUDES PALLIATIVE CARE IN UNDERGRADUATE MEDICAL
The Medical Council of India (MCI) has now added the missing link. It
has included palliative care in undergraduate medical curriculum as part of its
new AETCOM (Attitude, Ethics and Communication) module. Please see
We call it the missing link for a reason.
Though the Government of India had created the National Program for
Palliative Care (NPPC) in 2012 and though the Indian Parliament amended the
draconian NDPS Act in 2014, all that had little impact because medical students
were still not learning palliative care and were qualifying without seeing or
learning pain management, leave alone all aspects of palliation.
NOW WE CAN FLY!
And fly, we will.
Thank you, Professor Naveen Salins, head of Palliative Medicine of
Manipal Academy of Higher Education (MAHE), for gifting us your analysis of the
AETCOM module, indicating which disciplines the various aspects of palliative
care will be taught in. Precious work! As usual, you combine brain power with
sheer painstaking hard work. Your work is a great gift to our country.
PALLIATIVE SEDATION [HTTPS://PALLIUMINDIA.ORG/2019/03/PALLIATIVE-SEDATION/]
THIS IS CERTAINLY NOT ABOUT EUTHANASIA: THIS IS ABOUT TREATING
Every palliative care worker has come across this situation: The
patient is in intolerable pain (or breathlessness or agitation) and despite all
you do, continues to be so. You look up Oxford Textbook of Palliative Medicine;
you google all over the cyber world; yet there is no solution in sight. The
patient is in agony; the family is in agony.
Yes; this happens. Palliative care professionals are only human beings.
They can get rid of much of the suffering; but not all the time.
When everything fails (refractory symptoms, if you want to get
technical) and the patient is near the end of life, we discuss within the team;
we discuss with the patient if he is competent to understand and take
decisions, we discuss with the family, and with consensus, provide deep
sedation to relieve the “intolerable suffering”.
The objective is to relieve symptoms, not to cause death. And this is
not something that a palliative care team does every day; this is an
Read the article titled _Reflections on Palliative Sedation_
[https://journals.sagepub.com/doi/full/10.1177/1178224218823511] by the master,
Dr Robert Twycross, on the latest on this ethical dilemma/imperative.
URGENT NEED FOR GUIDELINES TO COMMUNICATE WITH CHILDREN ABOUT LIFE THREATENING
On 14 March 2019, The Lancet published two groundbreaking papers
collating evidence and global expertise to derive core communication principles
to assist healthcare professionals in communicating with children about their
own life threatening condition, or that of a parent.
These papers, led by a team at the University of Oxford, highlight the
importance of communicating with families about life threatening conditions in
ways that can make a real difference to the traumatic circumstances in which
families find themselves.
SETTING A TREND IN RELIEVING TERMINALLY-ILL OF THEIR SUFFERING
Director, Care Response International and founder-director, CRI U.K.
Gilly Burn has travelled the length and breadth of India, introducing
palliative care, finding pioneers, getting them trained and empowering them for
palliative care for over three decades. Ms. Burn visited India in 1989 to
submit a report for World Health Organisation based on her assessment and
recommendation on palliative care. “I am happy that my visit to the hospital in
Mangalore. The suffering of the patients brought change in my life which
subsequently led to founding of CRI. The aim is to relieve of pain to a large
extend among terminally ill patients,” she told The Hindu.
DR SUNIL KUMAR OF PALLIUM INDIA AT AAHPM ANNUAL ASSEMBLY, ORLANDO, USA
_A Fulbright Specialist from USA, Professor Marcia Glass writes:_
Dr. Sunil Kumar from Pallium India gave an engaging talk at the
American Academy of Hospice and Palliative Medicine on March 14, 2019. Dr.
Sunil was visiting after being awarded a competitive international scholar
fellowship through AAHPM.
He spoke about the burgeoning field of Indian palliative care and the
challenges his country has faced in this arena. He described the inspiring work
of his colleagues in Pallium India and the overall structure of their program.
