Pallium India Newsletter: Re: May 2017

  • From: Pallium India <info@xxxxxxxxxxxxxxxx>
  • To: "Brijesh Chaurasia / ZI Corp. Planning & Performance Mgmt" <Brijesh@xxxxxxxxxxxxxxxxxxx>
  • Date: Wed, 31 May 2017 16:47:55 +0530

Dear Brijesh,

Greetings from Pallium India.

You can write to Dr.Rajagopal at chairman@xxxxxxxxxxxxxxxx, i am also
marking the copy of this mail to Dr.Raj.

Manoj


*Information Centre*
PH: 09746745497


www.palliumindia.org
Pallium India, Arumana Hospital, Airport Road, Vallakkadavu P.O.
Thiruvananthapuram – 695 008, Kerala, India.

Phone/Fax (office): +91 471 2468991, +91 9387296889
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Information provided by Pallium India has been collected from different
sources and though every effort has been made to ensure that it is
up-to-date, its accuracy cannot be assured. Pallium India shall have no
liability for any damages, loss, injury, or liability whatsoever suffered
as a result of reliance on the information provided.

On 30 May 2017 at 11:40, Brijesh Chaurasia / ZI Corp. Planning &
Performance Mgmt <Brijesh@xxxxxxxxxxxxxxxxxxx> wrote:

Dear Dr Rajgopal,



Greetings Sir,



Hope all ok at your end.



Pl. reply to my email so that I can have your email id.



Or let someone provide me with email id of Dr.



Regards,



Brijesh Chaurasia

00966 502836851





*From:* palliumindia-bounce@xxxxxxxxxxxxx [mailto:palliumindia-bounce@
freelists.org] *On Behalf Of *Pallium India Newsletter
*Sent:* 30 April 2017 19:38
*To:* palliumindia@xxxxxxxxxxxxx
*Subject:* Pallium India Newsletter: May 2017



Welcome to the monthly newsletter from Pallium India
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This newsletter is brought to you by Pallium India
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May 2017 Newsletter
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A Call to Action for Ensuring Humane Care at the End of Life
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*‘The Mathura Declaration’* aims to promote Palliative and End of Life
Care (EOLC) to those who are terminally ill and dying.

*Mathura, Uttar Pradesh, India, 30th April 2017*: The newly formed
Citizens’ Action Needed for Dignity in Death (CANDID) and a multi
professional medical association called End of Life Care in India Task
force (ELICIT), bring together, for the first time, individuals from varied
walks of life to promote humane and compassionate care of terminally ill
and dying persons.

This Advocacy is found to be necessary against the backdrop of inadequate
awareness among the public, care-providers and policy-makers, of the
complex issues around compassionate and appropriate care of the terminally
ill and dying persons that impact every citizen’s life.

*Palliative and End of Life Care (EOLC)*, is about appropriate
transitioning from disease-oriented care to symptom management, ensuring
comfort in the dying phase.

*The Mathura Declaration states the following:*

1. Quality of life is a right guaranteed under the Constitution to every
citizen of India and must be upheld, including at the end of life.

2. Palliative and End of Life Care (EOLC) are important means to ensure
this.


Rights of Persons with Disabilities Rules 2017
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Now that the Parliament of India has passed The Rights of Persons with
Disabilities Act
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the relevant rules need to be framed. Government of India has prepared
draft rules and published it on its website
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.

On invitation from the Department of Social Justice of Government of
Kerala, a few of us from Pallium India including Ashla Rani and Anjali
Krishnan, attended a workshop held in Mascot Hotel,
Trivandrum, on World Health Day, April 7, 2017. The workshop was
inaugurated by the Honourable Minister for Health and Family Welfare,
Shailaja Teacher, and was blessed with the erudite analysis of the Act by
the former Chief Secretary of Kerala, S. M Vijayanand IAS.

Creation of realistic rules and spelling out the details would be key to
proper implementation. We congratulate the Department of social justice for
this activity and thank them for including the civil society.


Elisabeth Kübler-Ross Pallium Library inaugurated

“Palliative care must become the responsibility of the entire society
towards the needy,” said former Chief Secretary S. M. Vijayanand IAS, while
inaugurating the Elisabeth Kübler-Ross (EKR) Pallium Library at Pallium
India’s Arumana Hospital building. He also pointed out that India held a
dismal place in global Quality of Death index. While the society’s
involvement in Kerala’s palliative care scene was commendable, there was
still a long way to go.

S. M. Vijayanand added that he was fascinated by Pallium India’s slogan,
“Care Beyond Cure” and the motto of palliative care: “low tech, high touch”.

The inauguration of EKR Pallium Library was organized as part of the World
Health Day programs on April 7th, 2017. The library is for the use of the
trainees as well as for staff members and volunteers. There is a separate
section on EKR publications.

