Pallium India
Care Beyond Cure
* ~~~~~~~~~~~~~ *
! February 2016 !
* ~~~~~~~~~~~~~ *
http://palliumindia.org/2016/01/february-2016/
January 31, 2016
DEAR FRIENDS,
DEATH IS GOING TO BE MORE EXPENSIVE IN INDIA
[HTTP://PALLIUMINDIA.ORG/2016/01/DEATH-IS-GOING-TO-BE-MORE-EXPENSIVE-IN-INDIA/]
You would all remember the recent Economist-Lien Foundation report
[http://palliumindia.org/2015/10/frightening/] on the Quality of Death Index. ;
Following its publication, headlines in Indian media generally came out with
the comment that “India is not a safe place to die in”.
Well, it is getting worse. Already we have the problem that even in the
context of futile treatment or vegetative existence, people are subjected to
intensive torture at huge physical, emotional, social and financial cost to the
patient and family. Health care being poorly regulated in the country,
institutions and practitioners are free to institute policies that would
intensify suffering, even in the context of advanced cancer or terminal motor
neuron disease. The prevailing legal environment worsens the situation.
The recent decision by the government of Karnataka to enforce 8% luxury
tax on intensive care units
[http://health.economictimes.indiatimes.com/news/hospitals/karnataka-govt-enforces-8-luxury-tax-on-icus/50622882]
would be one step that is going to worsen the quality of death in India. The
link
[http://health.economictimes.indiatimes.com/news/hospitals/karnataka-govt-enforces-8-luxury-tax-on-icus/50622882]
will show you how much every day of the dying process is going to cost purely
in terms of money, living along other elements of suffering. And please note,
this excludes the cost of medicines.
–
SPOTLIGHT ON LIVING, DYING AND DIGNITY
[HTTP://PALLIUMINDIA.ORG/2016/01/SPOTLIGHT-ON-LIVING-DYING-AND-DIGNITY/]
“Palliative care is a neglected issue in the Indian healthcare system,
with few exceptions. The peer community – individuals, patients and their
families, medical professionals, and lawyers – is sharply polarised in the
discourse on the ethics of assisted dying or euthanasia in the Indian setting.”
This is an excerpt from the editorial in the January 2016 issue of the Indian
Journal of Medical Ethics (Vol.16, No.1) [http://ijme.in/index.php/ijme/] , ;
titled “ Healing and Dying with Dignity: Where does India stand?
[http://ijme.in/index.php/ijme/article/view/2327/4879] ” by Sunita Bandewar and ;
Sanjay Nagral.
M. R. Rajagopal writes in “ Access to palliative care: insights into
ground realities post-2014 amendment to NDPS Act
[http://ijme.in/index.php/ijme/article/view/2330/4886] ” about the history and ;
current status of palliative care in India. “Often death is over-medicalised,
and a system seems to have evolved in which a lot of people die in intensive
care units on artificial life support even in the face of obvious futility of
treatment, without the ethical alternative of withdrawal of artificial life
support and introduction of palliative care. While death was preceded by the
withdrawal of artificial life support in up to 90% of cases in intensive care
units in the USA, the Indian figure for the withdrawal of life support among
cancer patients was only 29%.”
In “ The caregivers’ point of view
[http://ijme.in/index.php/ijme/article/view/2329/4883] “, Sheela Jaywant looks ;
at the caregivers’ role in taking care of the patients. “The disabilities
brought on by illness can force the dying into a position of complete
dependence. Their quality of life can be so poor that they might actually
prefer to leave this mortal world rather than linger on in a sub-human life,
and the family might feel the same way. The helplessness of caregivers, who are
generally family members, stems from extreme economic adversity as well as the
insensitivity of the healthcare system.”
This issue of the journal [http://ijme.in/index.php/ijme/] is devoted ;
to palliative and end-of-life care, and presents five papers which together
offer insights into the complexities of the subject from ethical, legal and
medical perspectives against the backdrop of the Indian healthcare system and
the entrenched inequities in peoples’ access to healthcare. The authors of
these essays have been part of the processes involved in shaping key policies,
programmes and laws on these issues.
–
PALLIATIVE SEDATION LEGALISED IN FRANCE
[HTTP://PALLIUMINDIA.ORG/2016/01/PALLIATIVE-SEDATION-LEGALISED-IN-FRANCE/]
In a development that some see as a step towards euthanasia, France’s
parliament on 29 January 2016 passed a new legislation
[https://www.lifesitenews.com/opinion/frances-new-end-of-life-law-more-extreme-than-belgiums]
permitting terminally ill patients to receive deep and continuous sedation
till death.
