Care Beyond Cure
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! November 2016 !
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October 31, 2016
SINGING TO EASE PAIN [HTTP://PALLIUMINDIA.ORG/2016/10/SINGING-TO-EASE-PAIN/]
What a great musical extravaganza!
As a celebrated music composer and director, M. Jayachandran is not
unknown to anyone in Kerala. For the third time in recent years, he conducted a
musical show as a fund raiser – this time an event to raise funds jointly for
Heart Care Foundation in Kochi and Pallium India. He and 14 singers volunteered
their time and the audience loved every moment of it.
Thank you very much, M. Jayachandran and team!
LITTLE ANAVADYA DONATES TALENT TO PALLIUM INDIA
Nine year old artist Anavadya was in the Central Hall of Lulu Mall at
Kochi from 10 AM to 2 PM on 30 October 2016, to promote the musical evening to
be held at 6 PM that day. Many lined up to have caricatures of themselves drawn
by the little gifted artist.
Thank you and best wishes Anavadya.
A DAY WITH DR ROBERT TWYCROSS
Here is an opportunity to listen to the celebrated DR ROBERT TWYCROSS,
the teacher _par excellence_ who mentored most of the first generation
palliative care physicians in India.
* IMA Kerala state branch
* Consortium of Palliative Care Units of Ernakulam district and
* Pallium India
join hands to conduct a refresher course in Palliative Medicine for
doctors who are already trained in palliative care, as part of the state
conference of IMA.
The program will be conducted at CIAL CONVENTION CENTRE near Kochi
International Airport on 12TH NOVEMBER, 2016.
You can register on the spot.
Those who have registered for the IMA conference need to pay no
registration fee. For the others, it will be ₹1000. Do take this opportunity.
to view the tentative program schedule.
IMPORTANT MESSAGE TO RECOGNIZED MEDICAL INSTITUTIONS (RMIS) IN INDIA.
RMIs, please submit your morphine (or other essential narcotic drugs like
Fentanyl) consumption data for the period from 1 November 2015 to 31 October
2016 to the drugs controller of your state by registered post, along with your
estimated requirement for the coming year.
Please remember to keep a copy and evidence of posting in a separate
If you have any questions, please write to info@xxxxxxxxxxxxxxxx
WHO CALLS FOR BALANCE IN OPIOID POLICY
A new WHO document titled “ The Preventable Pain Pandemic
points out examples from Mexico and India as places where progress has been
made but where there is plenty of room for future work. It is 39 years now
since the WHO placed morphine on its essential medicine list, and “considers it
the gold standard in pain management and relief.” India also has this medicine
on its essential list; yet less than 1% of the hospitals stock or use it.
It is high time the situation changed.
This WHO document calls for “balance in national policies”.
GUIDE FOR PROGRAM MANAGERS FROM WHO
Belinda Loring and Marie-Charlotte Bouesseau from the World Health
Organization write to inform that the WHO manual “Planning and implementing
palliative care services: a guide for programme managers” has now been
published. It is available online at this link:
We are sure that the document will be an excellent resource
particularly for newly evolving palliative care programs.
PALLIATIVE CARE INCLUDED IN UN HUMAN RIGHTS COUNCIL RESOLUTION ON THE RIGHTS OF
From ehospice International edition: "
The UN Human Rights Council has passed a resolution on The Human Rights
of Older Persons ahead of the International day of Older Persons on 1 October.
Palliative care was specifically mentioned twice in this important
document. The resolution also renewed the mandate of Ms Rosa Kornfeld-Matte,
first Independent Expert on the enjoyment of all human rights by older persons.
Organisations and individuals working in hospice and palliative care
and related fields at national and regional levels can draw on this resolution
for their advocacy work."
Read More >>
INTERNATIONAL CONGRESS AT MONTREAL
The biennial international congress held in Montreal is something of an
institution. Initiated by the palliative care pioneer Dr Balfour Mount, it
attracts wide international attendance every time. This year’s congress was
held at Montreal convention centre from 18 to 21 October 2016.
Pallium India participated in 5 events. Our volunteer, Father Abraham
Varghese (Abeyachan) presented a poster on spiritual care in Kerala and Dr M.
R. Rajagopal gave the closing plenary talk ‘On caring – Today, Tomorrow’.
Pallium India also participated in 3 different workshops; one on politics of
programme development led by Dr Rajagopal, one on mentoring in palliative care
led by Dr Eduardo Bruera and one on the relevance of Kerala’s community
participation in western society by Dr Ann Broderick.
PALLIUM INDIA’S DAYS IN QUEEN’S UNIVERSITY, KINGSTON, CANADA
Since 2015, Pallium India has forged a strong tie with the department of
medical oncology and epidemiology at Queen’s University in Kingston, one of the
four most reputed universities in Canada. Dr Rajagopal was Visiting Professor
at Queen’s university from 23rd to 25th October, 2016. During this time, he
held teaching sessions separately for residents and for medical students. He
also delivered the H. G. Kelly Memorial Annual Lecture on 25 October.