Named after Swiss-American psychiatrist and near-death studies pioneer
Elisabeth Kübler-Ross, the EKR Pallium Library has a virtual library on the
National Cancer Grid.

The Elisabeth Kübler-Ross Foundation and its chief functionaries, Dianne
Gray and Ken Ross (Elisabeth’s son), had sent many precious books
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to us. Numerous books also came in as a gift from Dr.Odette Spruyt
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of Peter McCallum Cancer Centre, Melbourne, who has been a friend of
Palliative Care in India for over two decades; thank you Rotary Suburban of
Trivandrum for your kind and precious assistance in arranging the customs
clearance of the latter shipment.

*Library dedicated to palliative care – report in The Hindu*
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*Library dedicated to books on palliative care opened – report in The
Times of India*
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Pontifical Academy for Life organizes palliative care workshop in the
Vatican
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*Dr Rajagopal, Chairman of Pallium India, writes:*

It was a privilege for Pallium India to be one of 8 invited participants
at a workshop organised in the Vatican by the Pontifical Academy for Life
on 30 March, 01 April, 2017. The Catholic Church’s interest in palliative
care is truly gratifying and holds great promise for the future because its
healthcare institutions account for 26% of all in the world. If they all
incorporate palliative care into healthcare, it could remove a huge burden
of pain and suffering particularly in low and low-middle income countries.

The participants had a special treat – we stayed in Domus Sanctae Marthae
where Pope Francis stays and ate in the same dining room. Just being able
to see him twice a day was a treat considering what an amazing human being
he is, having discarded all luxuries that could be associated with the head
of one of the most powerful states of the world, and chose to live with
common people like us.

And it was truly a privilege to listen to Archbishop Vincenzo Paglio who
chaired the workshop. Here are a few pearls from his talk:

   - “A person should never be deprived of his/her dignity – even when
   one may be tempted to suspect that the person is unworthy.”
   - “In this world of palliative care, no one is abandoned.”
   - “Beware of the dictatorship of “I” – the ego.”
   - “Palliere” should not be used like a lid to hide suffering and to
   walk away.”
   - “Ignorance is cruel in this matter. Cultural illiteracy is not
   acceptable. We have to overcome the guilty silence.”

*[Top: Pope Francis / Bottom: Archbishop Vincenzo Paglia]*


Advocacy at the Commission on Narcotic Drugs
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Do we really appreciate what all it takes to ensure that you and I have
access to pain relief when we need it?

Well, among many other things, sustained advocacy at the international
level as well as at the national level in numerous countries.

Ms. Katherine Pettus, advocacy officer at the International Association
For Hospice and Palliative Care (IAHPC) writes in the April issue of IAHPC
Newsletter
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:

“The March advocacy highlight was the annual meeting of the Commission on
Narcotic Drugs (CND) in Vienna, which also happened to be the 60th
anniversary or ‘Diamond Jubilee’ of the CND. For many of us involved in
advocacy, especially those who work on improving access to controlled
medicines, this meeting marked a banner year, coming after the historic 2016
United Nations General Assembly Special Session (UNGASS)
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meeting on drugs last April. Like couples who have survived and matured
through sixty years of marriage, the Commission can celebrate its maturing
relationship with civil society organizations that have worked tirelessly
over recent decades to change the focus of international drug policy from a
punitive, criminal justice oriented approach, to one that is
person-centered and that prioritizes public health outcomes such as
improved access to medicines for pain and palliative care.”

You can read the full report here
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.


Salute the fighting angel, Odontuya Devaasuren.
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*Dr M. R. Rajagopal, Chairman of Pallium India, writes:*

Some people make you feel so humbled! Dr Odontuya Devaasuren is one such.

Thanks to a leadership development course conducted by Dr Frank Ferris and
team in San Diego, California, and Columbus, Ohio, I had the good fortune
to spend a few weeks with and to make friends with this amazing source of
energy.

While a medical student in Leningrad, she had to witness her father
suffering from lung cancer back in Mongolia. Later, her mother-in-law also
died in suffering from liver cancer.

But this exceptional woman made great good come out of her father’s and
mother-in-law’s suffering. She brought palliative care to Mongolia. She
worked hard, forcefully and persistently, to bring in changes in government
policies. Some policies were downright crazy. In a country where food had
to be rationed, the ration included two bottles of vodka every time!

But Odontuya was so successful in changing policies and in influencing
medical education that in 2015, Mongolia came 28th among 80 countries in
the Economist Intelligence Unit’s “Quality of Death Index” (though it is
only a low-middle income country, coming 124th among world nations in gross
national income). Compare that with India, another low-middle income
country, listed as 67th out of 80!

