Care Beyond Cure
We are glad to start with some good news.
For many years, we have been trying to make methadone available for pain
management in India. We had the paradoxical situation where this medicine was
being manufactured for export to other countries while our own people were
denied it. A few years back, it was approved for sale in India for treatment of
drug dependence; but not for pain management. As morphine is currently the only
oral opioid of step III of the analgesic ladder for pain management, we have
had no second line opioid for those who do not tolerate morphine well. For all
practical purposes, opioid switching was only a dream in India.
Things are looking up, however. On 27 October 2015, a subject expert committee
meeting was held by Central Drug Standard Control Organization. Though the
committee members had misgivings, Dr Sushma Bhatnagar was able to present the
facts systematically, supported by documentary evidence, which has convinced
them. The committee has recommended that the drug should be available for the
management of persistent pain.
RENDEZVOUS WITH THE OCEAN ON WORLD PALLIATIVE CARE DAY
_Ashla Rani, a volunteer, writes:_
Pallium India organized a get-together of patients and families on
World Palliative Care Day, October 10, at Shanghumuham beach, Trivandrum. The
program was attended by patients, families, volunteers, well-wishers and many
others. A group of 20 volunteers from Government Model School were present, in
addition to Pallium India’s own team, to make sure everyone was comfortable.
State Bank of Travancore Chief General Manager E. K Harikumar and Pallium
India’s patient Manoj inaugurated the event. Pallium India CEO Mr Manoj G.S.,
Chairman Dr M. R. Rajagopal and others spoke on the occasion.
Naushad, a cancer patient, described how the nurses, whom he referred
to as ‘angels on earth’, look after him lovingly while taking care of his every
need. His words expressed clearly that care delivered with love and not as a
‘duty’ significantly improves the quality of life of a patient and allows him
to live with dignity.
Everyone began to mingle, and share stories and experiences. There were
also dance, song and skit performances to entertain the audience.
A couple of us discussed how we can help more people who are confined
to the four walls of their house. There are many who are not even aware of the
facilities that are available. How do we find them, how do we ensure that they
get the care they need? If everyone could find people in their own
neighbourhood who are bed-bound or wheelchair-bound, there would not be so many
‘hidden’ patients in our country!
After the programs, everyone went for a rendezvous with the waves. Then
we parted, with a promise to meet again next time.
Click here for the photos of the event.
MR KESHAV DESIRAJU JOINS PALLIUM INDIA AS A TRUSTEE.
We are proud to announce that Mr Keshav Desiraju has joined Pallium
India as a trustee.
Mr Desiraju is an officer of the Indian Administrative Services of
1978- batch and an alumnus of the Universities of Bombay, Cambridge and
Harvard. He has made his mark in many positions in the Government, including
that of the Union Secretary of Health & Family Welfare. Mr Desiraju has been
described as a visionary and a man of action with enormous capacity to
articulate complex ideas. He was the deciding factor behind the creation of
India’s National Program for Palliative Care (NPPC).
Mr Keshav Desiraju, it is an honour to have you on board with us.
WANTED MEDICAL OFFICER FOR PALLIATIVE CARE SERVICES AT JAIPUR
* Qualification: MBBS
* Salary: INR 40000 per month
* Type of appointment: Contractual for One Year, can be extended for
two more years
* Upper age limit: 65 years
* Preference to candidates with palliative medicine or Oncology
* Computer familiarity desirable
_CONTACT OR APPLY TO:_
R. K. Birla Cancer Center, SMS Medical College Hospital, Jaipur
Dr Hemant Malhotra drmalhotrahemant@xxxxxxxxx
[mailto:drmalhotrahemant@xxxxxxxxx] Dr Ashwin Mathur drmathurashwin@xxxxxxxxx
For more openings, visit our Careers
Lien Foundation is shaking us and asking us to wake up.
Do you take pride in the quality of health care in India? See the
that the Singapore-based Lien Foundation has published, ahead of the World
Palliative Care Day, which falls on October 10th.
