India is one of the largest and most populated countries in the world, with over one billion inhabitants. Although it has one state, Kerala, with some of the most progressive health policies in the world for palliative care, very little progress has been made in the rest of the country.
A key problem is the lack of doctors, nurses and other health workers who are trained in palliative care. And, despite the fact that India has its own supplies of licensed opium production, few health care facilities have morphine available; in fact it's estimated that less than 1% of those who need pain relief actually receive treatment.
For many years, we have been working with Pallium India and other local partners to identify those areas most in need, and the best way forward given the limited resources available. Typically, we work with local health authorities to run courses to train a range of health workers who are involved in providing palliative care and/or train others to do so. We then provide ongoing mentoring and support. We think this is one of the most effective ways of building sustainable capacity for palliative care.
A couple of years ago we started working in the small mountainous state of Mizoram in the north-east of India. More recently, at the invitation of the Sanjay Gandhi Postgraduate Institute of Medical Sciences in Lucknow, we have begun working in Uttar Pradesh which alone has a population of about 180 million!
'The Story of Palliative Care'
Click the image to watch this short film which gives a moving glimpse on the need for palliative care, and the plight of those who cannot afford it. It draws on Cairdeas' involvement in India.
Thanks to Snappin' Turtle for putting this together.
All to lift sagging spirits
The following article appeared in the Indian newspaper, The Pioneer, 26 June 2010, about the training course which took place at the Sanjay Gandhi Post Graduate Institute of Medical Sciences (SPGIMS) in June 2010.
"Hope should never die", even for those who are in the last phase of their life. Trying to live up to this catchline, the SPGIMS is all set to give a more humane touch to healthcare provided to cancer patients in the advanced stage of the disease and are bed-ridden.
The Institute has come up with Palliative Care service for such patients.
Apart from making an assessment of the condition of patients, the doctors, nurses and clinicians involved reach out to the patients and their kin with a helping hand.
The patients in advanced stage of the disease will be assessed by means of physiological, social, emotional and spiritual treatment so as to minimise the trauma.
Although the hospital has already attended 813 patients since June 2009, a team from the hospital has started a home-based service for the patients who are bed-ridden.
As per plans, a team of doctors will also visit the houses of the patients, assess their condition and provided counselling to the attendants.
To give further impetus to the initiative, the Department of Anaesthesiology, SGPSIMS, and Cancer Aid Society, in collaboration with UK-based Cairdeas International Palliative Care Trust, and Palliative Care Partnership, organised a five-day international workshop on palliative care, which concluded on Friday.
During the workshop, as many as 45 clinicians, nurses and social workers from various regions of the state were sensitised on the isssue.
The participants were informed about the pain and other distressing problems faced by cancer patients.
"Reaching out to patients through home visits can hep us provide proper treatment, address the concerns of patients and help families play a more active role in their care. Home visits make it less likely for th patients to be admitted," said organising secretary of the workshop Dr Dhiraj.
According to doctors, the aim was to rekindle hope and boost the sagging spirits of the patient an family members.
Efforts were made to lessen the trauma faced by the kith and kin of the patients through proper counselling.
Medical Director of Cairdeas, Dr Mhoira Leng, said that palliative care was an urgent humanitarian responsibility.
"It is about living. It is about putting life into the last days of terminally ill patients, not just adding days in their life," added Dr Leng.
Other than SGPGIMS, six other institutions that participated in the workshop included Emmanuel Hospital Association (Lalitpur), Kanpur Medical College, Chhatrapati Shahuji Maharaj Medical University (CSMMU), Jawahar Lal Nehru Medical College and Hospital of Aligarth Muslim University (Aligarth) and Cancer Aid Society.