Read this article by Andrew North
<https://emea01.safelinks.protection.outlook.com/?url=http%3A%2F%2Fwww.independent.co.uk%2Fnews%2Flong_reads%2Fa-surprisingly-good-place-to-die-mongolia-and-palliative-care-a7663806.html&data=02%7C01%7Cbrijesh%40zamilindustrial.com%7Cf6453bbd376d4c24b0ab08d48fe7acb1%7Ccfdb9f84010a49519bfc0335b2ab3bb5%7C1%7C0%7C636291672589938079&sdata=aJWWlbqAv5R9BgGjcCLgOiOlZxHZvjj9BDHuzRMs3vM%3D&reserved=0>,
friends, and join me in saluting the compassionate fighting angel, Odontuya
Devaasuren.

*[Photo: Dr Odontoya Devaasuren during the leadership course at Columbus,
Ohio]*


OBITUARY: Art Lipman
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Very sad loss! We lost Art Lipman
<https://emea01.safelinks.protection.outlook.com/?url=http%3A%2F%2Fwww.legacy.com%2Fobituaries%2Fdeseretnews%2Fobituary.aspx%3Fn%3Darthur-g-lipman-art%26pid%3D185193927%26&data=02%7C01%7Cbrijesh%40zamilindustrial.com%7Cf6453bbd376d4c24b0ab08d48fe7acb1%7Ccfdb9f84010a49519bfc0335b2ab3bb5%7C1%7C0%7C636291672589938079&sdata=KG3qjedWMTzyJNMvF9ha4KV2E8JugXP6bYuzUpyeEoM%3D&reserved=0>,
editor of the Journal of Pain and Palliative Care Pharmacotherapy, with
whom we collaborated on the “Narratives” feature in that journal, to
Myelofibrosis on 23 April 2017.

It was a pleasure to work with you, dear Art. Rest in peace!


Video Of The Month
<https://emea01.safelinks.protection.outlook.com/?url=http%3A%2F%2Fwww.youtube.com%2Fwatch%3Fv%3Dc1VWmdpsEsA&data=02%7C01%7Cbrijesh%40zamilindustrial.com%7Cf6453bbd376d4c24b0ab08d48fe7acb1%7Ccfdb9f84010a49519bfc0335b2ab3bb5%7C1%7C0%7C636291672589938079&sdata=WuFIrcUh24sGh%2BBBLvQCLKuMZotO5ASKcEQK7p9dvLI%3D&reserved=0>


<https://emea01.safelinks.protection.outlook.com/?url=http%3A%2F%2Fwww.youtube.com%2Fwatch%3Fv%3Dc1VWmdpsEsA&data=02%7C01%7Cbrijesh%40zamilindustrial.com%7Cf6453bbd376d4c24b0ab08d48fe7acb1%7Ccfdb9f84010a49519bfc0335b2ab3bb5%7C1%7C0%7C636291672589948087&sdata=OfhzWY%2BCa0tBb7G8spwwg54cFxZ9oyfrFRa8FO7ElTU%3D&reserved=0>TNG
Award acceptance speech by Dr M. R. Rajagopal (with English subtitles):

Dr Rajagopal explains the significance of palliative care and how everyone
can support it.


Despite The Risks, Morphine Can Offer Hope
<https://emea01.safelinks.protection.outlook.com/?url=http%3A%2F%2Fwww.npr.org%2Fsections%2Fgoatsandsoda%2F2017%2F04%2F08%2F522994283%2Fvideo-despite-the-risks-morphine-can-offer-hope&data=02%7C01%7Cbrijesh%40zamilindustrial.com%7Cf6453bbd376d4c24b0ab08d48fe7acb1%7Ccfdb9f84010a49519bfc0335b2ab3bb5%7C1%7C0%7C636291672589948087&sdata=P1OHzvMKVWYso0POYMmudwLatZRp0tCILigeQ53%2FcHg%3D&reserved=0>

*By Malaka Gharib, NPR.org*

Morphine. It’s why Zubair in Kerala, India, can ride his motorcycle, work
at his coffee shop and bring an income home to his family. Without his
daily dose, living a normal life is nearly impossible.
“The pain is like someone stabbing you with a needle on your body and
joints,” he says of his life after being diagnosed with a bone tumor in
1979. Since then, he’s had to have a series of progressive amputations
below his right knee.

Read More ->
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Donate to Pallium India
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<https://emea01.safelinks.protection.outlook.com/?url=http%3A%2F%2Fpalliumindia.org%2Fdonate&data=02%7C01%7Cbrijesh%40zamilindustrial.com%7Cf6453bbd376d4c24b0ab08d48fe7acb1%7Ccfdb9f84010a49519bfc0335b2ab3bb5%7C1%7C0%7C636291672589948087&sdata=%2FUWFZwOQ1YV5r5XVgj954HIAcSyjahlAYOUeXxONcmw%3D&reserved=0>The
money you give will pay for essential free medicines for the poor, for
their travel to the clinic or for schooling of their children, or other
forms of care. Please give whatever you can. No amount is too small.