Pallium India has entered into an understanding with the university for
continued, need-based research activities that will be helpful to our country.
We are very grateful to Dr Christopher Booth and team for making this
A DAY WITH THE LEGENDARY DR MICHAEL KEARNEY
We are very proud of our collaborators at Tanda, Himachal Pradesh. The
palliative care pioneers in the state, Professors Parveen Sharma, Rekha Sharma
and Ms Rajani Arora got together to plan their first academic activity – a one
day educational program for nurses.
The legendary Dr Michael Kearney, the Irish Physician who is the author
of such well-known books like “Mortally Wounded”, blessed the event with his
presence. (The picture shows Dr Michael Kearney and Dr Parveen Sharma).
Pallium India is proud to work with this team in initiating the first
palliative care service in HP. Thank you Dorabji Tata Trust, for funding this
STUDENTS IN PALLIATIVE CARE
Alpha Charitable Trust is one of the palliative care leaders in Kerala.
Under the stewardship of the founder, Mr K M Noordeen, it achieves great
heights. Recently, Pallium India had an opportunity to participate in an annual
meeting of student volunteers in palliative care. We did expect a lot of
participation; but the crowd was beyond our expectation. There were around 400
students in a large hall, actively participating in deliberations and
contributing in numerous ways, declaring by their action that palliative care
is as much someone’s responsibility as right.
We thank Alpha Charitable Trust for honouring Chairman of Pallium
India, Dr M R Rajagopal, with their Alpha Excellence Award.
REMEMBERING PAIN RELIEF ON WORLD ANAESTHESIA DAY
The Cochin Anaesthesia Research Society, a vibrant group of
anesthetists based in and around Kochi, organized the World Anesthesia Day
celebrations on 16th October 2016 with an emphasis on pain management. October
16th is a much remembered day on which William Thomas Green Morton demonstrated
surgical anaesthesia successfully, and thus conquered surgical pain.
The humanist cardiac surgeon, Dr Jose Chakko Periyappuram, the founder
of the Heart Care Foundation of Cochin was the chief guest. (This organization
partnered with Pallium India to conduct the musical event by the noted music
director M Jayachandran at Cochin on 30 October 2016.)
The event saw the honoring of the senior anaesthesiologist Dr T.A
Mohanan with a lifetime achievement award. The audience was reminded of Dr
Morton’s legacy and the fact that anaesthesiologists have a duty not only to
make the person unconscious during surgery but also to keep them as pain-free
and comfortable as possible in the perioperative period.
MISUNDERSTANDINGS GALORE! HERE IS ONE MORE PROOF.
Despite all the news reports in the media, misunderstandings continue
even among medical professionals. Despite all the declarations of the World
Health Assembly and International Narcotics Control Board, pain continues to be
Please see this report: Too little, too late: Why palliative care is
vastly inadequate in India
Is there not violation of our fundamental right to life with dignity
when hospitals do not stock or use the essential medicine, morphine?
How can we justify medical and nursing curricula which do not include
SC KEEPS OUT OF DEBATE ON RIGHT TO REFUSE TREATMENT
The confusion in the public mind between euthanasia and withdrawal of
life support seems to be getting deeper and deeper.
Please see the latest Supreme Court decision
Let us hope the Parliament is not confused when the matter is placed
THE CONFUSION GETS CONFOUNDED
How will we ever get out of the confusion? The average citizen of India
continues to be confused between passive euthanasia and withholding or
withdrawal of life support. The result: failure of formation of a strong public
In the month of October, we participated in 2 workshops in Kerala aimed
at clearing the confusion. One was organized by Pain and Palliative Care
Society, Thrissur. Led by many of the intelligentsia of Thrissur, this
institution is one of the best palliative care centres in the state. Many
dignitaries including the erudite education minister of Kerala state, Prof. C.
Raveendranath, participated in the event.
The second was in Ernakulam organized by the palliative care department
at General Hospital. This hospital has been famous for its exceptional quality
of care and for public participation in health care delivery. The palliative
care unit in this hospital certainly has achieved significant integration of
palliative care into oncology practice. We hope these workshops and many like
them that we make happen in Kerala clear the confusion in the public mind, at
least upto a point.
SUICIDES IN INDIA: 2-DAY SEMINAR IN HYDERABAD
A two day seminar on “Suicides in India: Tendencies, Prevention and
Mitigation of the Social Crisis” was organized on 5th & 6th October, 2016 at
Nizam College, Hyderabad, by the Department of Sociology, Nizam College,
(Osmania University) in collaboration with Centre for Action Research and
People’s Development (CARPED).
