Pallium India Newsletter: June 2014

From: Pallium India Newsletter <info@xxxxxxxxxxxxxxxx>
To: "" <palliumindia@xxxxxxxxxxxxx>
Date: Tue, 01 Jul 2014 14:58:46 +0000

Pallium India
Care Beyond Cure

IF THEIR DEATH CAN MAKE A DIFFERENCE TO THE LIVING
[HTTP://PALLIUMINDIA.ORG/2014/06/IF-THEIR-DEATH-CAN-MAKE-A-DIFFERENCE-TO-THE-LIVING/]

On 2nd June, 2014, newspapers across Kerala carried a report that a
family of three was found dead in a hospital in Kanhangad. As per these
reports, the parents first killed their nine-year-old son who had been admitted
to the hospital, before taking their own lives. A suicide note found in the
room said that they were driven to this extreme step because they were unable
to tolerate their son’s unbearable, unrelieved pain.

The news points to a huge violation of human rights that exists in our
healthcare system. Valuable lives were lost only because there was failure of
medical aid in the form of palliative care. Palliative care involves, very
often, prescription of morphine, an opioid medication. It is included in the
National List of Essential Medicines. And yet, the sad truth is that majority
of hospitals in Kerala do not have morphine, do not have doctors trained in
palliative care and patients are denied pain relief.

Pallium India has filed a petition with the Kerala Human Rights
Commission to bring attention to this issue. A copy of the petition can be seen
here
[http://palliumindia.org/cms/wp-content/uploads/2014/06/Petition-before-KSHRC.pdf]
. We are hopeful that the Human Rights Commission will take action on this by
giving instructions to all medical institutions in the state to provide
palliative care with adequate stock of morphine and allied opioids.

STRENGTHENING OF PALLIATIVE CARE AS A COMPONENT OF COMPREHENSIVE CARE
THROUGHOUT THE LIFE COURSE
[HTTP://PALLIUMINDIA.ORG/2014/06/STRENGTHENING-OF-PALLIATIVE-CARE-AS-A-COMPONENT-OF-COMPREHENSIVE-CARE-THROUGHOUT-THE-LIFE-COURSE/]

A few days ago, we had blogged about an important resolution
[http://palliumindia.org/2014/05/you-may-not-know-it-but-your-life-has-been-changed-on-23-may-2014/]
adopted by the World Health Assembly at Geneva. This resolution is now
available as a PDF on the website of World Health Organization (WHO), and can
be accessed here [http://apps.who.int/gb/ebwha/pdf_files/WHA67/A67_R19-en.pdf]
.

KERALA’S FLAG FLEW HIGH IN ODISHA
[HTTP://PALLIUMINDIA.ORG/2014/06/KERALAS-FLAG-FLEW-HIGH-IN-ODISHA/]

Kerala’s flag flew high during a workshop on “Innovative practices in
the health sector” organized at Bhubaneshwar, Odisha on 23-24 June 2014. About
80 senior officials from all over Odisha attended the workshop where 14
innovators in health care from various parts of the country got together to
listen, discuss and learn. The program was organized by the Centre for
Innovations in Public Systems (CIPS).

Two innovations from Kerala found their way into the list of 14. One
was the palliative care movement of Kerala, presented by the Chairman of
Pallium India, Dr M. R.Rajagopal, and the other, the journey towards quality by
Dr Haneesh Meerasa of Government General Hospital, Ernakulam, the latter
describing the growth of a government hospital to an NABH accredited
institution. Incidentally, the palliative care unit at that hospital is a very
successful example for the whole country, and we congratulate Dr Mathews
Numpeli as well as the doctors in the hospital for making that happen.

What will this workshop achieve? Will it help to reduce the
disease-related suffering in the country?

WE THINK, YES, BECAUSE A CRITICAL MASS OF HEALTH ACTIVISTS HAVE NOW BEEN
SENSITIZED. SEVERAL PEOPLE FROM THE FACULTY AND PARTICIPANTS EXPRESSED INTEREST
IN STARTING PALLIATIVE CARE IN THEIR RESPECTIVE STATES.

