Pallium India Newsletter: March 2014

From: Pallium India Newsletter <info@xxxxxxxxxxxxxxxx>
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Date: Mon, 31 Mar 2014 21:28:19 +0000

Pallium India
Care Beyond Cure

DONE! THE PROCESS IS COMPLETE!
[HTTP://PALLIUMINDIA.ORG/2014/03/DONE-THE-PROCESS-IS-COMPLETE/]

THE DOCUMENT IS NOW UP ON GOVERNMENT OF INDIA’S WEB-SITE. All the
formalities are over and the Amendment of the Narcotic Drugs and Psychotropic
Substances (NDPS) Act of India can be now seen on the Government of India’s
website [http://www.egazette.nic.in/WriteReadData/2014/158504.pdf] .

The most relevant provisions are:

* In section 4 of the Act, the addition of the words, “and for ensuring
their medical and scientific use” is a very significant acknowledgement of the
purpose of the amendment.
* In section 2, the Amendment brings in the term, “Essential Narcotic
Drugs” (END), which will include narcotic drugs notified by the Central
Government for medical and scientific use.
* In section 9, the Amendment transfers the powers for making rules
regarding Essential Narcotic Drugs to the Government of India, so that the
whole country will now have a uniform system pertaining to these essential
opioid medicines.

The next step will be a notification by the Department of Revenue,
enlisting the essential narcotic drugs, which should include morphine and other
opioids used for pain relief, followed by the framing of “NDPS Rules”, which
will delineate the procedure to be followed with respect to stocking,
distribution, transport, possession and use of these drugs throughout the
country.

The note available from the Lawyers’ Collective is descriptive of the
changes and while recommending that anyone interested reads that page, we also
use this opportunity to thank Tripti Tandon and everyone at Lawyers’
Collective, for playing a major role on this matter in addition to the
government officials (particularly Mr Rajesh Nandan Srivastav, the Director of
Narcotics Control in Revenue Department). And so many members of the palliative
care community in India worked together and contributed in various ways;
everyone of them certainly deserves appreciation for the selfless work and
commitment.

Though it has taken a long time, we are all immensely happy that the
Amendment spells out the purpose of the Act as inclusive of medical and
scientific use and that the whole country will now have a uniform procedure
through Central Rules, which will be fairly simple.

Thank you every one, for making this happen.

MORE MEDIA ATTENTION

Why cancer patients are cheering a recent change in the narcotics law
– Scroll.in News
[http://scroll.in/article/one-achievement-of-indias-least-productive-parliament-amending-narcotics-act-to-help-cancer-patients?id=657603]

Critical Analysis of the NDPS Amendment : Detailed and Critical
analysis of NDPS amendment
[http://www.lawyerscollective.org/updates/parliament-passes-ndps-amendment-bill-2014-gains-losses.html]
from the International Drug Policy Consortium highlights the major role played
by the Lawyers’ Collective. Indeed, we used to run to Ms Tripti Tandon of
Lawyers’ Collective for all legal advice and support when working with the
Department of Revenue of Government of India.

SPECIAL THANKS TO YOU, LAWYERS’ COLLECTIVE.

THANK YOU, STATE BANK OF INDIA
[HTTP://PALLIUMINDIA.ORG/2014/03/THANK-YOU-STATE-BANK-OF-INDIA/]

Pallium India’s Trivandrum Institute of Palliative Sciences (TIPS) has
four teams going out on home visits every day. We badly needed a vehicle. State
Bank of India came to our rescue.

In the background in the photograph, you will see a “Tavera” vehicle.
In the foreground you see Dr M Sreenatha Sastry, Chief General Manager of State
Bank of India, handing over the symbolic key to the Chairman of Pallium India,
Dr M R Rajagopal. In addition to the vehicle, they also gave us Rs 8 Lakhs
worth of equipments which were badly needed for our new inpatient facility. In
his remarks on the occasion, Dr Sastry said that SBI certainly takes corporate
social responsibility seriously.

