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.

Needed: A concerted shift in the medical system

2016 May 28

“In India, there is a fight-to-the-death mentality about treating the terminally ill,” writes Dr Jean Jacob in an article titled “Last Resort: India is a bad country to die in” published in The Caravan dated 1 May 2016. “Doctors treating a patient who is past the point of being able to make her own decisions are bound to obey the wishes of her relatives, who typically opt to use all possible means to prolong her life, no matter how artificial that life might be.”

Dr Jacob writes about an 83-year old man with terminal lung cancer who was brought to the Intensive Care Unit of his hospital where he was on duty as an intensivist. After receiving a battery of treatments aimed at prolonging his life, his vital organs began to fail, and their functions were compensated with drugs and invasive tubes. “Confined to a cold bed, isolated from his family and friends, and at the mercy of strangers in white coats, he had a mental breakdown. He raved about how the nurses were trying to kill him, and demanded that he be set free.”

Dr Jacob continues: “To address the situation here, India will need legal reform, and a concerted shift in the medical system to provide greater access to end-of-life care outside hospitals. Such care, if properly planned, can be provided effectively and affordably in patients’ homes, through community-based approaches. There are numerous good examples of such systems across the world, but perhaps the best one for India to consider already exists on its soil.”

Read the complete article at: http://www.caravanmagazine.in/perspectives/last-resort-india-palliative-care

The Economist on The Problem of Pain

2016 May 26

“Americans are increasingly addicted to opioids. Meanwhile people in poor countries die in agony without them”, says this recent article in The Economist that explores how ‘tighter prescribing’ to prevent abuse has caused unintended harm elsewhere.

“The International Narcotics Control Board (INCB), an independent monitor that oversees the implementation of UN drug conventions, estimates that 92% of all morphine, an opioid commonly used to control the pain caused by cancer, is consumed in America, Canada, New Zealand, Australia, and parts of western Europe—which between them hold only 17% of the world’s population.”

“A report in 2009 by Human Rights Watch found that of some 300 Indian medical colleges, only five taught palliative care. The consequence is that few doctors know how to prescribe opioids safely. Even for patients with advanced cancer, they avoid morphine.”

Read the complete article: http://www.economist.com/news/international/21699363-americans-are-increasingly-addicted-opioids-meanwhile-people-poor-countries-die

Slow, very slow progress; but clearly positive trend in access to pain relief in India

2016 May 21

We have generally relied on the quantity of morphine going out of the Government Opium and Alkaloid Works (GOAW) as the index of access to pain relief in India. Practically, the whole amount is utilised in India and though, this is not the perfect way of assessing consumption, it is still a reasonably reliable index.

We are very glad to report to you that the trend is clearly positive. The first time in the last quarter century, the consumption of morphine in the country went up above 300kg. In fact, it was 329kg in 2015.

Morphine Consumption Chart 1998-2015

We thank Mr A. K. Saxena of GOAW for providing the statistics and all at Department of Revenue of Government of India for the support.

Better days are coming! (Wish they would come a bit faster, though.)

Syndicate Bank supports palliative care

2016 May 21

Syndicate Bank donation

On May 20th, 2016, Syndicate Bank donated a car to support Pallium India’s home visit program. At a function organized in Syndicate Bank Regional Office, Vazhuthacaud, Syndicate Bank General Manager Shri C. B. L. Narasimha Rao presented the keys of a brand new Datsun GO+ to Dr M. R. Rajagopal, Chairman of Pallium India. The program was attended by Syndicate Bank Regional Manger, Pallium India’s CEO and Justice M. R. Hariharan Nair.

We thank you for your support!

Children back home from orphanage, family rebuilt: the power of pain relief.

2016 May 20

We palliative care workers are often at a loss to convey adequately to others the simple fact: Intensity of pain can be beyond our imagination.

See this video: Using Morphine to Stay Alive

Zubair had intolerable pain from what had been diagnosed as giant cell tumor. 3 step-wise amputations later, he was in agonising pain – like needles being stabbed into him all the time.
He lost his job.
He lost his home.
He had to send his children to an orphanage.

In 1994 he was started on morphine. He has to take it even now.
But today, he is earning. He works all day, still on morphine.
He brought his children back from the orphanage. They had an education and are grown up men and women now, earning for themselves.

Thank you Ankita Rao and Atish Patel for this visual evidence about the power of pain relief.