RAHMATH LIVES. [HTTP://PALLIUMINDIA.ORG/2014/06/RAHMATH-LIVES/]

Some of our readers may remember Rahmath, an exceptional patient under
our treatment, who smilingly went through agonising pain and eventually
succumbed to the disease while spreading light and sweetness around her. (We
had written about her here
[http://palliumindia.org/2011/08/one-more-of-us-died-this-week/] and here
[http://palliumindia.org/2011/09/rahmath-lives-on-in-memories-and-more/] ) She
and her family were in dire economic situation, but still she could give a lot.
Now that she is gone, her daughter Sunitha continues to live a difficult life
and tries hard to sustain her mother’s tradition.

When Rahmath died, the daughter had insisted on donating part of her
meagre inheritance to Pallium India. When we protested saying that she could
ill afford it, she replied, “I have no choice. I have to do it for my mother.”
Eking out a precarious living with a low paid job, she continued to send money
on every single death anniversary of her mother.

Recently, tragedy struck again. Her husband had an accident and died a
sudden death from head injury, leaving her to fend for three of her children,
15, 12 and 10 years old. Just as the rituals following the death were going on,
she called us. She was making an urgent transfer of some money to us and wanted
to ensure that on the very same day, our patients in our inpatient facility and
their families should be given a meal in memory of the departed.

SUNITHA, YOU ARE A LESSON IN _GIVING_. WE BOW BEFORE YOUR MOTHER’S MEMORY AND
BOW IN RESPECT OF YOUR ESSENTIAL HUMANITY.

(In the picture, the late Rahmath, daughter Sunitha and two of
Sunitha’s children).

A MUSICAL EVENING WITH A DIFFERENCE
[HTTP://PALLIUMINDIA.ORG/2014/04/A-MUSICAL-EVENING-WITH-A-DIFFERENCE/]

East India Palliative Care presents “A Musical Evening with a
Difference: Music, life, death and palliative care” on Monday 7 July 2014 (6.15
pm – 8.15 pm) at The Nehru Centre, London.

The events include Welcome by Sangeeta Bahadur, Minister of Culture,
followed by an Introduction by David Oliviere, Former Director of Education and
Training, St Christopher’s Hospice, London.

Viola da Cunha, a mezzo soprano, accompanied by Yuki Osedo (piano),
will lead the evening of music. She will include a song cycle using poems
written by a patient during her last days in a London hospice. A short
presentation by Dr Sankha Mitra, Chairman of the EIPC Project, will be
concluded by Rabindra Sangeet performer, Dr Susmita Ghosh Mitra from Kolkata.

For more details on this event, visit: www.nehrucentre.org.uk
[www.nehrucentre.org.uk] / www.hcilondon.in [www.hcilondon.in]
For enquiries, contact: davidoliviere@xxxxxxxxxxx

PALLIUM INDIA IS PROUD TO BE EIPC’S PARTNER IN ADVANCING PALLIATIVE CARE IN
EAST AND NORTH-EAST INDIA.

GOOD NEWS FROM THE REGION – ASIA PACIFIC HOSPICE NETWORK
[HTTP://PALLIUMINDIA.ORG/2014/06/GOOD-NEWS-FROM-THE-REGION-ASIA-PACIFIC-HOSPICE-NETWORK/]

Asia Pacific Hospice Network (APHN) had its council meetings over three
days – 12, 13 and 14 June, 2014, at Hong Kong. We are glad to report about some
welcome development in the region. Assisted by the Lien foundation, APHN has
started a program called The Lien Collaborative which is successfully moving
ahead with initiating palliative care programs in Bangladesh, Myanmar and
Srilanka. We are so glad to hear of the welcome development among our
neighbors!.

KUDOS TO DR CYNTHIA GOH AND MR WENG WAI OF APHN AND TO MR LEE POH WAH OF LIEN
FOUNDATION.

MUSIC IN USA RELIEVES PAIN IN INDIA.
[HTTP://PALLIUMINDIA.ORG/2014/06/MUSIC-IN-USA-RELIEVES-PAIN-IN-INDIA/]

Like last year, our friends Care and Share USA and Seattle Saptaswara
organized yet another successful fund raiser among Malayali crowd in Seattle,
Washington. The musical event, Ganolsavam, raised $17,000 to support Pallium
India’s rehabilitation programs.