The way the news is projected gives cause for concern. Palliative
sedation is generally considered ethically right and part of good palliative
care, though limited to extreme situations. Will those providing it be seen as
clandestine practitioners of Euthanasia?
–
MANJUTHULLI – AN EXHIBITION AND SALE TO HELP PALLIUM INDIA’S PATIENTS
[HTTP://PALLIUMINDIA.ORG/2016/01/EXHIBITION-AND-SALE-TO-HELP-PALLIUM-INDIAS-PATIENTS/]
A group of volunteers including palliative care activists and artists
is organizing an exhibition and sale of paintings and craft products. This
4-day event, _Manjuthulli_, will take place from February 4, 2016 to February
7, 2016 at Museum Auditorium, Trivandrum. The program will be inaugurated by
Shri Soorya Krishnamoorthy at 3 p.m. on 4th February.
Part of the funds raised from this program will be used to support
Pallium India’s patient care activities
[http://palliumindia.org/programs/activities/] . ;
We request your presence and support for this event. Your contributions
will go a long way in improving the life of people with chronic and
life-limiting diseases.
DATES: February 4 to February 7, 2016
VENUE: Museum Auditorium, Trivandrum
INAUGURATION: 3 p.m., 4th February, 2016
Contact: info@xxxxxxxxxxxxxxxx [mailto:info@xxxxxxxxxxxxxxxx] / ;
(0)9746745502
_If you are unable to attend the event but wish to support us, please
Donate [http://palliumindia.org/donate] ._ ;
–
PALLIUM INDIA’S “PAINT A ROOM MISSION” KICKED OFF
[HTTP://PALLIUMINDIA.ORG/2016/01/PALLIUM-INDIAS-PAINT-A-ROOM-MISSION-KICKED-OFF/]
On January 15, 2016, as part of Kerala Palliative Care Day programs,
Pallium India’s new initiative, “Paint a Room” was inaugurated by Deputy Mayor
of Thiruvananthapuram, Adv. Rakhi Ravikumar, at Manaveeyam Veedhi,
Thiruvananthapuram.
Pallium India cares for several people who are bed-bound. Their lives
are confined to the four walls of their room. The sights that some of us take
for granted – of nature and her astounding creations – are denied to them, for
they may not even have access to a window. Our intention is to make a small
difference in their lives, if we can.
With the ‘Paint a Room’ mission, we try to understand their interests
and what makes them happy, and paint those pictures on their wall, with colours
they find pleasing. Will it make their lives more pleasant? We certainly hope
it does, at least a tiny bit.
This activity was kicked off with support from friends and well-wishers
of Pallium India. But to keep going, we need support from each one of you as
well. WILL YOU HELP US? Please contact us [http://palliumindia.org/contact/] to ;
know how you can.
Kerala Palliative Care Day is celebrated across the state every year on
January 15. This year, the focus of palliative care day was on “Knowledge and
Compassion for Quality Care”. Several programs were conducted by palliative
care enthusiasts to increase awareness on palliative care and to improve access
to essential medicines for the needy.
To see more pictures of the program at Manaveeyam Veedhi, please visit
our Facebook page
[https://www.facebook.com/media/set/?set=a.1304268262932583.1073741852.141945799164841&type=3]
.
–
TWO EXCEPTIONAL NURSES HONORED
[HTTP://PALLIUMINDIA.ORG/2016/01/TWO-EXCEPTIONAL-NURSES-HONORED/]
All palliative care nurses can take pride in the fact that the founder
of the hospice movement, Dame Cicely Saunders, had started out as a nurse. Two
of her followers were recently honored in Kerala.
SMT RADHA was in government service in Thrissur. She had started out as
a staff nurse and retired as the District Nursing Officer in 2001 after 33
years of service. Her humane service stood out as a beacon and helped as a
guiding light to a lot of younger nurses. After retirement, she is more active
than ever as a volunteer at Pain and Palliative Care Society, Thrissur. On 17
January 2016, at a function organized by the ATMA foundation (
www.atmafoundation.org [http://www.atmafoundation.org] ;), Sri Therambil
Ramakrishnan (honorable MLA) and Smt Ajitha Jayarajan (honorable Mayor of
Thrissur, herself a volunteer in palliative care) honored Radhedathi (as Smt
Radha is fondly called). It was Pallium India’s privilege to be present at the
event.
REV. SR. ELIZABETH is a super woman. With the help of two trainee
nurses, she manages a large establishment with about 50 inmates, the majority
of them destitutes and many of them requiring palliative care. Pallium India is
privileged to be associated with Karunya Vishranthi Bhavan where she works and
to provide medical support for their palliative care patients. On 20 January
2016, Sr Elizabeth was honored by K.C. Vamadevan Foundation with the
prestigious K.C. Vamadevan award. The award was presented by Sri Adoor
Gopalakrishnan at a function in Trivandrum.