To donate, please visit: palliumindia.org/donate
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Write to us: info@xxxxxxxxxxxxxxxx / 9746745497


#LaughAtDeath
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<https://emea01.safelinks.protection.outlook.com/?url=http%3A%2F%2Findianexpress.com%2Farticle%2Ftrending%2Fviral-videos-trending%2Fwatch-hold-back-tears-laugh-along-as-elders-with-terminal-diseases-laughatdeath-4592561%2F&data=02%7C01%7Cbrijesh%40zamilindustrial.com%7Cf6453bbd376d4c24b0ab08d48fe7acb1%7Ccfdb9f84010a49519bfc0335b2ab3bb5%7C1%7C0%7C636291672589948087&sdata=LIzjY9RIZl8QFvIwbhx9Ho3w%2FQzC%2F2gtOOk8TpxfG9I%3D&reserved=0>

A video shared by End of Life Care India on YouTube is bringing Netizens
to tears, as a handful of elders crack jokes with beaming smiles and put up
a funny act about their medical conditions and the irreversibility of it.
The clip has four elders trying their hands at stand-up comedy, while they
bravely joke around about death.

Read the article and watch the video….
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Death is inevitable. A bad death is not.
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“Honest and open conversations with the dying should be as much a part of
modern medicine as prescribing drugs or fixing broken bones. A better death
means a better life, right until the end.”

An article published in *The Economist* on 29 April, 2017, titled “How to
have a better death
<https://emea01.safelinks.protection.outlook.com/?url=http%3A%2F%2Fwww.economist.com%2Fnews%2Fleaders%2F21721371-death-inevitable-bad-death-not-how-have-better-death%3Ffsrc%3Dscn%2Fpn%2Fte%2Fbl%2Fed%2Fendoflifecarehowtohaveabetterdeath&data=02%7C01%7Cbrijesh%40zamilindustrial.com%7Cf6453bbd376d4c24b0ab08d48fe7acb1%7Ccfdb9f84010a49519bfc0335b2ab3bb5%7C1%7C0%7C636291672589948087&sdata=KJLe%2BHuSgABuIVWgo%2BBiZeo8j3ZlnfaFSheM%2Fum8Deg%3D&reserved=0>”
explores how death and the dying process have changed over the course of
the century. Chronic illnesses, followed by long confinement in the
Intensive Care unit, have become common. Some even undergo surgery in the
last month of their life.

“To give people the death they say they want, medicine should take some
simple steps.” Read the complete article: How to have a better death
<https://emea01.safelinks.protection.outlook.com/?url=http%3A%2F%2Fwww.economist.com%2Fnews%2Fleaders%2F21721371-death-inevitable-bad-death-not-how-have-better-death%3Ffsrc%3Dscn%2Fpn%2Fte%2Fbl%2Fed%2Fendoflifecarehowtohaveabetterdeath&data=02%7C01%7Cbrijesh%40zamilindustrial.com%7Cf6453bbd376d4c24b0ab08d48fe7acb1%7Ccfdb9f84010a49519bfc0335b2ab3bb5%7C1%7C0%7C636291672589948087&sdata=KJLe%2BHuSgABuIVWgo%2BBiZeo8j3ZlnfaFSheM%2Fum8Deg%3D&reserved=0>


Wheelchairs don’t climb stairs: What society can and should be doing for
the differently abled
<https://emea01.safelinks.protection.outlook.com/?url=http%3A%2F%2Fenglish.manoramaonline.com%2Fwellness%2Fhealth%2F2017%2F04%2F03%2Feveryday-health-support-disabled.html&data=02%7C01%7Cbrijesh%40zamilindustrial.com%7Cf6453bbd376d4c24b0ab08d48fe7acb1%7Ccfdb9f84010a49519bfc0335b2ab3bb5%7C1%7C0%7C636291672589958091&sdata=gxL21%2B3hqM0HhCFWJPlpdNlbds6TaZ%2B9xvNsWIdbH9s%3D&reserved=0>

By Dr Rajeev Jayadevan, ManoramaOnline.com

As she went out with her friends for dinner, it suddenly dawned on
everyone. There was no ramp leading up to their restaurant. Only steps. Her
wheelchair could not walk up steps. She either had to be physically carried
up the steps, or they could look for another place with a ramp – which
probably didn’t exist.”

This is my recollection of a passage written by Ashla, a beautiful young
woman – articulate, educated and gainfully employed. There was just one
problem: she could not move her legs, and spent a lot of her life on a
wheelchair.
She did not want to burden her friends or the hotel waiters into carrying
her inside the restaurant.

If only there was a ramp!

Why did we, a civil society, leave her out?