India ranks 67th among 80 countries. Reporting this, the Times of India
says “ India isn’t the best place in the world to die
.” Also read the report in ehospice
See the list of countries and quality of dying. (Click on the image to
enlarge). For the complete report, please visit http://qualityofdeath.org/
CALL FOR NOMINATIONS – IAHPC BOARD OF DIRECTORS
The International Association for Hospice and Palliative Care
[http://hospicecare.com/home/] (IAHPC) calls for nominations to 3 seats in the
IAHPC Board of Directors to serve for the 2016-2018 term. IAHPC members can
nominate health professionals actively working in hospice and palliative care
with demonstrated interest in the development of international palliative care
initiatives and issues.
Deadline for nominations is NOVEMBER 30, 2015.
Nomination rules: Nominators may nominate one candidate only.
Self-nomination is not allowed. Nominees have to be nominated by another IAHPC
member. Click here to complete and submit a nomination form
The new directors will be elected by a vote of the current Directors
and will be announced in December 2015. For more details and to nominate,
please visit this link
TIPS, TRIVANDRUM, KERALA
* SIX WEEK CERTIFICATE COURSE IN PAIN AND PALLIATIVE MEDICINE (CCPPM)
[http://palliumindia.org/courses/ccppm] – 2 NOV 2015, 7 MAR 2016, 2 MAY 2016
* SIX WEEK CERTIFICATE COURSE IN PALLIATIVE NURSING (CCPN)
[http://palliumindia.org/courses/ccpn] – 2 NOV 2015, 7 MAR 2016, 2 MAY 2016
* 10-DAY FOUNDATION COURSE IN PALLIATIVE MEDICINE
[http://palliumindia.org/courses/foundation/] – 2 NOV 2015, 7 MAR 2016, 2 MAY
2-DAY VOLUNTEERS TRAINING PROGRAM is conducted at Trivandrum Institute
of Palliative Sciences, Arumana Hospital, Trivandrum. Anyone interested in
learning about palliative care can attend.
contact: info@xxxxxxxxxxxxxxxx [mailto:info@xxxxxxxxxxxxxxxx] , +91
GCRI, AHMEDABAD, GUJARAT
* SIX WEEKS CERTIFICATE COURSE IN PAIN AND PALLIATIVE MEDICINE (CCPPM)
[http://palliumindia.org/courses/gcri-ccppm] – 1 MARCH 2016
* SIX WEEKS CERTIFICATE COURSE IN PALLIATIVE NURSING (CCPN)
[http://palliumindia.org/courses/gcri-ccpn] -1 MARCH 2016
MNJIO & RCC, HYDERABAD, TELENGANA
* ONE MONTH CERTIFICATE COURSE IN PAIN AND PALLIATIVE MEDICINE (CCPPM)
[http://palliumindia.org/courses/hyd_ccppm/] FOR DOCTORS, NURSES, SOCIAL
WORKERS AND VOLUNTEERS – 4 JANUARY 2016, 7 MARCH 2016
Contact: mnj.palliative@xxxxxxxxx [mailto:mnj.palliative@xxxxxxxxx] ,
+91 91772 38901
BMCHRC, JAIPUR, RAJASTHAN
* 6 WEEKS’ CERTIFICATE COURSE IN PAIN AND PALLIATIVE CARE FOR DOCTORS
AND NURSES [http://palliumindia.org/courses/jaipur_ccppm/] – 2 MAY 2016
Contact: Dr Anjum Khan Joad. palliumjaipur@xxxxxxxxx
For more details on the courses we offer, please visit:
FROM REJECTION TO FOUNDATION STONE – REFLECTIONS ON A NURSING DEVELOPMENT IN
Plans for a new fellowship in palliative nursing are underway in
Kozhikode, Kerala. Its first cohort of students has been recruited and will
help to shape and test the proposed programme. Read the news in ehospice.com
AWARD FOR PROJECT HAMRAHI
It was sheer pleasure to receive the certificate from Palliative Care
Australia to Project Hamrahi for Innovation in Palliative Care
In Project Hamrahi [http://palliumindia.org/programs/hamrahi/] , a
group of about a dozen each of doctors and nurses from Australia and New
Zealand join together to support palliative care in India. A doctor-nurse team
gets an attachment with one palliative care team in India. They would visit for
at least one week every year and the relationship lasts for many years.