THE FIRST PALLIATIVE CARE CENTRE IN THE STATE OF MEGHALAYA OPENED AT NEIGRIHMS
[HTTP://PALLIUMINDIA.ORG/2014/03/THE-FIRST-PALLIATIVE-CARE-CENTRE-IN-THE-STATE-OF-MEGHALAYA-OPENED-AT-NEIGRIHMS/]

Pallium India is proud to announce the opening of a Pallium India
collaborative project with the North East Indira Gandhi Regional Institute of
Health and Medical Sciences (NEIGRIHMS), Shillong. This project has already
trained a doctor and a nurse – Dr Plabon and Ms Bilsheba – for six weeks at
Trivandrum.

The palliative care clinic was inaugurated on 27 March, 2014
[http://www.theshillongtimes.com/2014/03/28/palliative-care-the-missing-chapter-in-internal-medicine/]
. This project is funded jointly by Savitri Waney Trust, Farida and Yusuf
Hamied Foundation and Bruce Davis Trust. Our congratulations to Dr P.
Bhattacharya, who directs the project and Dr Ahangar, the Director of
NEIGRIHMS.

CAREVISION INDIA PROJECT IN KOLKATA WITH PALLIUM INDIA
[HTTP://PALLIUMINDIA.ORG/2014/03/NEW-PALLIUM-INDIA-PROJECT-WITH-CAREVISION-INDIA-KOLKATA/]

CareVision India, a Non-Government Organization founded by Dr
Sanghamitra Bora, will be starting its Free Home-Based Palliative Care Service
for the poor and underprivileged patients of the society from 1st of April
2014. Pallium India collaborates with CareVision India in this project. The
unbelievable suffering of patients in need of care in Kolkata will be partly
taken care of by this initiative.

We hope this will be but a beginning. I am sure working with other
organizations, including Eastern India Palliative Care program founded by Dr
Sankha Mitra, we shall be able to do much more in the North-East India region.

Best Wishes, Dr Sanghamitra, and Thank You, kind donor, who does not
wish to be named in these columns!

WHAT DIFFERENCE DID THE PROJECT HAMRAHI MAKE IN SILCHAR?
[HTTP://PALLIUMINDIA.ORG/2014/03/WHAT-DIFFERENCE-DID-THE-PROJECT-HAMRAHI-MAKE-IN-SILCHAR/]

Project Hamrahi (_Hamrahi_ in Hindi means ‘fellow traveller’) is a
collaborative project between APLI (Australasian Palliative Link International)
and Pallium India. In this, a doctor-nurse team from Australia / New Zealand
builds a partnership with one palliative care link centre in India that Pallium
India catalysed or works with. The visitors get the satisfaction of having made
an enormous difference to a growing palliative care centre and maybe also learn
a little bit about local customs and practices. The Indian centre, which often
works with limited staff and limited capacity, gains by an annual visit of a
week and support from the same team. So far, the program has been hugely
successful.

One such team, Dr David Brumley, Ms Sarah Corfe and Dr Oliver Haisken
worked with the palliative care team in Cachar Cancer Centre in Silchar, Assam.
The palliative care team is led by the physician, Dr Iqbal Bahar, and by the
palliative care nursing supervisor, Ms Sarita.

We asked Dr Ravi Kannan, the Director of the institute, what difference
the Project Hamrahi made. Here is his reply: "

_They came and spent time with our nurses and doctors. For our nurses,
I think the biggest advantage that Project Hamrahi offered was that it improved
their self-esteem. That somebody from abroad is willing to come and consider
spending time with them, talk to them, explain things to them, work with them,
improved their self-esteem and confidence tremendously. The APLI team also
pointed out how things could be changed, how the records can be maintained;
they actually did an audit at the end of each visit. In the audit, we listed
out things that we should achieve before the next visit. That really ensured
that things get moving. They also brought material they could distribute, small
things that could make incremental and significant progress. On their first
visit, they gave us funds to train two nurses and we sent them to Trivandrum
for training. This visit, they have offered to fund the training of two more
nurses and we’re hoping to send them to Hyderabad._"

