Pallium India Newsletter: February 2010 Pallium India Newsletter
- From: Pallium India <info@xxxxxxxxxxxxxxxx>
- To: palliumindia@xxxxxxxxxxxxx
- Date: Tue, 16 Feb 2010 20:29:04 +0000
PALLIUM INDIA NEWSLETTER
PALLIUM INDIA NEWSLETTER - FEBRUARY 16, 2010
http://palliumindia.org/newsletter
**
Visit our website for the full newsletter: http://palliumindia.org/newsletter
(This is a simple text-only email, the full version has additional
photos & links)
**
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REFLECTING ON OUR CULTURAL IMMERSION COURSE
"Four years ago, I lost my mother and my aunt in a road accident. My
sisters aged 4, 2 and 1 though injured, survived. As they cried out in
pain, I didn’t even know if they were getting the right medicines to
reduce their pain. All of us suppressed the pain of losing our mother.
What might have gone through the minds and hearts of my little
sisters?- I have never enquired. Till today, I had never felt that
those were things I should have found out. It never struck me that
even my grief was something I should discuss with anyone else.
But, after coming here and experiencing the special interest and care
all of you have given us, I can’t help but cry. The solace in sharing
one’s grief and in crying- I have realised today. When I get back
home, I will talk to my sisters; I will try to understand their fears
and grief. I am grateful to you for having given me the awareness and
the capability to do this…"
This was what Jeanette George - one of the seven students who came to
Trivandrum from Iowa University in USA for a three week cultural
immersion course on palliative care - shared with us. There were also
participants from various parts of India – Assam, Andhra Pradesh,
Tamilnadu, Uttar Pradesh and Kerala.
We are happy that the participants acquired not just professional
training, but also gained valuable lessons in living life
holistically.
Thank you participants, and thank you Professor Rajagopal Rangaswamy,
Professor Joann Eland and Ms Donalda Carson.
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ANNUAL CONFERENCE OF IAPC
TRICHY: 11-14 FEBRUARY 2010
The Annual Conference of the Indian Association of Palliative Care
concluded on 14 February 2010 at Trichy. All delegates were extremely
appreciative of the arrangements and hospitality offered by the team
lead by Dr Mohanasundaram Thyagarajan. At this conference Dr Sukdev
Nayak stepped down as president, and Dr Nagesh Simha was installed as
the new president. Thank you for your performance as president, Dr
Sukdev Nayak and congratulations Dr Nagesh Simha.
TAMIL NADU’S GIFT TO PALLIATIVE CARE OFFERED AT TRICHY
At the inaugural function of the Trichy conference Dr Mayilvahanan
Natarajan, the vice chancellor of the Dr M G R Medical University of
Tamilnadu announced the decision of the University to start a
Post-Graduate Fellowship in Palliative Medicine. Thank you Dr
Mayilvahanan for this contribution to the palliative care movement in
India.
LUCKNOW, 11-13 FEBRUARY 2011
We shall look forward to the next annual conference at Lucknow, Uttar
Pradesh. Mr Piyush Gupta of Cancer Aid Society is the organizing
secretary.
For details please see:
http://iapcon2011.com/download/IAPCON_2011_Registration_form.pdf
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BRUCE DAVIS GOLD MEDAL
This year’s Bruce Davis Gold medal was won by Dr Bhaswant Dhanireddy
from PGI, Chandigarh.
The medal was founded by Mr Wilfrid Bruce Davis from UK who has
supported the palliative care movement in India for more than a decade
now.
The medal is awarded following a competitive examination held by the
Institute of Palliative Medicine at Calicut. We congratulate the
winner and thank Mr Bruce Davis for his contribution to the palliative
care movement in the country.
====
HANNAH GARDNER ON OPIOID AVAILABILITY IN INDIA
Please read Hannah Gardner’s article at the problem of unrelieved pain in India:
"MORPHINE LAWS LEAVE MILLIONS IN PAIN"
http://www.thenational.ae/apps/pbcs.dll/article?AID=/20100208/FOREIGN/702079900/1140
Thank you Hannah, for strengthening the cry for justice from people in pain!
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STUDENTS' CORNER
Postgraduate Qualifications (MSc) in Palliative Medicine and Palliative Care
15 Commonwealth Scholarships available to cover Diploma/MSc course
fees for students in developing Commonwealth countries.
Two pathways are available:
1. The Postgraduate Diploma/MSc in Palliative Medicine (open to doctors)
2. The Postgraduate Diploma/MSc in Palliative Care (open to healthcare
professionals)
Each qualification can be studied as an adult or paediatric option.