Ashley from Care & Share writes to us about the event:

Seattle Saptaswara is a non-profit troupe founded in 2009 with the
mission to raise funds for deserving causes through musical events. Ganolsavam
is their annual event to support Care & Share’s projects in Kerala. Around 40
people, including musicians and volunteers, worked close to 4 months in
planning, practising and marketing for the grand success of Ganolsavam 2014.
Combined, its an effort of more than 2000 hours! Being a huge supporter of
quality palliative care, Care & Share has decided to spend all the funds raised
to support Pallium India’s rehabilitation projects. Kudos to Saptaswara and
Seattle crowd, your support and efforts will bring hope and comfort to a number
of families. For more details please visit here
[http://www.careandshare.com/ganolsavam2014.html] .

A BIG THANK YOU TO CARE AND SHARE, TO SEATTLE SAPTASWARA AND TO THE SEATTLE
MALAYALI COMMUNITY!

“HELPING SOULS” MOVE INTO PALLIATIVE CARE IN TAMIL NADU
[HTTP://PALLIUMINDIA.ORG/2014/06/HELPING-SOULS-MOVE-INTO-PALLIATIVE-CARE-IN-TAMIL-NADU/]

Udhavum Ullangal is a very successful non-government organization in
Tamil Nadu, working mainly in the areas of cancer awareness and early
detection. Once cancer is detected, they support the patient through treatment.

It is indeed lucky for people in Tamil Nadu that Udhavum Ullangal is
now venturing into the field of palliative care in Tirunelveli. On 22 June
2014, Pallium India was privileged to join the team at Tirunelveli during the
inauguration of their day care centre and new early detection unit. Their
volunteers already have gone through training in palliative care at Pallium
India and shortly they hope to launch a full-fledged palliative care service.

BEST WISHES TO MR SANKAR MAHADEVAN AND ALL AT UDHAVUM ULLANGAL ON THIS NEW
ENTERPRISE; AND THANK YOU FOR ALLOWING PALLIUM INDIA TO BE PART OF IT.

DR NAIDOO, INCB, AND OPIOIDS
[HTTP://PALLIUMINDIA.ORG/2014/06/DR-NAIDOO-INCB-AND-OPIOIDS/]

The International Narcotics Control Board (INCB) has the huge task of
controlling abuse of opioids. But the board believes in and promotes the
principle of balance – that is, while abuse must be curtailed, access to pain
relief has to be maintained.

Dr Liz Gwyther writes in ehospice
[http://www.ehospice.com/southafrica/ArticleView/tabid/10689/ArticleId/11079/language/en-GB/View.aspx]
about a meeting with Dr Lochan Naidoo, the President of the International
Narcotics Control Board. Dr Naidoo is an internationally recognized addiction
medicine professional. He is planning a high level review and an update of the
report on opioid availability for the United Nations General Assembly meeting
in 2016.

Dr Gwyther’s report also mentions Pallium India’s request for focus on
the availability of low cost opioids and formulations in developing countries.
Dr Naidoo noted this matter, Dr Liz Gwyther reports. She goes on to add, “Dr
Raj also reminded us of the palliumindia.org/manifesto
[http://palliumindia.org/manifesto] signed by 60 launch partners – including
HPCA – across the world.”

THANK YOU, DR LIZ GWYTHER AND DR ZODWA SITHOLE, FOR BRINGING ATTENTION TO THE
LAMENTABLE LACK OF ACCESS TO OPIOIDS AROUND THE WORLD. THANK YOU, DR NAIDOO.
YOUR WORD COUNTS GLOBALLY. WE ARE VERY GRATEFUL TO YOU.

PEOPLE ONLY DIE ONCE [HTTP://PALLIUMINDIA.ORG/2014/06/PEOPLE-ONLY-DIE-ONCE/]

“People only die once,” says Dr Taranjit Singh in his article “
Improving quality of life of dying patients
[http://epaper.tribuneindia.com/294228/The-Tribune/TT_26_June_2014#page/9/2] ”
in the Tribune dated 26 June 2014. “They (and their families) don’t always know
what is available, and can’t always express preferences. Who will speak for
their needs and preferences at the end days of life? Will it take another 19
years to secure funding to implement the Pain and Palliative Care policy?”