–
PALLIUM INDIA WINS PALLIATIVE CARE AWARD FOR THE SAARC COUNTRIES
[HTTP://PALLIUMINDIA.ORG/2016/01/PALLIUM-INDIA-WINS-PALLIATIVE-CARE-AWARD-FOR-THE-SAARC-COUNTRIES/]
Pallium India has been adjudged the winner of the Palliative Care Award
for the SAARC Countries 2015-16 instituted by Cancer Aid Society.
The award and the prize money of ₹ 100,000 will be presented during the
inaugural function of the International Conference of Indian Association of
Palliative Care (IAPCON) on 12th February, 2016 at Pune.
Cancer Aid Society is an India-based non-governmental organization
working on a variety of areas including palliative care, advocacy, tobacco
control, and disease prevention, and holds a special consultative status with
the United Nations ECOSOC.
–
A WHEELCHAIR FROM THE OTHER SIDE OF THE GLOBE
[HTTP://PALLIUMINDIA.ORG/2016/01/A-WHEELCHAIR-FROM-THE-OTHER-SIDE-OF-THE-GLOBE/]
What makes Dr Ann Broderick, a consultant in palliative medicine from
Iowa, USA, sweat it out for months together, helping people in Trivandrum?
What makes her lug around a wheelchair
[https://annbroderick.wordpress.com/2016/01/21/sindhu/] , all the way from USA ;
to Trivandrum?
What makes Vince Wolrab and Jason at JVA Mobility donate the equipment
to someone in a faraway land on the other side of the globe, whom they may
never get to see?
If this is not spirituality made visible, what is it?
Read the story in Dr Broderick’s blog
[https://annbroderick.wordpress.com/2016/01/21/sindhu/] . ;
–
PRATHEEKSHA AWARD FOR DR M. R. RAJAGOPAL
[HTTP://PALLIUMINDIA.ORG/2016/01/PRATHEEKSHA-AWARD-FOR-DR-M-R-RAJAGOPAL/]
Dr M. R. Rajagopal, Chairman of Pallium India, received the Pratheeksha
Award from members of Pratheeksha Charitable Society on Kerala Palliative Care
Day, January 15, 2016, in honour of his contribution to the palliative care
scene in India.
–
PALLIUM INDIA PARTICIPATES IN REPUBLIC DAY DINNER AT RAJ BHAVAN
[HTTP://PALLIUMINDIA.ORG/2016/01/PALLIUM-INDIA-PARTICIPATES-IN-REPUBLIC-DAY-DINNER-AT-RAJ-BHAVAN/]
Pallium India activists Ms Ashla Rani and Dr Siju Vijayan were among
the invitees at the annual Republic Day dinner hosted by Shri P. Sathasivam,
the Honorable Governor of Kerala, at the Raj Bhavan on 26th January, 2016. It
was heart-warming to see that they were included in the guest list, whichh was
otherwise comprised of ministers, senior IAS officers, officers of the Armed
Forces, and social and literary luminaries. The Governor personally gave Ashla
and Siju gifts and also gave a handsome check of donation to Pallium India.
We bow before you, Your Excellency, the Governor of Kerala, Shri P.
Sathasivam.
Our new readers may not know that over a year ago, responding to a
request
[http://palliumindia.org/2014/11/they-demand-their-right-and-the-governor-is-sympathetic/]
from Ashla and her friend George Thomas, the Governor had made the necessary
alternations to Raj Bhavan
[http://palliumindia.org/2015/01/the-governor-of-kerala-takes-one-giant-step-forward/]
to make it wheelchair-friendly, thus setting an example for India.
–
REHABILITATION TRAINING PROGRAM AT CMC VELLORE
[HTTP://PALLIUMINDIA.ORG/2015/03/HALF-WAY-HOME-FOR-PARAPLEGIC-PATIENTS/]
Pallium India team participated in a training program at Rehabilitation
Institute of CMC, Vellore, as part of the Half-way Home project of Kerala
Social Justice Department.
Read about the Half way Home project
[http://palliumindia.org/2015/03/half-way-home-for-paraplegic-patients/] ;
–
Inauguration of palliative care centre at NKPSIMS, Nagpur
[http://palliumindia.org/2016/01/inauguration-of-palliative-care-centre-at-nkpsims-nagpur/]
In the presence of Sri Devendra Fadnavis, Chief Minister of
Maharashtra, Union Minister for Transport Sri Nitin Gadkari and many other
dignitaries, the palliative care center in NKP Salve Institute Of Medical
Sciences And Research Centre and Lata Mangeshkar Hospital, Nagpur, was
inaugurated by Dr Prabhat Nichkaode, Professor of Surgery and Coordinator of
Palliative care, on the 24th of December 2015. This center is started under
Pallium India and Jamshedji Tata Trust Project “Improving Access to Pain Relief
and Palliative Care in India”.