Read More ->
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Certificate Course in Essentials of Palliative Care
<https://emea01.safelinks.protection.outlook.com/?url=http%3A%2F%2Fpalliumindia.org%2F2017%2F04%2Fcertificate-course-in-essentials-of-palliative-care%2F&data=02%7C01%7Cbrijesh%40zamilindustrial.com%7Cf6453bbd376d4c24b0ab08d48fe7acb1%7Ccfdb9f84010a49519bfc0335b2ab3bb5%7C1%7C0%7C636291672589958091&sdata=fz8YYr9cz%2F9cTObW9SHoMA9epR6N7f9vqd1%2Byd1vNrI%3D&reserved=0>

Certificate Course in Essentials of Palliative Care (CCEPC), conducted by
Indian Association of Palliative Care will begin on *1st June 2017*, at 
*Arumana
Hospital Building, Perunthanni, Thiruvananthapuram*.

It is a basic course in Palliative Care for Doctors and Nurses. This
course aims to inculcate the principles of palliative care to improve
patient care through proper communication and effective management of
difficult symptoms. This program will help doctors and nurses in their day
to day professional life.

*Who can apply?*

Doctors who have successfully completed MBBS/ BDS (including those doing
their internship) and Nurses with Diploma in Nursing/ Bsc Nursing

*Course Fee*

A heavily subsidized course fee of ₹2000/- for doctors and ₹1500/- for
nurses

Registered candidates who do not clear the examination in the first
attempt will get one more chance to appear in the examination without
paying additional fee.

*How to apply*

If you are interested to apply for this course, please *download the
application form*
<https://emea01.safelinks.protection.outlook.com/?url=http%3A%2F%2Fpalliumindia.org%2Fcms%2Fwp-content%2Fuploads%2F2017%2F04%2FCCEPC-Application-Form-2017.pdf&data=02%7C01%7Cbrijesh%40zamilindustrial.com%7Cf6453bbd376d4c24b0ab08d48fe7acb1%7Ccfdb9f84010a49519bfc0335b2ab3bb5%7C1%7C1%7C636291672589958091&sdata=vegLuboR8kunGOS%2Bf%2BKe6mOO4QtovDE%2B%2F2tCBypx2SM%3D&reserved=0>,
fill it up and send it to us at education@xxxxxxxxxxxxxxxx

*Course Outline*

CCEPC has two components, Part A and an optional Part B (Hands on Training
in Palliative Care)

*Part A* consists of a contact session of 15 hours followed by 8 weeks of
distant learning. This will be followed by an evaluation consisting of
theory examination and spotter examination. The examination will be in
August 2017.

The candidate also have to submit a Reflective Case History (online
submission), which will be evaluated by National Faculty.

Candidate successful in the theory and spotter examination and those who
have secured pass grade in the Reflective e Case History will be awarded
the Certificate in Essentials of Palliative Care.

*Part B*, Hands-on Training in Palliative Care, is optional and consists
of 10 days Hands-on Training. This should be done at a palliative care unit
authorized by IAPC. At the end of the 10 days posting, the candidate has to
submit a logbook duly attested by the mentor.

The certificate awarded to candidates who successfully complete the Hands
on Training will enable them to apply for license to stock and dispense
oral morphine under the Narcotic Drugs and Psychotropic Substances (NDPS)
Act.

*Course Content*

   - Introduction to Palliative Care
   - Communication Skills
   - Spirituality, Ethics in Medical Practice, Psychological Issues
   - Management of Pain and other Symptoms
   - Nursing Issues
   - Palliative Care in HIV/AIDS
   - Care of the Elderly and Paediatric Palliative Care
   - Palliative Care Emergencies
   - End of Life Care

*Have Queries?*

Contact us: education@xxxxxxxxxxxxxxxx / +91918589998760


IAPCON 2018
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<https://emea01.safelinks.protection.outlook.com/?url=http%3A%2F%2Fpalliumindia.org%2Fcms%2Fwp-content%2Fuploads%2F2017%2F04%2FIAPCON-2018-Flyer.jpg&data=02%7C01%7Cbrijesh%40zamilindustrial.com%7Cf6453bbd376d4c24b0ab08d48fe7acb1%7Ccfdb9f84010a49519bfc0335b2ab3bb5%7C1%7C0%7C636291672589958091&sdata=UkbJ2e%2BiaJRg%2F%2Feta6Ywl2UtCxsuM53LJ9eUKyKyan4%3D&reserved=0>The
25th Annual Conference of the Indian Association of Palliative Care (IAPCON
2018
<https://emea01.safelinks.protection.outlook.com/?url=http%3A%2F%2Fwww.iapcon2018.com%2F&data=02%7C01%7Cbrijesh%40zamilindustrial.com%7Cf6453bbd376d4c24b0ab08d48fe7acb1%7Ccfdb9f84010a49519bfc0335b2ab3bb5%7C1%7C0%7C636291672589958091&sdata=IgPClaNSIfLdtoSE2izEl7LBpo%2BM3gRzT4DQO%2FIemko%3D&reserved=0>)
will be held from 23rd to 25th February, 2018, at Jawaharlal Auditorium,
AIIMS, New Delhi. The theme of the conference is *Create, Collaborate and
Communicate*.

