At this moment, over a million people in India are in unimaginable pain. We refuse to look the other way. We choose to hear the cry, and to do what we can.
Please join us. Your help is needed.

Scottish Parliament hosts the Religions of the World Charter for Children’s Palliative Care

2017 February 23

On the 8th of February 2017, Silvia Lefebvre D’Ovidio presented the ‘Religions of the World Charter for Children’s Palliative Care’ to Members of the Scottish Parliament, faith community leaders, child-patients and their families, international palliative care advocates and members of the press, in a ground-breaking initiative promoted by The Edinburgh Medical Missionary Society (EMMS) International.

This is the first time that an important political institution has acknowledged the significant value of this Charter and the role that religions can play in the development and diffusion of palliative care for seriously ill and dying children around the world.

EMMS International commented: “This event represented a historic moment for Scotland’s Parliament; it was an ideal opportunity for MSPs to learn more about this unseen problem and contribute to creating a fairer world where every child receives palliative care should they need it.”

Let us hope that this initiative will be taken as an example and reproduced in other institutions around the world.

How good is access to palliative care in Kerala?

2017 February 22

What do you think? Poor? Good? Very good? Excellent?

Read the article in the Journal of Global Oncology, titled “Oral Morphine Use in South India: A Population-Based Study” by M.R. Rajagopal, Safiya Karim, and Christopher M. Booth.

Access to palliative care is notoriously difficult to measure. The world has accepted per capita morphine consumption as the index.

If you want the good news, access to pain relief in Kerala is at least four times better than the national average.

But wait, there is some bad news to follow. If we take UK and some West European countries as ideal (USA and Canada are not ideal as their high consumption is suspected to reflect some diversion of prescription drugs to illicit channels), 150-200mg of morphine (or its equivalent) per year would be optimal. Unfortunately, the consumption in Kerala is still only about one hundredth of that. And, only 1/4th of the global average.

You find it difficult to believe? Yet this is a fact despite the widespread recognition of the Kerala model. Why? The main reason is that hospitals do not use morphine for pain relief following operations, after accidents or even in cancer pain. The essential morphine is not available in majority of the hospitals.

Moreover, even in cancer, pain relief reaches too few, too late. There is almost unbelievably high variation in opioid access between various districts of Kerala.

We are glad that the Government of Kerala is considering palliative care as one of its focus areas. Things are bound to improve in the next few years.

IAHPC Traveling Scholarships to APHC and IPHPC Conferences

2017 February 21

The International Association for Hospice and Palliative Care (IAHPC) announces that it will provide the following scholarships:

  • Twenty (20) scholarships to support the travel of palliative care workers to attend the 12th Asia Pacific Hospice Conference (APHC) 2017. The conference will take place at the Suntec Singapore Convention and Exhibition Centre in Singapore on July 27-29, 2017. Deadline to apply: February 28, 2017

In order to apply for a traveling scholarship, applicants must be current members of IAHPC and should not ave received grants from IAHPC in the past 3 years.  (If you wish to apply and are not an IAHPC member, you may join by clicking here.)

Preference will be given to applicants:

  • Living in Lower, Lower-Middle and Upper-Middle income categories as per the World Bank income classification data. See here.
  • Applicants who have been IAHPC active members for two or more consecutive years.
  • Actively working in palliative care.
  • Graduated less than 10 years ago from specialty or medical school
  • Have an accepted abstract for poster / oral presentation. Proof of acceptance of the poster will be required.

More detailed information about the application process and the online form are available at the IAHPC website here. If you need information on how to apply please contact Genevieve Napier, IAHPC Manager of Programs and Projects at

The Elephant in the Room: an external view

2017 February 17

There’s an elephant in the room.
It is large and squatting, so it is hard to get around it.
Yet we squeeze by with, “How are you?” and “I’m fine,”
and a thousand other forms of trivial chatter.
We talk about the weather. We talk about work.
We talk about everything else, except the elephant in the room.
“The Elephant in the Room” by Terry Kettering

There is indeed a large elephant in the room – we have become quite adept at squeezing past it. That large elephant is the burden of disease-related suffering and the room is India.

How does it all look to someone looking in from outside?

Jesse Bossingham is a volunteer from USA. According to his blog, he is “interested in the ways medicine is culturally, spiritually, and institutionally located.” Specifically, he wishes to “study different modes of death and dying around the world.”

As a part of that quest, Jesse spent two weeks at Pallium India this February, observing the way we function, trying to understand the culture and methods. “I had hoped to fade into the background and watch, but it is clear that won’t work.” As he does not understand Malayalam, he has to rely on body language and hasty translations.

In the course of a fortnight, he senses the elephant in the room – huge, clear and ominous. In his blog titled “Talking About the Elephant: Two Weeks at Pallium India“, Jesse writes about his experiences as he shadowed the home visit team, and at the outpatient clinic, and in the inpatient ward. The little things that we do not perceive, that we consider normal, that we take for granted, jump out at us from Jesse’s words. Do read Jesse Bossingham’s blog.

Bruce Davis Gold Medal 2016 awarded to Rohanti Ravikulan

2017 February 15

In an elegant inaugural function of the 24th International Conference of the Indian Association of Palliative Care (IAPCON 2017) held at Coimbatore on 10th February 2017, the coveted Bruce Davis Gold Medal was handed over to Dr Rohanti Ravikulan with a citation and a cash award of ₹25,000.

The Gold Medal was instituted by Institute of Palliative Medicine, Kozhikode, in honor of Wilfrid Bruce Davis MBE, who has been a godfather of palliative care in the country from early years.

Congratulations, Dr Rohanti Ravikulan, and thank you, Bruce, for your contribution to relieving disease-related suffering in this country.