During the Q and A session, he fielded questions about Pallium’s innovative
volunteer program and their inpatient unit’s experience with ketamine (a novel
drug in America that is only recently gaining traction in the U.S.). Dr Sunil
did a wonderful job representing his organization and his country.
PALLIATIVE CARE – EVERYONE’S BUSINESS
A truly inspiring and interactive session on Palliative Care at DAV
(PG) College, Dehradun was co-ordinated by Pallium – Ganga Prem Project
Manager, Ms. Shareena Bhaya, and conducted by Dr. Jyotsna Seth of Seema Dental
College on 16th March 2019.
It was heartwarming to experience the positive / creative involvement
of young students – various questions were posed by the students on whether
palliative care can lead to reversal of illness, what is the success rate, do
we need to stay away from cancer patients?
The faculty are also very enthusiastic to get involved long term, the
college is in the process of signing a MOU with Ganga Prem Hospice towards
promoting and supporting palliative care.
Memorandum of Understanding (MoU) to be signed between Ganga Prem
Hospice, Rishikesh and DAV (PG) College, Dehradun in the interest of the
students and the need of higher education with following areas of common
* Creating awareness about palliative care by organizing sensitization
talks in the college, on dates and venue, as per the convenience of both
* The college will provide a platform for intimating the students, and
developing compassion towards the noble works of Ganga Prem Hospice (GPH),
devoted to provide palliative care to terminally ill patients.
* The students of the college selected as volunteers will escort the
patients to GPH, besides providing a healing balm to them through their
sensitive understanding of the problems of terminally ill patients.
* The student volunteers will help the GPH team members in homecare
visits within the city of Dehradun.
THE ECONOMIST’S EVENT IN SINGAPORE
Pallium India took part in a panel discussion on palliative care as
part of The Economist’s War on Cancer event at Singapore on 29 March 2019.
Kudos to the Economist Events team for ensuring the strong presence of
cancer survivors. That truly acknowledges the value of the recommendation by
Astana declaration on Universal Health Coverage that “Healthcare for all has to
be healthcare with all”.
Actress Gautami Tadimalla was a strong presence, sharing her personal
experience with cancer. It was truly heartwarming to see how she made a lot of
good to come out of her cancer experience by forming Life Again Foundation.
_* Image courtesy:
STANFORD ACQUIRES ARCHIVE OF ELISABETH KüBLER-ROSS
The family of Elisabeth Kübler-Ross, M.D. has donated the official
archive collection of the late iconic psychiatrist, author and hospice pioneer
to Stanford Libraries’ Department of Special Collections. Dr. Kübler-Ross is
the legendary author of 24 books including the groundbreaking bestseller _On
Death and Dying_, which is being published in its 50th anniversary edition.
Please read: Stanford acquires archive of palliative care pioneer
Some time back, Elisabeth Kubler-Ross foundation had donated a large
collection of EKR’s books
[https://palliumindia.org/2018/02/ken-ross-visits-pallium-india/] to Pallium
India’s Elisabeth Kubler-Ross library
at Trivandrum Institute of Palliative Sciences.
Thank you, Ken Ross and all at EKR foundation.
DISABILITY INCLUSIVE DISASTER RISK REDUCTION AND POTENTIAL RECOVERY STRATEGIES
IN THE KERALA FLOOD AND LANDSLIDES 2018
It was Pallium India’s privilege to take part in MITRA, a 1-day
workshop on Inclusive Disaster Management jointly organized by KSDMA and Care
Pallium India’s project officer Vyshnavi presented to the audience the
efforts that Pallium India undertook to assess the health-related suffering in
some disaster-affected areas and the interventions undertaken.
We hope the deliberations will make us prepared to face any future
VACANCY: JUNIOR / SENIOR RESIDENT AT GCRI, AHMEDABAD
[http://gcriindia.org/] Gujarat Cancer & Research Institute
[http://gcriindia.org/] , Ahmedabad, Gujarat invites applications to the posts
of JUNIOR RESIDENT & SENIOR RESIDENT.