Dr Taranjit Singh is referring to the 19 years of work that it took to
achieve amendment of the Narcotic Drugs and Psychotropic Substances Act of
India. He is also referring to the National Program for Palliative Care (NPPC)
created by the Government of India in 2012, which had its teeth extracted at
the last minute, when the proposed budget allocation did not materialise.

THANK YOU, DR TARANJIT SINGH, FOR YOUR ARTICLE HIGHLIGHTING THE NEED FOR
PALLIATIVE CARE.

INDIA, SOUTH AFRICA AND THE REST OF THE WORLD – JOAN MARSTON ON SOUTH AFRICAN
TELEVISION.
[HTTP://PALLIUMINDIA.ORG/2014/06/INDIA-SOUTH-AFRICA-AND-THE-REST-OF-THE-WORLD-JOAN-MARSTON-ON-SOUTH-AFRICAN-TELEVISION/]

“India produces a third of the world’s opium, but until recently, the
legislation to provide that medication was so difficult that many hospitals
refused to actually stock opioids,” said Joan Marston, CEO of the International
Children’s Palliative Care Network (ICPCN), in an interview with South African
Broadcasting Corporation(SABC).

She also spoke about 67th World Health Assembly (WHA) at Geneva and the
landmark resolution on palliative care that was passed at the event, which asks
that palliative care be integrated into the health system of all participating
countries as part of comprehensive care and across the life course of a person.
“So it means that from the tiny little newborn baby right up to the oldest of
the elderly should receive palliative care.”

YOU CAN THE WATCH THE COMPLETE INTERVIEW HERE…
[HTTP://WWW.EHOSPICE.COM/INTERNATIONALCHILDRENS/ARTICLEVIEW/TABID/10670/ARTICLEID/10835/LANGUAGE/EN-GB/VIEW.ASPX]

OUR CHAIRMAN JOINS THE GOVERNING COUNCIL OF KUHS
[HTTP://PALLIUMINDIA.ORG/2014/06/OUR-CHAIRMAN-JOINS-THE-GOVERNING-COUNCIL-OF-KUHS/]

We are proud to announce that the Chairman of Pallium India, Dr M R
Rajagopal, has been invited to the Governing Council of the Kerala University
of Health Sciences as a nominee of the Chancellor.

The Kerala University of Health Sciences (KUHS) currently has 249
colleges affiliated to it and nearly 70,000 students enrolled in it, and has
jurisdiction all over Kerala. This University has the mandate to stream line
health professional education in the State, enhance and uphold its academic
standards, and promote research.

WE ARE GRATEFUL TO DR MOHANDAS AND KERALA UNIVERSITY OF HEALTH SCIENCES FOR
THIS HONOR.

WE EMERGE DESERVING LITTLE CREDIT….
[HTTP://PALLIUMINDIA.ORG/2014/06/WE-EMERGE-DESERVING-LITTLE-CREDIT-2/]

“The doctors in Senegal’s second city of Touba have long since given up
trying to prescribe the drug that stops the pain of cancer. There aren’t any
morphine tablets in the city. The only place it can sometimes be found is in
the capital, Dakar, four hours away – but government regulations prevent them
from writing prescriptions for it anyway.”

In this article titled “ The African cancer patients dying in
unnecessary pain
[%20http://www.theguardian.com/world/2014/may/29/african-cancer-patients-dying-unnecessary-pain]
” Krishnan Guru-Murthy of the Guardian writes about the unnecessary pain that
patients with advanced cancer have to endure because of the lack of basic pain
medication. In the absence of morphine, doctors are forced to prescribe
paracetamol, and when the pain gets worse, Tramadol also.

“The World Health Organisation estimates that 80% of the world faces
shortages of morphine and the vast majority of the global supply is consumed by
just six countries. As Africa develops the crisis will intensify as cancer
rates and populations grow.” What kind of health care systems have we created
for ourselves! As J Hinton said, “We emerge deserving of little credit; we who
are capable of ignoring the conditions which make muted people suffer”.