A training session was conducted on the 23rd of December for faculties
by Dr Navin Salins of Tata Medical Center and Dr Prabhakaran Nair of Pallium
India.
Dr Kajal Mitra and Dr Nichkaode deserve special mention for the
untiring support given to us in making the palliative care center a reality.
–
IMPORTANT STRIDES IN UAE’S PALLIATIVE CARE SCENE
[HTTP://PALLIUMINDIA.ORG/2016/01/IMPORTANT-STRIDES-IN-UAES-PALLIATIVE-CARE-SCENE/]
It is curious that the Middle East does not have much palliative care –
curious because in the rest of the world, though it is a relatively low-cost
affair, palliative care access is best in affluent countries. The Middle East
has no dearth of money; yet there is a vast ocean of health -related suffering.
Let us forget the possible reasons. Some good things seem to be
happening, with the Universal hospital in Abu Dhabi, UAE, taking the lead. On
22 January, 2016, a one-day palliative care educational program
[http://www.khaleejtimes.com/nation/uae-health/universal-hospital-conducts-1st-uae-palliative-care-conference]
was organized by Dr Shabeer Nellikode and team, with Dr Sakshi Sadhu acting as
the anchor. The faculty included doctors and nurses from UK, USA and India.
Notable luminaries were Dr S. H. Advani, the famous oncologist from Mumbai, Dr
Simon Dein from the UK and Dr Haroon Choudhri , who was named one of the top
ten doctors in USA.
At present, the Tavam Hospital at Alain, UAE appears to have the only
effective palliative care unit in the whole country. As in every other country,
UAE has its own multiple barriers to access to pain relief.
BEST WISHES TO DR SHABEER NELLIKODE AND TEAM FOR CREATING A SEA CHANGE BY
BRINGING IN PALLIATIVE CARE TO CHANGE THE HEALTH CARE SCENE FOR THE BETTER.
–
DR STEPHEN CONNOR APPOINTED EXECUTIVE DIRECTOR OF WHPCA
[HTTP://PALLIUMINDIA.ORG/2016/01/DR-STEPHEN-CONNOR-APPOINTED-EXECUTIVE-DIRECTOR-OF-WHPCA/]
Dr Stephen R. Connor, Ph. D, a valuable friend and supporter of
palliative care in India, has been appointed as Executive Director of the
Worldwide Hospice Palliative Care Alliance
[http://www.ehospice.com/articleview/tabid/10686/articleid/17897/language/en-gb/dr-stephen-connor-appointed-executive-director-of-the-worldwide-hospice-palliative-care-alliance.aspx]
(WHPCA).
In 2006, as Head of NHPCO, Dr Connor worked with Pallium India and 16
palliative care pioneers from various parts of the country to develop the
minimum standards in palliative care (which can be seen at:
http://palliumindia.org/about/standards/ ;
[http://palliumindia.org/about/standards/] ;)
CONGRATULATIONS, DR STEPHEN CONNOR. AND BEST WISHES TO YOU IN YOUR NEW ROLE.
–
DR ODETTE SPRUYT DELIVERS FIRST “APHN DIALOG” TALK
[HTTP://PALLIUMINDIA.ORG/2016/01/DR-ODETTE-SPRUYT-DELIVERS-FIRST-APHN-DIALOG-TALK/]
Asia Pacific Hospice Network (APHN) has launched a new initiative – a
pilot education program for palliative care workers in the Asia Pacific
regions. The first such program, a trial run, took place at 2.30 to 3.30 p.m.
IST on Wednesday the 27th of January. Dr Odette Spruyt gave the first talk,
summarising the global regional and country status of palliative care in the
Asia Pacific Hospice Region.
Among the various topics that were discussed, to us the most exciting
recent event happens to be the World Health Assembly’s resolution on
integration of palliative care into health care. Efforts are under way for
implementation of the resolution by the World Health Organization. The world
over, palliative care activists are working together towards it. The Non
Communicable Diseases (NCD) Alliance has been one strong force persuading
action. Whether it be the area of opioid access, palliative care education or
creation of policy and its implementation, the WHA resolution could be a strong
tool for palliative care activitists in their attempts at persuading government
action. In recent months, a country NCD alliance is developing in India.