Early Bird registration closes on *30th June, 2017*.

Last date to submit abstracts: *30th October, 2017*.

For more details on the Conference, please download the brochure
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.


Attitude of health care providers on dignity of patients
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*Sarath Mohan S., Medical Social Worker at Pallium India, writes:*

As a social worker, I am still learning about dignity and its importance
in human life. My beliefs and ideas about dignity relate to what I have
learnt and what I have experienced throughout my life. I would define
dignity as a feeling of having one’s human value and worth being
acknowledged. It is also associated with autonomy and having control over
one’s destiny.

I would like to throw some light on the influence of health care providers
in the dignity of a person, through a personal experience. My father was
diagnosed with a kidney disease, a year ago. He has diabetic retinopathy
and is partially blind too. Now he cannot walk without support. One day,
after consultation in a corporate hospital, he was asked to wait outside
the room. He waited in a wheelchair for the support staff to come.

No one turned up for a long time. When we – the family members – tried to
move the wheelchair, they did not allow us to do so. Their motto was, “We
are here to care for you. You do not need to do anything.”

So my father ended up waiting for more than half an hour in that hospital
corridor. He has physical limitations which confine him to a wheelchair.
But his dignity and self-respect does not have any confinement! I noticed
his devastated face clearly because of being hurt and undignified. The same
hospital staff, so-called ‘compassionate health care providers’, did not
even ask his permission before giving an injection or checking blood
pressure. I wonder how these ‘compassionate health care providers’ justify
themselves personally and professionally for treating patients without
respecting their dignity. This is not just the case of my father, but of
many other patients as well.

Anybody working in health care has the prodigious opportunity and a
responsibility to think about others’ dignity and how they personally
influence the experience of the people whom they care for. Especially from
palliative care point of view, maintaining dignity warrants compassion.
Seeing a person as a person first is paramount, not just as a diagnosis or
a container of diseases. Every person’s self-image and the way in which
health care providers see that has an intimate connection. That means,
patients and families expect a lot from the health care providers. It is
the responsibility of health care providers to meet their needs.

Only after working at Pallium India did I get the big picture of
compassionate care and respecting the dignity of a person. Every nursing
procedure will be carried out only after a “May I…..?”. Communication of
bad news will be always done in empathetic and systematic way. I have seen
nurses who speak to apparently unconscious patients before medical
procedures and shifting. There is no better way to respect their dignity.
In palliative care, we strive to improve the quality of life of patient and
families and thereby we are respecting/valuing their dignity. We give a
voice to the patient regarding one’s own process of dying, minimizing
physical and emotional suffering, respecting their privacy, and caring for
them with empathy. We see them as people who are seeking help with a
medical concern.

Patients would like to see themselves through health care providers. If
they are able to see that, we have done something remarkable to respect and
maintain their dignity. Understanding the suffering of others and
willingness or a wish to make a difference in people’s life is all what we
need to do to value the dignity of that person. So we health care providers
should have the desire for that.

I have not come across any better definition of dignity than these great
words by Dame Cicely Saunders. Remembering that great lady with huge
respect and passion.

*“You matter because you are you, and you matter to the end of your life.
We will do all we can not only to help you die peacefully, but also to live
until you die.”*

*(Image: Sarath with a patient)*


Poor, but very rich.
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Usha does not have much of worldly possessions; she works as a house-maid
to a doctor.

Her son sadly died in a road traffic accident two years back. A year later
some compensation was paid to her by the insurance company. Usha did not
hesitate; she donated a substantial part of it to Pallium India. She had
heard about us from her employer.

We thought the matter ended there. But she was back at the time of the
second death anniversary of her son, with another donation – what she had
saved from her earnings.

Can you not see God in her?


Thank you, Bank of India.
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At an elegant and simple function at Bank of India premises in Trivandrum
on 15 March 2017, Kul Bhushan Jain (G.M NBG, South), A B Vijaykumar (Kerala
Zonal Manager NBG, South), Anil Kumar Jha (Kerala Deputy Zonal Manager NBG,
South) handed over to Pallium India a brand new vehicle for our home visit
programme.

Thank you, dear friends at Bank of India, for your support and for
conveying that we all have a responsibility towards our suffering fellow
human beings.


Thank you, Liliana, Sarah and Aparna.
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We had floated a request through our social media – *Did anyone have an
unused laptop to donate?*

The experience from the last many years made us reasonably sure that the
plea would not go unheeded; that we would get one.

We were wrong. We got three!

   - Liliana De Lima, executive director of IAHPC sent a Microsoft Tablet
   PC all the way from USA through our well-wisher, Dr Chitra.
   - Sarah Chandy sent an Apple Laptop through our volunteer, Smriti Rana.
   - Aparna Kurian sent an Apple Laptop through our volunteer, Annu
   Kurien.