Congratulations to Odette Spruyt, the innovator and the person who
received the award from Palliative Care Australia, on our behalf too.
ARE DOCTORS MORE AFRAID OF DEATH THAN “NORMAL” PEOPLE?
It was interesting to read two articles, one after the other. In _The
Washington Post_ of 26 October 2015, Aaron Kheriaty writes
about how doctors use euphemisms and avoid the word ‘death’. Doctors say
“declaring a patient” when they mean “declaring death”. Doctors say someone
“expired” as if they are talking about a cough medicine, rather than “died”.
_The Independent_ of 6 October 2015 quotes several people
who know they are going to die of some disease or other, and talk about the
experience. Interestingly, none seems to be afraid of the word “death”. There
is one person who says, “I told my doctor I wanted to switch to palliative care
and discontinue all chemo. And it changed my life……. This time last year, my
life was already gone. And somehow, amazingly, I have it back.”
_The Washington Post_ hastens to add that gradually non-doctors also
are getting to be more and more afraid of the word “death”, we becoming a
death-denying society. The article asks us to re-learn the art of dying and of
tending to the dying.
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
DONATE TOYS FOR CHILDREN!
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
Contact Pallium India’s Information Centre (9 am to 12 noon, except on
Sundays & National Holidays) for INFORMATION RELATED TO PALLIATIVE CARE and
about ESTABLISHMENTS WHERE SUCH FACILITIES ARE AVAILABLE in India.
TELEPHONE: +91-9746745497 E-MAIL: INFO@xxxxxxxxxxxxxxxx
ADDRESS: Pallium India, Arumana Hospital, Perunthanni, Trivandrum
For more details, please visit: http://palliumindia.org/info-centre/
SAHAYATRA MALAYALAM NEWSLETTER
SAHAYATRA, Pallium India’s Malayalam print magazine, is meant for
anyone interested in palliative care – patients and families, palliative care
professionals, volunteers and well-wishers.
Click here to read the latest issue:
To subscribe to Sahayatra
, please send your complete postal address to info@xxxxxxxxxxxxxxxx
[mailto:info@xxxxxxxxxxxxxxxx] . The yearly subscription rate for Sahayatra is
Rs.150/- However, we send Sahayatra free of cost to patients and families.
Connect with us: Facebook [https://www.facebook.com/palliumindia]
Twitter [https://twitter.com/palliumindia] Linkedin
NEW WHO INFOGRAPHIC ON PALLIATIVE CARE
The WHO has released an infographic on the importance of implementing
the World Health Assembly’s resolution on palliative care.
Using easy to understand pictures, the infographic sheet explains what
palliative care is, when it is needed, and who it is needed by. Click here to
view the infographic.
It also illustrates the global need for palliative care, as well as the
gaps in and barriers to access.
_ Click here to read more.
NARRATIVES ON PAIN AND RELIEF: GIVING VOICE TO THE VOICELESS
In another step forward, the Journal of Pain and Palliative Care
Pharmacotherapy now has a page on the website
[http://explore.tandfonline.com/page/med/ippc-pain-narratives] where all the
narratives published so far can be accessed.
If you are in any way connected with palliative care, you must be
having a story in you, that touched your heart. Do please put it in writing and
send it to us: info@xxxxxxxxxxxxxxxx [mailto:info@xxxxxxxxxxxxxxxx] . You get
an indexed publication to your credit. And also the satisfaction of having
helped the cause. _ Read more here.
Here are some of the narratives that have been published:
Through the Eyes of Child
[http://www.tandfonline.com/doi/full/10.3109/15360288.2013.782938] : Mary
Macey’s reflection on her childhood and adolescence, after losing her mother
and how palliative care brought her experience into focus.
When Two Worlds Meet
[http://www.tandfonline.com/doi/full/10.3109/15360288.2012.708392] : Lyndsey
Brahm writes about the cultural immersion that she experienced when she visited
the east from the west.
They Suffer in Silence
[http://www.tandfonline.com/doi/full/10.3109/15360288.2012.679336] : Savita
Butola writes about the intensity of grief, related to life-limiting disease in
the developing world.
