Is every dying person also a living person?
Could grieving turn into a disease?
How ‘complicated’ can grief be?
Do people who deny death often have horrible ends?
Does suffering cease to be suffering when it has meaning?
Are you good at saying ‘final’ goodbyes?
Here is a discussion on these and many other questions related to dying. Listen to this SynTalk – short for Synthesis Talk – a concept developed and realised by an amazing couple from Mumbai, Rajat and Jyothi.
In this talk, titled “The Last Few Days” Abodh Aras, an animal lover and CEO of “Welfare of Stray Dogs”, Dr Santosh Chaturvedi, professor of psychiatry from NIMHANS and Dr M. R. Rajagopal, chairman of Pallium India talk to Rajat on 11 May 2019.
For all SynTalk episodes, click here: https://soundcloud.com/SynTalk
Pallium India’s attempts to understand the health care needs of people living in tribal areas of Trivandrum led to an expedition on 7th April 2019 to Chatanpara, a small tribal village in Vithura panchayat in Trivandrum district. I was lucky to be a part of the medical camp that was held to commemorate World Health Day.
We were a group of 20 that included doctors, nurses, MSWs, admin staff and palliative care assistants. We enjoyed the scenic beauty en route the 90 min drive to our destination and reached around 10.30 a.m. Chatanpara has a small tribal settlement of about 90 houses and these tribes are called Kani tribes. The chief of the tribe called ‘Moopan’ was Echan Kani.
We set up camp in Chatanpara and split into two teams: one for outpatient service and the other to cover home care. I was in the OP team. It took personal visits by our Advocacy manager Babu Abraham to many of the hamlets to get about 20 patients to come to the OP clinic and they were attended to. Most of the ailments noticed were diabetes, hypertension and a couple of cases of cancer. We were surprised to learn that although visits by other organizations including Ayurveda hospital preceded ours, the tribals were not keen on availing these facilities. They have their own traditional medicines with which they managed their minor ailments. The patients comprised of 3 generations and each of them had their own attitude towards seeking healthcare. Whilst the older generation never ever availed health care services even for deliveries, the next generation managed their minor ailments traditionally. The new generation of school/college going youngsters were more informed and receptive to seeking health care facilities.
It struck me that tobacco was very much part of their lives especially among the older generation. Even women in their early 30s were addicted to this habit. I made them aware of the adverse effects of chewing tobacco but they have become so addicted that I doubt very much if my words had the desired effect. An old lady said she could do without food for a day but couldn’t afford to miss her tobacco.
The younger generation, on the contrary, are very well informed and try to induce the elders to kick the habit. Another factor that drew my attention was that generally they were all malnourished perhaps due to ignorance and tobacco chewing. Even a mother who had insufficient breast milk to feed her 3 month old baby didn’t know of formula feeds.
Our home care team visited about 10 houses and they had the same story to tell. It is understood that the team was assisted by 2 natives and the trek to many of the houses was ardous involving steep climb and descent, carrying our medical kits. It involved crossing a stream and guarding against bisons and elephants about which the team was warned.
Most of the families had a thatched hut as well as a proper cemented one provided by the Panchayat, but they preferred to stay in the thatched hut by day and the other one by night. I found this to be rather unique. We were also spellbound by the cleanliness within their houses. Every family had a loyal companion, their friendly dog. Almost every family grew coffee bean, mangoes, jackfruit etc. in their premises.
This trip was truly fascinating for me, rewarding and will remain etched in my memory for a long time to come.
May 12, 2019, 3:00 PM to 4: 30 PM
Nurses care.
They dispense comfort, compassion and care.
Often, they make more difference to human lives than any other health care professional.
Palliative nursing provides relief from pain and other suffering, and provides mental, social and spiritual well-being to individuals with life-limiting illnesses, and to their family.
The concept is gradually changing. Palliative care is no longer limited to certain incurable diseases; it is not only end-of-life care. Today, palliative care encompasses relief from all serious health-related suffering.
