The Winter session of the Indian Parliament begins for nine days today, the 5th of December 2013. We hope that in this session, the Parliament will take up the Amendment to the Narcotic Drugs and Psychotropic Substances (NDPS) Act. The Amendment, that would ensure easier access to morphine, has been pending with the Parliament of India for a year. The last two sessions had failed to take it up. If passed, this would bring relief to the millions in pain from cancer, HIV / AIDS or other diseases.
India has at least a million cancer patients who need pain-relief and another 25 lakhs living with HIV. Current statistics show that morphine is available to only 1% of these patients.
India’s consumption of medical morphine, which was over 600 kilograms in 1985 when the NDPS came into existence, came down to a mere 38 kilograms in 1998.
We are doing all we can to bring the matter to public attention and to advocate with the Parliamentarians. Pallium India has again written to individual parliamentarians both by snail mail and email. We have also submitted to the Prime Minister and Finance Minister, a petition signed by about 175 prominent physicians in the country. The State Minister for Parliamentary affairs, Mr Rajiv Shukla has personally promised all support. Likewise, the whole palliative care community of this country is working hard to talk to individual ministers and to members of Parliament.
On the down side, this is a short session. The pressure will be more than in previous sessions.
We can only hope for the best.
It is not too late to register for the 21st International Conference of Indian Association of Palliative Care. The event is from 14th to 16th February, 2014 at KIMS, Kusabhadra Campus, KIIT, Bhubaneswar. For more details and to register, please visit the official website: http://iapcon2014.in/
The 22nd International Conference of Indian Association of Palliative Care is to be held at Hyderabad, from 13 -15 February 2015.
The Conference Secretariat:
Room No 34, Department of Palliative care,
MNJ Institute of Oncology and RCC
Red hills, Hyderabad, Andhra Pradesh, India-500004
Pallium India is particularly proud of its outreach project, for which it collaborates with Thanal Charitable Trust in the Union Territory of Lakshadeep in Kavaratti Island.
Pallium India is equally proud for association with an Australian team – the Hamrahi Project – which undertakes to match Palliative Care professionals from Australia to individual outreach projects of Pallium India to provide annual mentoring support. As part of the Hamrahi project, Dr Sophia Lam and Ms Sarah Rose visited Lakshadweep and spent several days with the local team including the founder of the program, Maulana and the pioneering team, Dr. Ali Azhar Amini and with nurse Mohammed Kafi. The beautiful island of Lakshadweep was also home to a huge burden of disease-related suffering, which the Palliative Care team is now addressing. Project Hamrahi’s support means a lot to us.
Thank you very much, Dr. Odette Spruyt, the chief force behind Hamrahi, Dr Sophia Lam and Ms Sarah Rose. And thank you USCPRC for the funding which allowed us to get started. Maulana, Ali and Kafi congratulations on all that you have achieved.
Pallium India participated in the International Conference on Emergency Medicine held at Vythiri Village in Wynad in northern Kerala on 18 November 2013. We discussed three elements of possible inter-phase between emergency medicine and palliative medicine.
The first was in the area of Pain Management, which, sadly, is very much lacking in any aspect of medical practice in our country.
Second was the area of communication and the need for the emergency medicine team to keep the patient and the family informed and therefore to learn the art and science of it.
And thirdly, about the need to have education, guidelines and protocols for withholding or withdrawing life support in situations of futility of treatment.
Professor V. S. Mahadevan of Stanford University, USA, who had earlier delivered a plenary lecture, responded to this from the audience, by agreeing to the importance of the three elements. He particularly asked a question. Why is it that most hospitals do not have opioids? When he asks for pain medication in India, all that he gets are injections of Diclofenac or Tramadol.
This is a very vital question, Dr. Mahadevan. Of course, there are numerous regulatory barriers to opioid access, which we hope will be removed by the Indian Parliament in its Winter session in December 2013. But we are sure, it is not only a question of regulations. All the regulatory barriers that apply to morphine also apply to Fentanyl, a much more expensive opioid. Why is it that the more expensive Fentanyl is available in many hospitals in many formulations while morphine is not?
Those who participated in the discussion on the subject agreed that closer interaction between emergency medicine and palliative medicine is indeed necessary. Dr. P.P.Venugopalan and team (who organized this conference and facilitated this interaction), Pallium India thanks you. And we congratulate you for taking emergency medicine out into the community and saving many precious lives.
Our close associate, Dr. Priyadarshini Kulkarni, who is the Medical Director of Cipla Palliative Care and Training Centre at Pune is the winner of this year’s annual award of Cancer Aid and Research Foundation. Congratulations Dr. Priyadarshini Kulkarni