The seminar encompassed several serious deliberations on suicides and
the delegates discussed on psychological, social and anthropological aspects of
suicides. The topics included “Euthanasia, assisted suicide and the right to
die” and “Suicides in advanced cancer”. It is a well known fact that advanced
cancer patients have significant suicidal thoughts. There are methods that
could be used to identify the psychiatric needs of such patients and treat them
effectively with palliative care.
The seminar explored the role of community and creating awareness on
palliative care in coping, preventing and mitigation of suicides.
CHITTOOR’S EUTHANASIA SEEKERS
The Hindu reports
In this Andhra Pradesh district, parents unable to cough up the money needed
for treatment are moving petitions seeking euthanasia for their ailing
For three generations Jalla Ramanappa’s family did not have a girl
child. In a country where the premium on the male child knows no bounds, the
Jalla family’s wish for a girl was unusual. But when his sister-in-law
delivered the first baby girl followed by the arrival of his own bundle of joy,
Gynana Sai, on October 10, 2015, celebrations erupted in the Jalla household.
“My brother had a son and a daughter and I and my wife yearned for a
complete family like his. Our prayers were answered when Gynana was born, a
year after my son Sai Teja’s birth,” says Ramanappa, a farm
labourer-turned-salesman. He and his elder brother, Jalla Srinivasulu, a
teacher in a private school, got married to two sisters, and live in a modest
two-room house in a remote tiny village abutting the first railway station in
the area that lent it the name RS Kothapalli in Chittoor district of Andhra
Read More >>
FOR DIGNIFIED DEATH, JAIPUR NEEDS PALLIATIVE CARE UNITS
Times of India reports:
Two years ago, a 40-year-old patient undergoing treatment for blood
cancer committed suicide by jumping from the third floor of a city-based
hospital. The incident brought to light the importance of providing palliative
care for such patients and give them a dignified, pain-free and good quality of
life. But, the state has fallen woefully short in creating such facilities and
providing universal access to palliative care. Only a few hospitals have
palliative care units in the state.
The strict norms of narcotics department for using and storing
morphine, used in palliative care, is one of the major reasons hampering the
setting up of palliative care units.
Read More >>
Kerala University of Health Sciences to brush up soft skills of
Times of India reports:
Recognizing that the lack of proper communication skills is one of the
main reasons for increasing conflicts between doctors and patient’s relatives,
Kerala University of Health Sciences (KUHS) is focusing on developing
communication skills of future doctors.
“We plan to teach communication skills to all MBBS students before
internship as part of curriculum. What is happening now is that though
treatment is perfect, problem starts when there is no proper communication.
Properly communicating the treatment course to the patient and family is part
of the treatment process. Often doctors tend to ignore it stating that they are
overloaded,” said KUHS governing council member Dr K Mohanan.
Students will also be taught medical ethics and basics in palliative
care before internship.
Read More >>
HERE IS A NEW BOOK TO READ: “TWO JOURNEYS” BY USHA JESUDASAN.
You don’t know Usha Jesudasan?
It would be a treat to get to know her. Her first work that we came
across was “I will lie down in peace” in which she shared with us the agonies
that her husband Dr Jesudasan went through in the last year of his life. And
the agonies that she and their children went through as the medical system
failed to relieve his pain and suffering.
Here in _Two Journeys_, Usha shares with us more of herself. The
journey of her mother who lost her life to cancer and Usha’s own cancer story.
Watch this short video [https://youtu.be/vVXUmYoBtFU] on Youtube; you
will not regret it. And dont miss the book.
Purchase it here:
MOM IS NOT SUFFERING ANY MORE
A father-daughter duo recalls their personal trauma over the tragedy of
losing their closest person to terminal cancer and struggling to help her cope
with the pain. A case for respecting end of life choices of a patient and
access to Palliative Care.
Jayanta Sinha writes in PatientsEngage.com: "
She is my wife, my child’s mother – the most beloved one – who passed
away at the age of 49 years after a painful journey of seven long months.
Smriti Kana was always a good student and aspired to be a doctor to
help the poor and the needy. But her conservative parents did not extend to her
much freedom and she was even prevented from taking up the job of a nurse in
the Indian Army. We got married when she was 26. We quarrelled with each other,
blamed each other on different occasions but never even imagined parting ways.
She was my friend. We did everything after discussing, even for minor issues.
Read More >>
TWO MORE STORIES OF INTENSIVE TORTURE
It is happening all around us, every day. It is happening to our near
ones. We suffer with them and feel helpless.
Read two heartrending stories published recently in PatientsEngage
the Journal of Pain and Palliative Care Pharmacotherapy
In the first, “ The medical system failed us
Usha Ravi, an intensive care nurse working in Australia, narrates her mother’s
harrowing experience in the ICU. Eventually the author saves her from the
torture chamber and takes her home only to find that she has to move heaven and
earth to obtain some pain medicine.