NO. OF VACANCIES: 1 each
NATURE OF JOB: Full time Residency
QUALIFICATION: MBBS or Diploma in Clinical branch for Junior Resident,
MD in Clinical branch for Senior Resident
PLACE OF JOB: Dept of Palliative Medicine, Gujarat Cancer & Research
EXPERIENCE: As per prevailing rules of MCI. "
HOW TO APPLY
Interested candidates can send detailed and updated CV to
drpritisanghavi@xxxxxxxxx [mailto:drpritisanghavi@xxxxxxxxx] with email
subject as “Application for the post of Junior Resident / Senior Resident”.
For more details Contact: Dr Priti Sanghavi, drpritisanghavi@xxxxxxxxx
[mailto:drpritisanghavi@xxxxxxxxx] / 9825420656"
VIDEO OF THE MONTH:
PSYCHOLOGICAL ASPECTS OF PAIN [HTTPS://YOUTU.BE/N3P6COSDMHK]
Click here to watch the video: https://youtu.be/n3P6COSDMhk
_(Video by Mike Hill, Moonshine Agency [https://moonshine.agency/] )_
KERALA A ROLE MODEL IN MAKING TOURISM DISABLED-FRIENDLY: MINISTER
Kerala is the first state in the country to create basic infrastructure
and amenities for the disabled in tourism centres, thereby setting itself as a
role model for others, said Minister for Tourism, Kadakampally Surendran, on
Speaking after unveiling the new initiatives of Thenmala Ecotourism
Promotion Society (T.E.P.S) at a function here, the Minister unveiled a Braille
Brochure on the attractive spots at Thenmala and a video brochure in sign
OPINION: THE PROBLEM WITH THE PHRASE ‘BEAT CANCER’
The idea that you can “beat” something as insidious as cancer
perpetuates the myth that the patient is wholly responsible for their recovery,
not a human caught up in an endless cycle of surgeries, chemotherapy, radiation
and relapses. And if they don’t beat it? That’s failure.
DONATE TO PALLIUM INDIA [HTTP://PALLIUMINDIA.ORG/DONATE]
The money you give will pay for essential free medicines for the poor,
for their travel to the clinic or for schooling of their children, or other
forms of care.
PLEASE GIVE WHATEVER YOU CAN. NO AMOUNT IS TOO SMALL.
To donate, please visit:
http://palliumindiausa.org/ [http://palliumindiausa.org/] (USA)
Write to us: info@xxxxxxxxxxxxxxxx [mailto:info@xxxxxxxxxxxxxxxx]
Call us: +91-9746745497 (India) / +1-718-273-8597 (USA)
_ All donations to Pallium India are tax deductible._
UPCOMING EVENTS [HTTP://PALLIUMINDIA.ORG/COURSES/]
* APR 26-28, 2019: Three day volunteer training program in Trivandrum
including home visits. Contact: info@xxxxxxxxxxxxxxxx
* APR 26-28, 2019: Kuttikkoottam summer camp for children who receive
educational support from Pallium India. Donate and support. Contact:
9746745502, info@xxxxxxxxxxxxxxxx [mailto:info@xxxxxxxxxxxxxxxx]
* MAY 1, 2019: 10-day Foundation course in palliative medicine, at
Trivandrum. Register: https://palliumindia.org/courses/
[https://palliumindia.org/courses/] Contact: education@xxxxxxxxxxxxxxxx
* MAY 21, 2019:10-day Foundation course in palliative medicine, at
Trivandrum. Register: https://palliumindia.org/courses/
[https://palliumindia.org/courses/] Contact: education@xxxxxxxxxxxxxxxx
* JUNE 3, 2019: 6 weeks certificate course in palliative MEDICINE and
NURSING (CCPPM, CCPN) at Trivandrum. Register: http://palliumindia.org/courses/
[http://palliumindia.org/courses/] Contact: education@xxxxxxxxxxxxxxxx
[mailto:education@xxxxxxxxxxxxxxxx] / 8589998760.