Pain – When It Affects the Person
[http://www.tandfonline.com/doi/full/10.3109/15360288.2011.625469] : the impact
of pain on the body and mind, written by Edassery Divakaran
WE NEED YOUR HELP [HTTP://PALLIUMINDIA.ORG/2015/09/WE-NEED-YOUR-HELP/]
With rising costs, our Trivandrum Institute of Palliative Sciences is
struggling to make ends meet.
We have an educational support program for the children of our
patients. These children have been forced to drop out of school when disease
ravaged the family. We provide financial support to complete their education,
till they qualify from a course that helps them earn for their family.
For this year, we need ₹ 15 LAKHS (US$ 22,800). For example, right now,
we have two girls who need to start on their nursing education, next week, and
we need your help.
WHATEVER YOU CAN GIVE, HOWEVER SMALL, WILL MAKE A DIFFERENCE.
Those who are willing, please contribute
* _FOR TRANSFER FROM WITHIN INDIA_:
State Bank of India
Branch: Pattom, Trivandrum
Beneficiary: M/s Pallium India Trust
Account No: 30086491915
IFS Code: SBIN0003355
MICR No: 695002007
* _FOR TRANSFER FROM ABROAD_:
Branch: Vazhuthacaud, Trivandrum
Beneficiary: M/s Pallium India Trust
Account No: 003700900000036
IFS Code: DLXB0000037
SWIFT Code: DLXBINBBXXX
* Please send cheques and drafts to: Pallium India
Address: Arumana Hospital, Airport Road, Subash Nagar, Vallakadavu P.O.
Thiruvananthapuram – 695 008, Kerala, India.
For more information, please write to us: info@xxxxxxxxxxxxxxxx
NEWS FROM AROUND THE WORLD
Palliative Medicine accepted as a medical specialty in Bangladesh
Human rights report highlights inequalities in access to palliative
Quality Of Death: UK Tops, India 67th, Above China
Right to pain relief: 5.5 billion people have no access, warn UN
The case for palliative care advocacy: Much ‘more’ to be done
Vulnerable communities, education and healthcare policy – news from
A cure may not always be possible; but care always is.
Submit Abstracts to IAPCON2016
Free “Introduction to Palliative Care” Online Course by LCPC,
Hospital workers find solace in pausing after a death
Why people with kidney disease opt for palliative care over dialysis
Two accidents, a wheelchair and a National award from APJ Abdul Kalam:
Shivani Gupta’s heroic tale [http://her.yourstory.com/shivani-gupta-1005]
Pharmacists Can Improve Palliative Care
Making Friends With Death
A nurse by herself. At the end of a life.
Medical students use self-reflection to improve patient care
SHOULD OLD AGE BE “BRANDED” AND “SOLD”??
“How does old age come into the purview of palliative care?” The
question was raised by a final year medical student from the USA who is
spending a few months with us, helping us as well as undertaking a research
project on psycho-social issues.
Her question was based on one of the patients in Pallium India’s
inpatient unit, Shantha (not her real name), an elderly, bed-ridden woman whose
family is abroad and who is cared for by a home nurse and our team. How does
Shantha come into the purview of palliative care? By the World Health
Organization’s definition, palliative care is for life-threatening diseases.
Shantha has no disease; there is no diagnosis except old age.
Pallium India has always looked at the phrase “life-threatening” with
the presumption that “life” means more than mere existence; that life confined
to a bed or limited by four walls does threaten “life” in its real meaning.
Unable to sit up by herself or even turn to a side, Shantha in her old age has
her life threatened and reduced to mere existence. Does she not deserve
physical, psychological, social and spiritual support? Treating her delirium
alone improved her quality of life remarkably. What would be the justification
in denying that care to her?
Perhaps the problem is that many diseases including cancer have been
“branded” and they “sell” well. There is nothing glamorous about plain, simple
old age, with physical debility. In this era of “business”, will the elderly
have no support till their problem is “branded and sold”? If so, would some
management experts come forward and advise us how to “brand” old age with
debility and “sell” it well enough so as to get care across to the needy?