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.

Palliative Care Training Program in Silchar, Assam

2015 April 22

Pallium India, in collaboration with the Cachar Cancer and Research Centre and with the support of International Association for the Study of Pain, organised a two-day sensitization training program in Pain and Palliative Medicine for the final year UG medical students of Silchar Government Medical College. This program was the first of its kind to be organised in the state of Assam. 87 UG students, 9 PG students, HODs of various departments, including the Principal and the Vice principal attended the program. The program was well received by the participants.

For most of the students as well as the faculty of the college, the concept of palliative care was new. At the end of the training, several students expressed interest in getting a better understanding of the practice of palliative care.

There is no palliative care service available at Silchar Medical College Hospital. Apart from one doctor, Dr.Iqbal, and two nurses, Ms. Sarita and Ms Achun, at Cachar Cancer and Research Centre, there are no trained palliative care healthcare professionals there. Dr. Iqbal, Ms. Sarita and Ms. Achun had undergone 6 weeks certificate training in palliative medicine / nursing from Trivandrum Institute of Palliative Sciences.

Silchar

Indian doctors arrested for giving Buprenorphine for treating addiction

2015 April 21

While on the one hand, the Government of India accepts that pain management is its obligation, as enacted by the Indian Parliament in February 2014, doctors prescibing Buprenorphine for addiction treatment have been arrested. The doctors in Punjab since then have stopped prescribing Buprenorphine too, as part of their addiction treatment. The extent of misery it can cause is unbelievable.

Well done, IMA!

2015 April 20

We congratulate the Indian Medical Association for being advocates on behalf of patients and families. IMA has taken a clear stand, which will reduce treatment cost and benefit all, irrespective of their income. The essential elements of IMA’s suggestion are

  • doctors must give attention to the cost of medicines
  • doctors must write names of medicines legibly in capital letters
  • doctors must write the generic name first
  • doctors must look for the least expensive brand, and  prescribe them

Finding the Right Balance between Opioid Use and Misuse

2015 April 18

Are you an activist in favour of access to pain management? Do you feel sad that so much of unnecessary suffering goes on around us, just because people who need opioids are denied it?

In all our enthusiasm, let us not allow the pendulum to swing too far the other way. The world is still suffering from the backlash in the USA.

Opioids have their role in treatment of chronic, non-cancer pain. No doubt. The American Pain Society’s recommendations of 2009 include this sentence, which summarises the situation: “Although evidence is limited, the expert panel concluded that chronic opioid therapy can be an effective therapy for carefully selected and monitored patients with chronic, non-cancer pain.”

However, they need to be used with caution. Read the article in Forbes.com, Opioid Misuse In Chronic Pain Patients Is Around 25%, New Study Shows, which states that the rate of addiction to opioids, when used in chronic non-cancer pain, can be as high as 10%. Depending on the social environment, up to 30% have been shown to be misused. Diversion to illicit channels must be guarded against.

We are happy that in India, though we were so keen to overcome the regulatory barriers to opioids, from the beginning we did not argue for unrestricted access to opioids through all pharmacies. When the “Narcotics Amendment Act” comes to be implemented, strong opioids will be available only through “recognised medical institutions”.

“I’ve seen first-hand how palliative care in India is compromised by privatisation”

2015 April 9

“India is a stark example of how commodifying healthcare can lead to corruption, erode doctors’ integrity and damage relationships with patients”, says Dr Hannah Fox who volunteered for a palliative care organization in Kolkata for six months. “Money ultimately distorts decision making regardless of the culture or country”.

Hannah FoxIn an article published in the Guardian, Hannah continues, “I looked after a young man with multiple myeloma, paralysis and the worst bedsore I have ever seen eroding through his left buttock to the bone. When I first met him he was smiley with a gentle manner and few complaints. Over a month his physical condition and spirit declined. When he developed a severe infection, his wife was the one to say ‘I think he is dying’. She was right, and a plan was made to withhold antibiotic and continue symptomatic treatment. The next morning I found he had been admitted to intensive care overnight. He had had a central line inserted, was hooked up to monitoring with pumps delivering expensive antibiotics and medication to maintain his blood pressure. He was no longer able to communicate, semi-conscious and distressed. His family was only allowed to visit for a few hours each day. Despite my best efforts the treatment continued until he died a week later”.

We hope the medical system in India will see the writing on the wall. There are many injustices; we need to focus on some in our advocacy. Every year, there are more voices raised against the social evil of torturing patients and families at end of life. This unethical practice has to stop.