Have Queries? Contact: info@xxxxxxxxxxxxxxxx
Find out more about our courses at: HTTP://PALLIUMINDIA.ORG/COURSES/
JOIN OUR FACEBOOK PAGE [HTTPS://WWW.FACEBOOK.COM/PALLIUMINDIA]
Pallium India’s Facebook page has over 8500 likes.
We regularly post articles related to palliative care from around the
_ CLICK HERE TO LIKE OUR PAGE [HTTPS://WWW.FACEBOOK.COM/PALLIUMINDIA]
We’re also on Twitter: @palliumindia [https://twitter.com/palliumindia]
PALLIATIVE CARE INFORMATION CENTRE [HTTP://PALLIUMINDIA.ORG/INFO-CENTRE]
Contact Pallium India’s Information Centre (9 am to 5 p.m., except on
Sundays and National holidays) for INFORMATION RELATED TO PALLIATIVE CARE and
about ESTABLISHMENTS WHERE SUCH FACILITIES ARE AVAILABLE in India.
or E-mail: info@xxxxxxxxxxxxxxxx [mailto:info@xxxxxxxxxxxxxxxx]
Address: Pallium India Trust, VP 80/13, Golden Hills, Venkode P.O., Vattappara,
For more details, please visit: http://palliumindia.org/info-centre/
THE HEALING GARDEN [HTTPS://PALLIUMINDIA.ORG/2019/03/THE-HEALING-GARDEN/]
_Krishnaraj Nambiar, Volunteer at Pallium India, writes:_
What does it take to transform a barren land into a beautiful garden?
And to infuse life into the monotony of existence of people with major health
Ian Wallace and his wife Dr. Anne Wallace from New Zealand showed that
it could be done not with a lot of money but with a vision, a lot of grit and
determination, the ability to mobilise and motivate people to lend a hand, and
the use of recyclable materials that would otherwise have been wasted.
The Wallaces recently spent a month in Trivandrum where Dr. Anne was
working on a project for Pallium India. She was joined by her husband Ian, a
Forester. Ian was saddened by the sight of the hardened waste land lying at the
far end of Pallium India’s premises. He visualised that it could be converted
into a beautiful garden that would enhance the quality of lives of our
in-patients. He soon set about buying the basic gardening tools of a shovel,
pick axe, wheel barrow etc and working throughout the day to dig up the ground,
clear it of weeds, rubble and waste. He used discarded wooden sleepers to build
a compost bin (to produce vermi compost), dug and prepared pits and planted
banana plants. He helped with preparing beds to grow spinach and planting
seedlings of tomato, bitter gourd, egg plant, okra, mint, coriander, chilly,
Roses, Lily, Bougainvilleas etc. His untiring efforts inspired a few caregivers
to lend him a hand. Dr. Anne too found time to help out.
The Wallaces also raised funds for the venture from their friends in
New Zealand and elsewhere, to give us a beautiful garden entirely free. We
learnt many a lesson from their initiative and applaud them for such a noble
gesture. Some of the plants have started yielding vegetables and are being used
in our half way home and the surplus sold to staff. All proceeds from the sale
go to the care of Pallium India’s patients.
Ian has aptly named the garden “The Healing Garden”.
We saw the garden truly healing people. Our lives acquired new meaning
when a young woman with only three more days to live, hooked up to a syringe
pump to ward off her incessant vomiting, was wheeled out to the garden and when
a smile lit up her face for the first time in several days.
It was heart-warming when a gentleman with paraplegia, till then a
“patient”, became a member of the healing team by untiringly engaging in
painting the flower-pots. And when Ashla, our chairman’s executive assistant on
her wheelchair, made a shaded area in the garden her office one day.
_Read more about what the Healing Garden means to the people in our
This article wouldn’t be complete without recognising the untiring
effort put in by Shriya Singh, an intern from IIM Kolkatta, Ramakrishnan the
caregiver and Shambhu the volunteer consultant.
The Wallaces were filled with emotion when bidding good bye to their
garden and to Pallium India. They have since been in frequent touch with us
from New Zealand enquiring about the welfare of The Healing Garden.
We look forward to the day when the garden will beckon the Wallaces to
make another trip to their creation.