These qualifications are designed to help busy professionals enhance
their knowledge and inform and improve patient care.
They are:
# modular and include symptom control, advanced communication skills,
ethical issues & understanding the evidence
# immediately clinically applicable & Culturally sensitive
# delivered mostly by e-learning
# interprofessional & based on reflective learning
Courses start in September and will be conducted at Karunashraya
Hospice, Bangalore followed by online learning.
Fees for 2010-2011 £1950 per year.
Closing date for Scholarship applications: *April 30th 2010*
For further information: Tel 00 44 (0)2920 196111 (UK) or
http://www.pallium.cardiff.ac.uk
E-mail Dippallmed@xxxxxxxxxxxxxxxxxxxxxxxx for an application form.
====
ACCOLADES
Pallium India is thankful to Lions Club District 324 E1 for the
recognition it has given Pallium India and to palliative care.
On 13 January, Melvin Jones Day, the day of remembrance of the founder
of Lions International, Dr Rajagopal received an Award of Excellence
on behalf of Pallium India.
It was a particularly gratifying experience to receive it from the
chief guest, Dr Sandhya IPS, Inspector General of Police, and a
long-time friend of the Palliative Care movement. We thank Mrs Indira
Ravindranath, the District Governor of Lions Club, Mrs Bhagawati
Marthandan who got us in touch and all members of the Lions District.
And while mentioning this occasion, it would be relevant to quote the
great man Melvin Jones himself, “You cannot get very far until you
start doing something for somebody else.”
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HUMAN RIGHTS WATCH REPORT
"Over 7 million people in India suffer avoidable pain simply because
they have no access to morphine, says a Human Rights Watch report on
India’s obligation to ensure palliative care"
http://infochangeindia.org/200912228109/Health/Books-Reports/Painful-facts.html
====
M V GOVINDANKUTTY MEMORIAL AWARD FOR SOCIAL WORK
This year's M V Govindankutty Memorial Award for Social Work
instituted by Pratheeksha Pain and Palliative Care Clinic, Koottanad,
Palakkad, goes to Shri Y Philippose, Founder President, Health Care
Charitable Society, (Karunya Pain and Palliative Care Clinic),
Thiruvankulam, Ernakulam. The award was given away at a function held
in connection with the Community Based Palliative Care Day on 15th
January 2010.
====
STAFF CLUB
Featured website, Palliative Drugs: http://www.palliativedrugs.com
The site provides essential independent information for health
professionals worldwide about drugs used in palliative and hospice
care. The content is based on the UK Palliative Care Formulary (PCF,
3rd edition) which was Highly Commended in the British Medical
Association 2008 book competition. It includes details about
unlicensed (unlabeled) indications and routes, and the administration
of multiple drugs by continuous subcutaneous infusion.
The bi-monthly Newsletter has been replaced by the regularly updated
'Latest additions' and 'News' sections, and the Bulletin board
expanded to cover non-drug issues. The search facility has also been
improved. To access the site, it is necessary to register. Click on
'To register for access..' to create your own username and password.
We will ask you to provide contact and other details, including your
registration number with a professional body like the Medical, Nursing
or Pharmacy Council of India.
Once registered, we recommend that you first read "Getting the most
out of the PCF3"
====
WHAT YOU SHOULD KNOW ABOUT NSAIDS
# A review article published in the December 15 issue of the American
Family Physician offers recommendations for prescribing nonsteroidal
anti-inflammatory drugs (NSAIDs) in the primary care setting.
# It should be avoided by those with significant upper intestinal
tract bleeding,,particularly in older persons taking anticoagulants
and with platelet dysfunction..
# Although low dose aspirin is cardioprotective, NSAIDs as a class can
worsen congestive heart failure and increase blood pressure.
# They can lead to bleeding problems and renal failure in persons with
cirrhotic liver disease.
# Asthma may be induced or aggravated.
# It is to be avoided in the last 6-8 months of pregnancy.
# There will always be patients with pain conditions relieved only by
NSAIDs. There is need to focus on balance between risk and benefit
before NSAID therapy As supplements to analgesic therapy,
nonpharmacologic treatment such as physiotherapy and physical exercise
may be considered.
*Am Fam Physician. 2009;80:1371-1378. Abstract*
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ANAESTHESIA DURING CESAREAN DELIVERY
"Childbirth is an emotion-filled event and the mother needs to bond
with her newborn baby as early as possible," writes Anthony A.