They are all in good use now. See the tablet busy in our ECHO (Extension
for Community Health Outcome) education program.


Vacancy: Medical Social Worker at Pallium India, Trivandrum

Organization: Pallium India
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Job Title: Medical Social Worker
No. of Requirements: 2 (Nos.)
Nature of Job: Permanent – Full Time
Qualification: Masters in Social Work (Full-Time) from a recognized
university
Experience: Fresher /1-2 years
Place of Job: Pallium India Trust, Arumana Hospital Building,
Eanchakkal-West Fort Road, Vallakadavu P.O., Trivandrum

*Job Description:*

   - Evaluation and management of problems of patients and families
   requiring palliative care with particular attention to social issues.
   - Auditing of palliative patient care with intent to identification of
   problems and bringing up possible solutions to problems to the attention of
   the administration.
   - Taking part in on-going research activities or initiating need based
   research programs with the approval of scientific committee.
   - Liaising with the Government departments for getting Scheme related
   information for the patients.
   - Taking steps to publish reports/data from audits or research
   programs with the objective of improved patient care anywhere.
   - Maintaining regular reporting to superior officials as advised in
   the contract.
   - Attending (first) and organizing (later) educational programs on
   behalf of Pallium India.
   - Maintaining good relations with clients, donors, well-wishers and
   staff during telephone conversations, email contacts, personal contacts or
   any other.

Interested candidates can send detailed and updated CV to
hr@xxxxxxxxxxxxxxxx with “*Application for Medical Social Worker*” as
subject. For more details, please contact: hr@xxxxxxxxxxxxxxxx / +91
9746745501

*For more vacancies, visit our Careers
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Engineering Students in support of palliative care
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PACE, the palliative care club of College of Engineering Trivandrum (CET),
organized a one-day workshop on palliative care, on 2nd April 2017. The
program was attended by staff and students of CET. Pallium India’s Advocacy
Manager, Babu Abraham, HR Manager, Arathy Venukumar, Volunteer Leela Devi,
Volunteer Krishnaraj Nambiar and Medical Social Worker Sherin Wilfred,
spoke to the participants about the significance of palliative care in
today’s society and shared their own experiences. Leela Devi also put
forward some suggestions to PACE on how to contribute to palliative care.
Dr K C Raveendranathan, Principal, CET, also addressed the audience.

Praveen T A, General Secretary of PACE, described the future plans of
PACE, incuding the decision to conduct ward-level survey in Kulathoor
division of Trivandrum Corporation for identifying people who need
palliative care and support and to provide help.

Dear staff and students of College of Engineering Trivandrum, thank you
for your support to palliative care. Your eagerness to help our fellow
human beings excites us.


Our little contribution towards a green earth
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That is the first organic vegetable harvest from the roof-top of Pallium
India’s Trivandrum Institute. No wonder our Sreelekshmi is looking so proud
about it.

Thank you Sr Hanife for funding this program!

No; sorry; they are not on sale. It goes to the kitchen of our half way
home for people with spinal cord injuries!


Best Poster Awards: Dr Arunangshu Ghoshal wins third place
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The 21st anniversary issue of the popular IAHPC newsletter
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carries the good news that Dr Arunangshu Ghoshal from India has won third
place
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in the Best Poster Awards of the International Palliative Care Network for
“Pediatric Palliative Care Referral Practices in an Oncology Setting: A
Five-Year Retrospective Chart Review”.

Dr Ghoshal forms an important link in the history of palliative care in
India. He was the first doctor to join the newly started postgraduate
degree course (MD) in palliative medicine at Tata Memorial hospital in
Mumbai in 2012.

Congratulations Arun, and thank you IAHPC, for sponsoring the posters.

*Read the April issue of IAHPC Newsletter
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*


Thousands of cancer patients denied wish to die at home
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*The Guardian*

Tens of thousands of people with cancer are dying in hospital every year
even though they would rather spend their final days at home or in a
hospice.

Although only 1% of cancer patients say they would prefer to die in
hospital, 38% do, according to research by Macmillan Cancer Support,
equating to 62,000 people a year across the UK.

Read More ->
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Demographic conundrum: Caring for a young nation that’s ageing, too
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India may be one of the youngest countries, with more than 60 per cent of
its population below 35 years of age, but the picture is set to change
dramatically in a couple of decades.

But does the recently released National Health Policy 2017 take this
impending demographic change into account?

It does hint at a “future-ready” approach, say healthcare specialists,
pointing to pre-paid health insurance that is a move towards ensuring
affordable healthcare for the elderly, often left outside the insurance
purview.

Read More ->
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The end of life
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*By Rahul Matthan, LiveMint*

While treating the terminally ill, doctors are forced to tread a
treacherous path. Whatever course of action we choose, our outcomes are
circumscribed by the limits of human understanding and modern science
offers scant hope for full recovery. Yet doctors, bound by ethical and
legal obligations, are obliged to utilize all the technologies at their
disposal to keep patients alive.