Perhaps, this could be an effective forum in every country. When different
organizations in different areas connected with NCDs come together, the
collective strength can be considerable.
–
WARNING: OPIOID AND BENZODIAZEPINE COMBINATION CAN BE RISKY
[HTTP://PALLIUMINDIA.ORG/2016/01/WARNING-OPIOID-AND-BENZODIAZEPINE-COMBINATION-CAN-BE-RISKY/]
The PAIN: Clinical Updates
[http://www.iasp-pain.org/PublicationsNews/NewsletterIssue.aspx?ItemNumber=4962]
from the International Association for Study of Pain (IASP) November 2015
issue is worth taking a look at for any doctor, particularly those interested
in pain management and palliative care. Though not new knowledge, the risk of
respiratory depression with these two medicines is not adequately known. Either
drug by itself, in clinically used long-term dosage schedules, is unlikely to
cause respiratory depression. But that is not true for a combination of the
two.
Sleeplessness is a common problem for people in pain and hence,
physicians are tempted to combine the two medicines. The risk of respiratory
depression must be remembered particularly when one of them is introduced for
the first time with the other, or when the dosage of one of them is increased.
As untreated, excruciating pain is a common problem in palliative care
clinics in India, it is not an uncommon practice to treat a pain crisis with an
initial parenteral titration of opioids. We would like to point out that this
practice along with concurrent administration of Benzodiazepines is
particularly prone to respiratory depression.
The risk is believed to be more in the combination of Buprenorphine
with Benzodiazepines.
We would also like to add from personal experience that rousability is
not an adequate index of safety. In the presence of opioid Benzodiazepine
combination, a patient who is rousable and breathing normally when awake can
still drop off to respiratory depression in the absence of stimulation.
–
OPIOIDS, DEPRESSION AND THE PRINCIPLE OF BALANCE
[HTTP://PALLIUMINDIA.ORG/2016/01/OPIOIDS-DEPRESSION-AND-THE-PRINCIPLE-OF-BALANCE/]
A study published in the Annals of Family Medicine by Jeffrey Scherrer
et al. [http://www.annfammed.org/content/14/1/54.long] points out an incidence ;
of new onset depression of 9-12% with medical opioid use, the incidence rising
with duration of use. The risk is seen in those who use it more than 30 days.
There has been significant publicity for this as well as other risks.
Would not the following be a balanced approach?
* to be aware of the possibility of depression with prolonged use and
to look for it and treat it if it happens,
* to avoid using opioids as first line treatment for non-cancer pain,
and nevertheless,
* to use opioids when it is indicated instead of condemning the person
to pain when nothing else helps.
–
HOME VISIT BLOGS BY IOWA STUDENTS
[HTTP://PALLIUMINDIA.ORG/2016/01/HOME-VISIT-BLOGS-BY-IOWA-STUDENTS/]
“It just awes me when someone who is in such pain or is constantly
taking care of others still makes it a point to ensure our comfort as a guest
in their home,” writes CJ
[http://elandphoto.com/India_2015/blog-2/files/55e9c2e8467cdd00b30d809d9038267f-14.html]
, a student from Iowa University who visited Trivandrum in December-January.
The students took part in Pallium India’s home visit programs, and recorded
their thoughts in a blog run by Professor Jo Eland
[http://elandphoto.com/India_2015/] . ;
“Family is so important and drives almost everything people do here. If
a family member falls sick, then the family will quit jobs and do whatever it
takes to stay home and care for their loved one. Caring for the sick is mostly
left up to the women and today we saw daughters, granddaughters,
daughters-in-law, sisters, and female neighbors all play a role in patient
care.”
Aparna, another student, writes
[http://elandphoto.com/India_2015/blog-5/files/a88e85dff315ebcfc99fd4636c6779ca-13.html]
, “It was difficult to restrain myself from blaming the family caretaker for
the poor condition of the patient, but I tried to keep reminding myself that I
would never know how it feels to be in their shoes
[http://elandphoto.com/India_2015/blog-4/files/1bb366b6e64c8b126bf166418e817017-10.html]
and what they are going through.”
For most of us at Pallium India, seeing everything through the eyes of
these students is a learning experience too. Please read all the blogs at
http://elandphoto.com/India_2015/ [http://elandphoto.com/India_2015/] ;
Every year, a team of students from Iowa University
[http://palliumindia.org/2015/12/iowa-comes-to-trivandrum-again/] , accompanied ;
by their Professors, Dr Jo Eland and Dr Ann Broderick, visit Pallium India. In
this cultural immersion course spanning three weeks, the students will learn
palliative care in relation to health care in the country, and contribute what
they can.