By the way, the institution is also being developed as a “Pain-free”
hospital under a Pallium India Collaborative Project directed by Ms Meg O’Brien
– “Treat the Pain” funded by American Cancer Society. It has been hugely
successful; I did a round of wards and almost none had more than score 2 pain.
The one patient who did have severe pain was being attended to by the pain
specialist as a pain emergency. Kudos to Dr Ravikannan, Dr Iqbal Bahar and Ms
Sarita.

WHAT CLAIRE ROQUES SAW
[HTTP://PALLIUMINDIA.ORG/2014/03/WHAT-CLAIRE-ROQUES-SAW/]

“Stringent and highly bureaucratic legislation, designed to prevent
illegal diversion of medication, has led to patients in pain being unable to
receive access to effective, affordable pain relief. A recent amendment to this
legislation has just been approved by the Indian Government and more detailed
information on these developments is available at the Pallium India website.”

The blog by Dr Claire Roques
[http://endoflifestudies.academicblogs.co.uk/studying-problems-of-pain-management-in-india-by-clare-roques/?fb_action_ids=517536971689594&fb_action_types=news.publishes&fb_ref=pub-standard&fb_source=other_multiline&action_object_map=%5B743979808996342%5D&action_type_map=%5B%22news.publishes%22%5D&action_ref_map=%5B%22pub-standard%22%5D]
gives a visitor’s perspective of the annual conference of Indian Association
of Palliative Care (IAPC) at and makes good reading.

NEW PALLIATIVE CARE CLINIC AT KAVARATTI, LAKSHADWEEP
[HTTP://PALLIUMINDIA.ORG/2014/03/NEW-PALLIATIVE-CARE-CLINIC-AT-KAVARATTI-LAKSHADWEEP/]

Pallium India collaborated with Thanal Charitable Trust to create the
first palliative care service in the Union Territory of Lakshadweep in 2013. It
is progressing by leaps and bounds. They inaugurated their new Pain and
Palliative care clinic in Kavaratti on 27-03-2014.

This facility which was constructed by a team of volunteers will run an
Out Patient facility for Pain and Palliative care. It will also serve as the
Head Office of the Lakshadweep Institute of Palliative Medicine. The foundation
stone for a new Hospice (5 bed) facility was also laid on the occasion.

CONGRATULATIONS DR SANKHA MITRA FOR WINNING THE AWARD “POWER TO EMPOWER, 2013″
[HTTP://PALLIUMINDIA.ORG/2014/03/PALLIUM-INDIA-CONGRATULATES-DR-SANKHA-MITRA-FOR-WINNING-THE-AWARD-POWER-TO-EMPOWER-2013/]

Dr Sankha Mitra submitted a project entitled “A Global Solution to
Global Problems”, which won 2451 votes. The award includes a cash prize of
Rs15,000 from Muthoot Pappachan Foundation, the corporate social responsibility
arm of the Muthoot Pappachan Group and is given by National Skill Development
Corporation (NSDC). The award was presented on 18 March 2014 at Gulmohar Hall,
India Habitat Centre, New Delhi.

COUNCIL OF EUROPE’S RECOMMENDATIONS FOR OLDER PEOPLE INCLUDES PALLIATIVE CARE
[HTTP://PALLIUMINDIA.ORG/2014/03/EUROPEAN-UNIONS-RECOMMENDATIONS-FOR-OLDER-PEOPLE-INCLUDES-PALLIATIVE-CARE/]

Mr Diederik Lohman of Human Rights Watch writes to inform us about the
new recommendations for Older Persons by the Committee of Ministers of the
Council of Ministers:
RECOMMENDATION CM/REC(2014)2

_D. PALLIATIVE CARE_

44. Member States should offer palliative care for older persons who
suffer from a life-threatening or life-limiting illness to ensure their
well-being and allow them to live and die with dignity.