In the second, “ When Pain is Medicine
[http://www.tandfonline.com/eprint/eSDHd8q6HJ8ZiSd8NbTE/full] “, Sindhu S.
writes about the horrendous suffering that her father had to go through. This
narrative also describes the feeling of helplessness. “I didn’t want to
infuriate the doctors in whose hands we had surrendered his body, and who had
broken down his body into isolated segments only they could put back together
again, if at all,” she writes. Eventually, she hears about palliative care and
decides to move him out. But the father dies that morning.
We thank the authors for sharing their story with the world. Both Usha
and Sindhu must have died a thousand deaths as they relived the agony of those
days, in the process of writing down their experience. Yet they did it, so that
others could learn from it. How many thousands of such stories will be
necessary to wake the medical world up and to infuse a bit of compassion into
LIFE ASKED DEATH: PALLIATIVE CARE IN ASIA
‘ Life Asked Death [http://lifeaskeddeath.com/] ’ is a film that
focuses on the suffering experienced by patients with cancer, and difficulty in
morphine availability, accessibility and affordability. Produced by Moonshine
Movies, ‘ Life Asked Death [http://lifeaskeddeath.com/] ’ highlights the scale
of pain and suffering that needs to be urgently addressed in Asia, and offers
insights into the positive outcomes that can be achieved even in
resource-limited countries. The documentary brings viewers to Bangladesh,
Myanmar and Sri Lanka to witness how Lien Collaborative’s specialist volunteers
bring palliative care and training to these countries. When international
experts and local stakeholders work together to develop palliative care
capacity in the government-run health systems, the barriers to pain relief and
humane care can be removed.
Watch ‘ Life Asked Death [http://lifeaskeddeath.com/] ’ now; you will
UPCOMING EVENTS [HTTP://PALLIUMINDIA.ORG/EVENTS]
NOVEMBER 7, 2016: 10 days Foundation Course for doctors at Trivandrum,
Kerala. Contact: info@xxxxxxxxxxxxxxxx [mailto:info@xxxxxxxxxxxxxxxx]
* NOVEMBER 7, 2016: 6 weeks certificate course for doctors and nurses
at Trivandrum, Kerala. Contact: info@xxxxxxxxxxxxxxxx
* NOVEMBER 7, 2016: 1 month Certificate Course in Palliative Medicine
for doctors and nurses at Hyderabad, Telengana. Contact:
* NOVEMBER 14, 2016: Six weeks certificate course for doctors and
nurses in Ahmedabad, Gujarat. Contact: palliumindia.gcri@xxxxxxxxx
For details, contact: 9746745502 / info@xxxxxxxxxxxxxxxx
[mailto:info@xxxxxxxxxxxxxxxx] . Find out more about our courses at:
INTERNATIONAL VISITORS [HTTP://PALLIUMINDIA.ORG/PROGRAMS/VISITORS/]
We welcome international visitors at Pallium India and appreciate the
support from our colleagues around the world. We request that you contact us at
least 2 weeks prior to your visit so that we can make the necessary
arrangements. Sorry; we would discourage “drop-ins” for fear of the impact on
We have observership programs for interested professionals and
students, collaborative visits, and long term placements. Click here
[http://palliumindia.org/programs/visitors/] for more information. Contact:
JOIN OUR FACEBOOK PAGE [HTTPS://WWW.FACEBOOK.COM/PALLIUMINDIA]
Pallium India’s Facebook page has over 5000 Likes. We regularly post
articles related to palliative care from around the world. Click here to Like
our page [https://www.facebook.com/palliumindia] ! We’re also on Twitter:
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:
Address: Pallium India, Arumana Hospital, Perunthanni, Trivandrum
For more details, please visit: http://palliumindia.org/info-centre/
MEANING OF LIFE [HTTP://PALLIUMINDIA.ORG/DONATE]
“I am a quadriplegic. I came to Pallium India as a patient; now I am a
full-time volunteer. I work as the chairman’s executive assistant. I also work
with and help people with paraplegia and bereaved children.”
These are the words of Ashla Rani, Pallium India’a volunteer, as she
addressed a thousand-odd gathering at the musical evening at Kochi on 30
“If given a choice, it is true, I would like to get up and walk. But it
is also true that compared to my life till I was 27 and had the accident, my
life has been so much more meaningful in the last few years.”
The audience broke into applause at this. Ashla continued:
“Help us. Just go to www.palliumindia.org/donate
[http://www.palliumindia.org/donate] and click on the Donate button. If you
give us what your family would spend dining out once a month, one person will
live pain-free for a month. If you share a fraction of what you spend
celebrating a birthday, a child will go to school for a whole year”.