At some point down this path, when medical complications begin to develop,
treating physicians have difficult decisions to make about what they should
do next. Do they keep their patient alive at all costs—using life support
if needed—or limit themselves to simply treating symptoms as they present
themselves, keeping the patient as comfortable as possible as the end draws
near?

Read More ->
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The Patients Were Saved. That’s Why the Families Are Suing.
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*By Paula Span, NYTimes.com*

What happened to Beatrice Weisman before dawn on Aug. 29, 2013, was not
supposed to happen: The medical staff at Maryland General Hospital found
her in cardiac arrest, resuscitated her and kept her alive.

The matriarch of a close-knit family on Maryland’s Eastern Shore, Ms.
Weisman, then 83, had suffered a serious stroke in June and had spent weeks
in two hospitals.

Fortunately, she and her husband had drafted advance directives; she named
her husband, William, to make medical decisions if she became unable to.

Read More ->
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Why does children’s pain get short shrift?
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When a child ends up in hospital, we assume everything will be done to
care for them, including minimizing pain.

Unfortunately, that assumption is wrong. Two new research papers serve as
a grim reminder that pain is systematically undertreated in children.

One study, led by Kathryn Birnie of the Centre for Pediatric Pain Research
at Dalhousie University in Halifax, found that fewer than half of
hospitalized children have a pain management plan. In other words,
controlling pain is often an afterthought.

The paper, published in the medical journal Pain Research and Management,
also shows that even so-called low-intensity pain matters a lot to patients.

Read More ->
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*June 1, 2017:* Certificate Course in Essentials of Palliative Care
(CCEPC) conducted by Indian Association of Palliative Care (IAPC), at
Trivandrum Kerala. Contact: education@xxxxxxxxxxxxxxxx / 8589998760 *June
2-4, 2017:* Painting exhibition at Trivandrum. Contact:
info@xxxxxxxxxxxxxxxx / 9746745502

*June 5, 2017:* One month certificate course
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 in
Pain and Palliative Medicine for Doctors, Nurses, Social Workers and
Volunteers in Hyderabad, Telengana. Contact: mnj.palliative@xxxxxxxxx

*June 5, 2017:* 10 days Foundation course
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 in
Palliative Medicine for Doctors. Contact: info@xxxxxxxxxxxxxxxx

*June 29-July 2, 2017:* Rehabilitation products sale at Saphalyam
Complex, Trivandrum. Contact: info@xxxxxxxxxxxxxxxx

*October 14, 2017:* International conference on Peri-operative Cancer
Care at Jawaharlal Nehru Auditorium AIIMS, New Delhi. Register:
http://www.irchoncoanaesthesia.com/
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For details on these programs, contact: info@xxxxxxxxxxxxxxxx. Find out
more at: http://palliumindia.org/courses/
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[image: image06]Palliative Care Information Centre
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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/
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PARTING SHOT The Tiny Things that lay us low
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*“When we stop making the world up in our heads and start meeting people
where they are, we meet… ourselves.”*

Sunshine Mugrabi is a dear, longtime friend of Pallium India. A few years
ago, she visited us at Trivandrum as a volunteer and accompanied our home
visit teams. In one of those visits, she met a man with a huge tumor on his
neck. As the doctor and he conversed, Sunshine was struck by his lack of
interest in hearing about his medication.

“I found myself getting frustrated with the man. He didn’t want to hear
anything about medicine or anything else the doctor had to say. All he
wanted to know was when he would be allowed to eat seeds again.” The doctor
explained that he would never be able to eat his favourite food, because it
can’t get past the tumor.

Everything came full circle when, a few years after her visit to India,
Sunshine had an accident. She could not move her arms or legs, and was in
excruciating pain. The doctors had no idea what was wrong with her. She was
debilitated and dependent on her husband.

Sunshine describes her biggest problem at the time – she wanted to be able
to eat more interesting food. “I wasn’t acting the way someone in a
terrible situation should act. I was thinking of my stomach rather than the
kinds of things dying people were supposed to think about.”

Sunshine recovered, in her words, “miraculously”. But that experience was
an eye-opener for her. And now she shares that experience with us.

Please read her blog *Tiny Things*
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.



*Thank you for reading & subscribing to our newsletter! Please share
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*Editorial Board:* K Govindan Kutty, Michael Minton, Sunshine Mugrabi, C
Mohanan, Kishore Nair, Rakesh Menon & M R Rajagopal.
Please send us feedback about the newsletter here...
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(A REGISTERED CHARITABLE TRUST)*

*Address:* Pallium India, Arumana Hospital, Airport Road, Vallakadavu
P.O., Thiruvananthapuram - 695 008, Kerala, India.

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