45. Any older person who is in need of palliative care should be
entitled to access it without undue delay, in a setting which is consistent
with his or her needs and preferences, including at home and in long-term care
settings.

Read more…
[http://palliumindia.org/2014/03/european-unions-recommendations-for-older-people-includes-palliative-care/]

PARTNERS IN CHILDREN’S PALLIATIVE CARE
[HTTP://PALLIUMINDIA.ORG/2014/03/PARTNERS-IN-CHILDRENS-PALLIATIVE-CARE/]

WHO defines health as not just absence of disease, but also “complete
physical, social and mental well-being”. Can a medical system run only by
nurses and doctors achieve it?

In the children’s palliative care service in Government S.A.T Hospital
at Trivandrum – started as a joint venture of Pallium India and the departments
of Pediatrics and Pediatric Neurology – family members of children join hands
with the staff and volunteers to plan and organize activities. True partnership
in care!

PALLIATIVE CARE – PUSHED THROUGH THE CRACKS
[HTTP://PALLIUMINDIA.ORG/2014/03/PALLIATIVE-CARE-PUSHED-THROUGH-THE-CRACKS/]

“At the end of that day, I knelt beside her bed to say Good-bye. Lucy
placed her hand on my forehead and said, ‘Bye, Lili, I am taking the best of
you with me’… I felt sad, angry, helpless, and frustrated with a healthcare
system and a culture that still does not embrace palliative care. It has to be
pushed through the cracks, delivered bypassing the conventional medical
practice…”

Read the article “Lucy”
[http://online.liebertpub.com/doi/abs/10.1089/jpm.2013.0322] by Liliana De
Lima, the Executive Director of the International Association for Hospice and
Palliative Care (IAHPC), in the Journal of Palliative Medicine 17:2, 2014. She
talks about meeting her dying childhood friend, now with advanced uterine
cancer. Read how Lucy teaches Liliana a lesson in letting go, as she prepares
to leave this world.

WE HOPE THIS ARTICLE MAKES YOU ANGRY – ANGRY ENOUGH TO DEMAND JUSTICE.

EXIT TEST AND MBBS [HTTP://PALLIUMINDIA.ORG/2014/03/EXIT-TEST-AND-MBBS/]

An item of news in the lay press suggested an “Exit Test” for MBBS
graduates. After passing all the examinations involved in the MBBS course, this
Exit Test would mean that they still would have to go through an examination
process at the national level.

Dr Praveenlal Kuttichira, who is a Professor of Psychiatry and
Principal, Govt Medical College, Thrissur, and Member of the Medical Council of
India and a Member of the Governing Council of Kerala University of Health
Sciences, writes about the various negative points associated with such a step.

Read more… [http://palliumindia.org/2014/03/exit-test-and-mbbs/]

PARTING SHOT

NOAH MICHELSON’S “5 THINGS I LEARNED FROM HELPING MY FATHER DIE”.
[HTTP://PALLIUMINDIA.ORG/2014/03/NOAH-MICHELSONS-5-THINGS-I-LEARNED-FROM-HELPING-MY-FATHER-DIE/]

“…..he drew enough breath to whisper, “I hope I was a good father to
you.” In that instant my heart stopped, and then, just as quickly, it swelled
to fill my entire chest — fill my entire body, fill every moment I had lived up
until that point — and I knew then exactly what was happening and finally came
face-to-face with what it means to be loved and to love, and for that to be
both everything and still not enough.

I couldn’t stop what was happening. I couldn’t fix it. I could barely
understand it. I just knew I was loved and told him that I was lucky to have
spent even a day — even an hour — with him”."

A touching reminder that in the end what matters most is to love and be
loved – thank you Ms Katherine Pettus, for sharing the story
[http://www.huffingtonpost.com/noah-michelson/5-things-i-learned-from-helping-my-dad-die_b_4936843.html]
with us.

Pallium India Newsletter: March 2014

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