_(Photo by Prof Jo Eland)_
–
PALLIUM INDIA’S OUTPATIENT CLINIC AT MURUKKUMPUZHA
[HTTP://PALLIUMINDIA.ORG/2016/01/PALLIUM-INDIAS-OUTPATIENT-CLINIC-AT-MURUKKUMPUZHA/]
_Dr Ann Broderick, Director of Palliative Medicine at University of
Iowa, writes about Pallium India’s Wednesday outpatient clinic at Murukkumpuzha
[http://www.ehospice.com/india/ArticleView/tabid/10675/ArticleId/18188/language/en-GB/View.aspx]
, and the volunteers, the patients and the family members who come together
and support each other._
Above the sound of the call to prayer in Murukkumpuzha, a group gathers
and chats in the public library on the second floor. Wednesday is outpatient
day and those who can climb the stairs come and visit with the Pallium India
team – nurse, doctor, social worker and volunteer.
Here, they will get an assessment of their social situation, their
symptoms and refills of their medications.
Many healthy appearing women are in clinic on this day. Their husbands
or fathers have been injured through accidents either in India or in Gulf
countries. Or the menfolk have had strokes and cannot make the trip to clinic.
The women serve as ‘proxies’ – reporting symptoms and getting some support for
the hard work that they do at home, in addition to their wage earning jobs.
_ Continue reading
[http://www.ehospice.com/india/ArticleView/tabid/10675/ArticleId/18188/language/en-GB/View.aspx]
_
Follow Dr Ann Broderick’s blog. [https://annbroderick.wordpress.com/] ;
–
OUR DIRECTORY OF PALLIATIVE CARE SERVICES
[HTTP://PALLIUMINDIA.ORG/2016/01/OUR-DIRECTORY-OF-PALLIATIVE-CARE-SERVICES/]
Pallium India’s website has a directory provided by our information
centre. You will find a map of India and a list of its states. Click on the
state (either in the map or in the list) and you will find a directory of
palliative care centres in that state.
We shall also be grateful to anyone who can help us to update it. Do
you know of a palliative care centre that is not included in our directory?
Please write to us. The information you provide may well save a lot of
suffering for someone in pain!
–
SEEKING EXPERIENCED INTERNATIONAL PHYSICIANS
[HTTP://PALLIUMINDIA.ORG/2015/03/SEEKING-EXPERIENCED-INTERNATIONAL-PHYSICIANS/]
Pallium India seeks clinically experienced international physicians who
are able to practice and teach in a variety of settings, include home visits,
outpatient visits, and the inpatient unit. They must be adaptable to new
environments and be able to commit to over 3 months. Pallium India will provide
translators as most patients will prefer to speak Malayalam. Teaching will be
done in English.
If you are interested, please write to us: info@xxxxxxxxxxxxxxxx
[mailto:info@xxxxxxxxxxxxxxxx] ;
–
DONATE TOYS FOR CHILDREN! [HTTP://PALLIUMINDIA.ORG/DONATE]
We are happily accepting toy donations for our weekly children’s
palliative care clinic. Certain specifications need to be considered before
sending the toys across, due to the nature of the children’s illnesses.
Kindly avoid toys with small breakable parts, anything with batteries,
toys with sharp edges, regular sized Lego pieces, jigsaw puzzles with small
pieces, games involving liquids (like the ones that shoot rings onto sticks at
the press of a button), stuffed toys that have fine hair and fluff, etc.
If you are interested in sending something across, do call us
(+91-9746745497) or write to us:info@xxxxxxxxxxxxxxxx. Thank you very much!
–
PALLIATIVE CARE INFORMATION CENTRE [HTTP://PALLIUMINDIA.ORG/INFO-CENTRE]
Contact Pallium India’s Information Centre (9 am to 12 noon) for
information related to palliative care and about establishments where such
facilities are available in India. Telephone: +91-9746745497 or E-mail:
info@xxxxxxxxxxxxxxxx
Address: Pallium India, Arumana Hospital, Perunthanni, Trivandrum
For more details, please visit: http://palliumindia.org/info-centre/ ;
[http://palliumindia.org/info-centre/] ;
–
READ: IT IS THE SAME STORY ALMOST EVERYWHERE. AND PLEASE WRITE.
[HTTP://PALLIUMINDIA.ORG/2015/12/READ-IT-IS-THE-SAME-STORY-ALMOST-EVERYWHERE-AND-PLEASE-WRITE/]
“Rini would attempt to sit down one moment, fail, and try to stand up,
but then would bend over to a side, her body totally refusing to obey her
will……. Still bent over, she crawled to the bedroom and tried to lie down; but
failed. Her body arched backward like a bow, the small of her back on the edge
of the bed and her head almost touching the bed.”