Palliative care nurses need to be empowered more than ever: to satisfy this growing need, for helping health care nurses to integrate principles of palliative care in their practice and to transmit enough nursing expertise to families and to volunteers.
Trivandrum Institute of Palliative Sciences (TIPS), a WHO Collaborating Centre created by Pallium India Trust, is organizing an online forum on International Nurses Day (May 12, 2019) to discuss and share experiences on how palliative care nurses can keep abreast with recent advances and learn to help nurses across all health care fields to integrate principles of palliative care.
You are welcome to join us online on 12 May 2019 at 3 p.m. Please do join in as individual or a group.
- The program is open only to those who have already been trained in palliative care.
- Participants should have good internet connectivity.
No; there is no registration fee.
Yes, we can help you with advice on technology.
Contact Details:
For more information on this session or if you need any assistance, please call us at +91-6282902450 or write to us at tipsecho@palliumindia.org
Moonshine Agency‘s feature film “Hippocratic – 18 experiments in gently shaking the world” has won 3 awards at this year’s Global Independent Film Awards including the Gold Medal Humanitarian Award (Hippocratic / M.R Rajagopal), Silver Medal Best Documentary Feature (Hippocratic / Mike Hill/ Sue Collins – Moonshine) and Silver Medal for Best Editing (Alex Archer).
Congratulations, Mike Hill, Sue Collins, Alex Archer and everyone at Moonshine Agency for this recognition!
To watch Hippocratic, visit http://hippocraticfilm.com/
Dr Rukmani Lobo, a palliative care physician in Goa, told us this story from Nagpur during her work with the hospice Snehanchal:
Snehanchal has social workers posted to stay near the registration desk in a major government hospital. (This privilege of occupying some space in a corridor was obtained after some long struggles; but eventually the powers permitted it.). The social worker’s role was to find people who needed palliative care and to direct them to the hospice.
One day, a social worker found a man and his wife lying helpless in a miserable state outside the hospital. A chowkidar was asking them to move away; but the man obviously was unable to. He had a nasty cancer on his cheek on which maggots were crawling about and feeding themselves. The hospital had told him the usual, ‘There is nothing more we can do. Go home and come back after a week for review.’
If only they had told him not to come back, they would have somehow gone to their village. But here he was having to come back to hospital. Strange, isn’t it? He is rejected without his wound with maggots being treated; yet the doctor’s word seems to be law to them.
The social worker wanted to take him to the hospice. Initially the family was reluctant to go. There was clear lack of trust in humanity! But after some persuasion, and after clear promises that no payment will be required, they accepted the invitation, possibly because they had little choice. The man and his wife were taken to the hospice.
The loving care cleared the wounds of maggots. The man lived there for nearly a month and died.
But the story does not end there.
A month later, a group of villagers led by the man’s wife came to the hospice. They carried several heavy sacks with them. They would not say what they wanted; they wanted to see the founder-director, Mr Jimmy Rana. The staff explained that he had gone back home for the day. But the family was insistent, “Just call him and let us talk to him.”
They obliged. Mr Rana came on line. When he learnt that it was the dead man’s family, he agreed to drive back to the hospice.
The sacks that the villagers brought had several jars of eatables and a jar of money too. That was the ritual; all the villagers would chip in with money and food stuff with which the family would host a feast. The villagers would enjoy the feast and then the man’s soul would be set free.
But in this case, the villagers had got together and decided that the usual ritual just wouldn’t do. They decided that they would not have the feast. Everything collected including all the money was to be donated to the hospice. They could think of no better way of setting the man’s soul free.
***
When we talk about the community participation in Kerala, too often we get an immediate response, “All that may happen in Kerala. It wouldn’t happen in our place.”
We are sharing the above story for the attention of everyone who believes in that line. There are people like these villagers, in every place. Maybe the busy habits of city-dwelling may have changed some, but deep inside there would be a lot of people in any community who would be willing to help those around them. They just need a facilitator who shows them the way to putting their humanity to practical use.