Bamigboye, from University of Witwatersrand in Nelspruit, South
Africa, and G. Justus Hofmeyr, from University of Fort Hare, Eastern
Cape Department of Health in East London, South Africa. "Any
intervention that leads to improvement in pain relief is worthy of
investigation. Local anaesthetics, either on their own or in
combination with opioids or nonsteroidal antiinflammatory drugs, have
been employed as an adjunct to other postoperative pain relief
strategies."
"A pharmacokinetic study of local anaesthetic absorption following
wound and peritoneal infiltration is necessary," the review authors
conclude. "Ultrasound guided direct block of anterior abdominal wall
nerves in caesarean section should be explored. An important research
agenda will also be the effect of the intervention on chronic pelvic
pain."
*Cochrane Database Syst Rev. Published online July 8, 2009.*
======
WEIGHING MEDICAL COSTS OF END-OF-LIFE CARE: THERE IS NO END TO THE DEBATE.
How far should doctors go to try to save a patient’s life? “If you
come into this hospital, we’re not going to let you die”, says Dr
David T Feinberg, the chief executive of the Ronald Reagan UCLA
Medical Center. According to data compiled at Dartmouth, Medicare pays
about $50000 during a patient’s last 6 months of care at UCLA whereas
Mayo Clinic in Rochester, Minn. incurs about $25000.The cost of
treatment of a patient awaiting a heart transplant reached $300000
before he died after 5 weeks in the ICU. The moot point is, what is
the cost-benefit ratio?
The current payment system encourages additional tests and procedures.
As one doctor said,” The more tubes you put in, the more you get
paid.” But, difficult family dynamics are also involved. Family
members don’t want to let go. And, doctors too have trouble letting
go. Doctors and nurses should talk to the patient and their families
about their choices, educate them about the realistic chances of
recovery; of the kind of life that awaits the patient even after the
expensive treatment. A patient waiting for a liver transplant is
seldom told about the severe repercussions of rejection; that he would
have to live with a ventilator and dialysis for the rest of his life.
If he was told, maybe he would opt for hospice care. Until recently,
palliative care especially at end of life was an afterthought at such
medical institutions.
Read more:
http://www.nytimes.com/2009/12/23/health/23ucla.htm?_r=1&pagewanted=all
If that is the reality for USA, how would such aggressive treatment
add to suffering in resource-poor countries like India?
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DARK HUMOUR?
Mr Innocent is a popular comedian of the silver screen in Kerala,
India and a palliative care enthusiast.
He was to receive an award at a public ceremony and a tobacco company
was one of the sponsors. They asked him to say a few good words about
their brand of cigarette. During his speech, Mr Innocent advised all
the women in the crowd to persuade their husbands to smoke this
particular brand more and more. He also advised them to get their
children to start smoking as early as possible. And he had some
innovative suggestions to them to make even snacks out of cigarettes.
The satire hit its target, bang on. The company withdrew from
sponsorship of the award from the next year.
The anecdote though funny, is thought provoking, and the scenario
lurking in the back drop very worrisome. Smoking among young people is
increasing at an alarming rate. Recently,an Indian Health Minister
bewailed that though his ministry was trying hard to ban smoking in
public places, there were seven other ministries – Finance, Labor,
Agriculture and several others – working in favor of tobacco.
As one palliative care worker wryly commented, smoking is good for the
palliative care business too!
====
FINALLY, A SWEET MESSAGE ON VALENTINE’S DAY
Pallium India got a sweet message from Ms Meera Mohan on Valentine’s
day – a poem.
It concludes with the prayer:
# On this Valentine's Day,
# I do sincerely pray
# That all the tears YOU've wiped away
# Will become guardian angels to protect YOU
# And, help YOU in your mission, all your life through!
The whole poem can be seen at http://palliumindia.org/2010/02/day-of-love/
Thank you, Meera!
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Editorial Board:
K Govindan Kutty
A Salahuddin Kunju
C Mohanan
Indira Ballal
Rakesh Menon
M R Rajagopal
PALLIUM INDIA (REGISTERED CHARITABLE TRUST)
Address: II Floor, S.U.T. Speciality Hospital. Plamood, Trivandrum
695004, Kerala, India
Phone : 91 471 244 0306 (office) & 91 938 729 6889 (mobile)
Fax : 91 471 244 0306
Email : info@xxxxxxxxxxxxxxxx
Web: http://www.palliumindia.org
-
Newsletter of Pallium India, a registered charitable trust formed to
fulfill the need for a stable organization working at the national
level to fight for needs of the suffering millions on India who are
in need of pain relief and palliative care.
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