In their narrative “ Pain in Bali
[http://www.tandfonline.com/doi/full/10.3109/15360288.2015.1098763] ” published ;
in the _Journal of Pain and Palliative Care Pharmacotherapy_, authors M. R.
Rajagopal and Kurnia Ito describe how mindless regulations and near-total lack
of pain education combine to inflict needless cruel suffering on people with
life-threatening diseases.
Kurnia Ito adds a possible reason, “It seems easier to get people
interested in cute cats than in terminally ill people in pain!”
Read the free access article “ Pain in Bali
[http://www.tandfonline.com/doi/full/10.3109/15360288.2015.1098763] ” in the ;
_Journal of Pain and Palliative Care Pharmacotherapy_.
Don’t you have a story in you? Do please write your story on pain,
suffering or relief and share it with the world. It will help your wound to
heal by sharing and help others by giving visibility to the issue. Read about
the narratives feature and other narratives
[http://palliumindia.org/2015/08/narratives-on-pain-and-relief-giving-voice-to-the-voiceless/]
.
–
NEWS FROM AROUND THE WORLD
* Conceptual foundations of a palliative approach: a knowledge
synthesis
[http://www.ehospice.com/canadaenglish/articleview/tabid/10678/articleid/18174/language/en-us/conceptual-foundations-of-a-palliative-approach-a-knowledge-synthesis.aspx]
* Study reports better quality of life for cancer patients who died
under hospice care
[http://www.ehospice.com/usa/articleview/tabid/10708/articleid/18071/language/en-gb/study-reports-better-quality-of-life-for-cancer-patients-who-died-under-hospice-care.aspx]
* Palliative care is cost effective
[http://www.ehospice.com/ireland/ArticleView/tabid/11070/ArticleId/17976/language/en-GB/View.aspx]
* JAMA focuses on care at end of life
[http://www.ehospice.com/usa/articleview/tabid/10708/articleid/18072/language/en-gb/jama-focuses-on-care-at-end-of-life.aspx]
* How we used to die; how we die now
[http://exopermaculture.com/2016/01/19/how-we-used-to-die-how-we-die-now/] ;
* No budget for 2 yrs, Maharashtra’s palliative care programme runs dry
[http://indianexpress.com/article/cities/mumbai/no-budget-for-2-yrs-palliative-care-programme-runs-dry/]
* Doctors in Haryana to be imparted palliative care training at PGIMS
[http://news.webindia123.com/news/Articles/India/20160126/2778803.html] ;
* Amidst suffering, some reassurance – Palliative care in Kerala
[http://www.thehindu.com/news/national/kerala/amidst-suffering-some-reassurance/article8115898.ece]
* In India, Dispensers of Balm Travel to Death’s Door
[http://opinionator.blogs.nytimes.com/2016/01/12/in-india-travelling-dispensers-of-balm-at-deaths-door/]
* Unhealthy trends and unholy nexus in the healthcare industry
[http://english.manoramaonline.com/news/opinion-pieces/health-feature-issues-super-speciailty-hospitals-doctors.html]
* We have medicalised mortality, says Atul Gawande
[http://www.hindustantimes.com/books/jlf-2016-we-have-medicalised-mortality-says-atul-gawande/story-kjxvxwW0Fop4N0lvrRowmM.html]
* Unequal Lives, Unequal Deaths
[http://opinionator.blogs.nytimes.com/2016/01/20/dying-at-home-when-youre-poor/?_r%3D2]
* CanSupport – Healing with empathy
[http://www.business-standard.com/article/beyond-business/healing-with-empathy-116012201494_1.html]
* What happens to homeless people when they are dying?