UPCOMING COURSES ON PALLIATIVE CARE IN TRIVANDRUM AND HYDERABAD
[HTTP://PALLIUMINDIA.ORG/COURSES/]

TRIVANDRUM, KERALA

The next six weeks course for doctors and nurses will start on August
4, 2014. For more details on this course, please visit:
http://palliumindia.org/courses/ccppm/ [http://palliumindia.org/courses/ccppm/]

Contact: info@xxxxxxxxxxxxxxxx, (+91)9746746530

HYDERABAD, AP

At our associate centre IN MNJ INSTITUTE OF ONCOLOGY in Hyderabad, the
next four weeks course will begin on 7 July, 2014 and end on 2 Aug 2014. For
more details on this course, visit: http://palliumindia.org/courses/hyd_ccppm/
[http://palliumindia.org/courses/hyd_ccppm/]

Contact: Ms. Vineela Rapelli – Program Coordinator,
mnj.palliativecare@xxxxxxxxx, (+91)91772 38901

Details on all these courses are available at
http://palliumindia.org/courses/ [http://palliumindia.org/courses/]

For more information about any of our courses, please write to us:
info@xxxxxxxxxxxxxxxx or call us: (+91)471-2440306

VOLUNTEERS’ TRAINING PROGRAM IN TRIVANDRUM [HTTP://PALLIUMINDIA.ORG/COURSES/]

Pallium India’s 2-day Volunteers’ Training Program is scheduled for 17
AND 19 JULY, 2014. Write to info@xxxxxxxxxxxxxxxx or call +91-471-2440306 to
register. If you are unable to attend this training, you could register for one
of the subsequent sessions on AUGUST 21 & 23 or SEPTEMBER 18 & 20.

For more information on the different courses we offer, please visit:
http://palliumindia.org/courses/ [http://palliumindia.org/courses/]

VACANCIES IN RAJASTHAN (JAIPUR AND JODHPUR)
[HTTP://PALLIUMINDIA.ORG/2014/06/VACANCIES-IN-RAJASTHAN-JAIPUR-AND-JODHPUR/]

Doctors, Nurses and Data entry operators wanted at RK Birla Cancer
Center, Sawai Mansingh Medical College Hospital, Jaipur and Sampurnananda
Medical College, Jodhpur.
* Medical Officer for Palliative Care
Qualifications: MBBS/MD/MS; RMC registered doctor is preferred. MBBS from MCI
recognized medical college with more than 5 years, RMC registered doctors can
also apply.
* Palliative Care Nurse
Qualifications: B.Sc. Nursing from NCI recognized nursing college, RNC
registered, is preferred. GNM nurse with more than 5 years of experience can
also apply.
* Data Manager cum Counsellor for Palliative Care
Qualifications: MSW with training in computer applications is preferred.
Minimum BCA or RSCIT or ‘O’ level (or higher) training in computer applications
can also apply.

For more details and to apply, please visit:
http://palliumindia.org/2014/06/vacancies-in-rajasthan-jaipur-and-jodhpur/
[http://palliumindia.org/2014/06/vacancies-in-rajasthan-jaipur-and-jodhpur/]

PARTING SHOT

WHAT CRIME DID THE CHILD DO TO BE DEPRIVED OF ANY CARE?

It was a pleasure and privilege to meet Mr K. R. Raja during the
inauguration of a day care centre and early detection centre for cancer at
Thirunelveli. Mr Raja is on crutches, because he had poliomyelitis as a child
and inappropriate intramuscular injections ensured his lower limb weakness. He
is a medical and psychiatric social worker, working in Palayamkottai Central
Prison. He heard about the event organized by Udhavum Ullangal (Helping Souls)
and attended a palliative care awareness program.

Working with prisoners, he has an observation to make. He finds a
significantly large number of men in prison who have killed their wives,
possibly in a fit of anger. Raja asks, “Okay, he has killed. He is assured of
at least three meals a day in prison. What crime did his child do to be
deprived of any care or even to starve?”

Those children are a part of the neglected members of our society whom
you and I find convenient not to see. Raja does not. He has a program to
support them.

THERE IS SO MUCH OF SADNESS IN THE SOCIETY; BUT ALSO SO MUCH OF GOODNESS.
SADDENING, AND HEART-WARMING.

Pallium India Newsletter: June 2014

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