[http://www.ehospice.com/uk/articleview/tabid/10697/articleid/18034/language/en-gb/what-happens-to-homeless-people-when-they-are-dying.aspx]
* Nobody teaches a physician the emotional consequences of medicine
[http://www.kevinmd.com/blog/2015/08/nobody-teaches-a-physician-the-emotional-consequences-of-medicine.html]
* Pain in Bali – a narrative
[http://hospicecare.com/about-iahpc/publications/newsletter/2016/01/global-palliative-care-community-highlights/]
* Bereavement care – a window to overcome your grief
[http://www.ehospice.com/articleview/tabid/10686/articleid/17859/language/en-gb/bereavement-care-a-window-to-overcome-your-grief.aspx]
* Coping with grief: That sick, hollow feeling after losing good
friends
[http://www.ehospice.com/ireland/ArticleView/tabid/11070/ArticleId/17971/language/en-GB/View.aspx]
* Palliative care in the Democratic Republic of Congo
[http://www.ehospice.com/southafrica/articleview/tabid/10689/articleid/18002/language/en-gb/palliative-care-in-the-democratic-republic-of-congo.aspx]
* Palliative care for Chronic Kidney Disease of unknown origin (CKDu)
in Sri Lanka
[http://www.ehospice.com/articleview/tabid/10686/articleid/17814/language/en-gb/palliative-care-for-chronic-kidney-disease-of-unknown-origin-ckdu-in-sri-lanka.aspx]
* New standards for children with cancer
[http://www.ehospice.com/internationalchildrens/articleview/tabid/10670/articleid/17968/language/en-gb/new-standards-for-children-with-cancer.aspx]
–
3-DAY REFRESHER COURSE IN PALLIATIVE CARE AT JAIPUR
[HTTP://PALLIUMINDIA.ORG/2016/01/3-DAY-REFRESHER-COURSE-IN-PALLIATIVE-CARE-AT-JAIPUR/]
Bhagwan Mahaveer Cancer Hospital and Research Centre (BMCHRC) and
Pallium India join hands to conduct a three-day refresher course in palliative
care for doctors and nurses. This course is open to any doctor or nurse who has
already taken the IAPC course or other hands-on courses of not less than ten
days duration.
The faculty include:
* Dr Mhoira Leng, Scotland
* Ms Florence, Makarere University, Uganda
* Dr Anjum Khan Joad, Jaipur
Sessions include advanced symptom management, advanced communication
skills and conflict management. Basic accommodation will be provided at
subsidised rates / free for limited early bird registrations.
* DATE: February 16 – 18, 2016
* COURSE FEE: ₹ 1000
* For more details, please contact: palliumjaipur@xxxxxxxxx
[mailto:palliumjaipur@xxxxxxxxx] ;
* _ Other courses from Pallium India [http://palliumindia.org/courses/] ;
_
–
UPCOMING COURSES [HTTP://PALLIUMINDIA.ORG/COURSES]
PALLIUM INDIA, IN COLLABORATION WITH OTHER ORGANIZATIONS, CONDUCTS
COURSES ON PALLIATIVE CARE FOR HEALTH CARE PROFESSIONALS AND VOLUNTEERS IN
DIFFERENT PARTS OF INDIA:
* TIPS, Trivandrum, Kerala. Contact: info@xxxxxxxxxxxxxxxx
[mailto:info@xxxxxxxxxxxxxxxx] – 7 MAR, 2016 ;
* MNJIO&RCC, Hyderabad, Telengana. Contact: mnj.palliative@xxxxxxxxx
[mailto:mnj.palliative@xxxxxxxxx] – 7 MAR 2016 ;
* BMCHRC, Jaipur, Rajasthan. Contact: palliumjaipur@xxxxxxxxx
[mailto:palliumjaipur@xxxxxxxxx] – 2 MAY 2016 ;
* GCRI, Ahmedabad, Gujarat. Contact: palliumindia.gcri@xxxxxxxxx
[mailto:palliumindia.gcri@xxxxxxxxx] – 1 MAR 2016 ;
For more details on the courses we offer, please visit:
http://palliumindia.org/courses/ [http://palliumindia.org/courses/] ;
–
PARTING SHOT
PAIN, UNRELIEVED PAIN! [HTTP://PALLIUMINDIA.ORG/2016/01/PAIN-UNRELIEVED-PAIN/]
Dr Ramesh Menon, who coordinates Pallium India’s international council
and is an anesthesiologist who lives in New Zealand, writes about the pain
management situation in India.
“A sad revelation came when I spoke with a cousin living in Chennai and
a carer for her 75 y old mother. This beloved aunt suffers from progressive
dementia and now seems to have an acute and increasing vascular occlusion of
both her lower limbs. From pictures my cousin sent me, she has obviously lost a
toe or two to gangrene and is at risk of losing an entire foot. She wails
periodically and has lost her mobility. My cousin is beyond tears and despair.
My aunt cannot understand why she is in pain and certainly cannot
express herself effectively, surely contributing to the poor pain assessment.
My cousin did not think it relevant to ask my advice until now. She
perhaps did not expect an anaesthetist to help where a vascular surgeon (a
Professor, no less) couldn’t?
I looked through the list of drugs the surgeon prescribed- treatment
dose LMW heparinoid (which has resulted in bruising all over), aspirin,
xanthinol, cilostazol, statin and so on. All prescribed in the genuine hope
that the blood flow would improve and the critical ischaemia overcome. Not one
pain killer was on the list! Her gangrene continues to progress meanwhile.”
The sad truth is that this situation is very common in most parts of
India. Many patients are left to suffer even there are solutions at hand.
