Published on: April 20, 2011

Dr Sreenivasa Surisetty is a palliative care physician in Tirupati, Andhra Pradesh. He took the trouble to undergo training in palliative care and provides free palliative care consultation and even does free home visits. He writes to say that patients seek him out and come on their own, but he asks:

“Why do doctors not refer patients to me?”

The frustration in Dr Sreenivasa’s words is palpable. It is the frustration shared by scores of pioneers who started palliative care service and found the public warmly responsive but were cold-shouldered by colleagues.

Best wishes, Dr Sreenivasa. We hope the well of compassion and empathy in you will help to quench that fire of frustration.

Principles of Communication to Ensure Patient Safety

Pallium India participated in an important event on World Health Day, 7th of April 2011, as part of the National Initiative on Patient Safety (NIPS).

The “Workshop for Patient Safety in Healthcare Facilities” (pdf) was organised by the Department of Hospital Administration of All India Institute of Medical Sciences at New Delhi, in collaboration with WHO (India).

This was the sixth workshop in which participants from 20 different medical colleges in different states of India participated. The meeting discussed, and generated action plans for several essential features for patient safety including surgical safety, infection control, drug-related factors and so on, but also communication as an important factor to ensure patient safety. Teams from participating Medical Colleges prepared action plans to improve communication within their institutions.

We believe that NIPS is a major and pragmatic initiative with the potential to make medical practice safer for 1.2 billion Indians. Inclusion of communication skills as an essential feature of NIPS shows the organisers’ vision.

Kudos to you, NIPS team! Pallium India considers it a privilege to be associated with you.

Watch a promotional video on NIPS at our blog…

Traveling scholarships from IAHPC for courses in Trivandrum and Hyderabad.

The International Association for Hospice and Palliative Care (IAHPC) has granted a scholarship program to Pallium India to provide for support to professionals who want to undertake 4-6 weeks’ courses at the Pallium India projects in Trivandrum and Hyderabad.

To compensate for the recent hike in travel and other costs, IAHPC has agreed to increase the maximum ceiling as follows:

  • Travel costs: Rs. 30,000
  • Accommodation: Rs. 10,000 per month

Please visit for details.

Pallium India’s World Health Day Interview with UNODC

On April 7th, the World Health Organization’s World Health Day 2011, the United Nations Office on Drugs and Crime published an interview with Pallium India’s Chairman, Dr M R Rajagopal, where he shares his thoughts on increasing the availability of opiod analgesics for patients in India, through balanced regulatory mechanisms:

India: The principle of balance to make opioids accessible for palliative care

In the state of Kerala in South India, Dr M R Rajagopal has been working in the field of ‘Palliative Care’ for over twenty years. As the Chairman of Pallium India, he and his team have been working to increase the availability of such drugs for patients. UNODC South Asia interviewed him to understand the dimensions of the situation in India and also some of the effective solutions that have been tried to improve access to these drugs, while ensuring that they are not diverted for illicit purposes.

The questions asked by UNODC:

  1. Please explain what is Palliative Care. How does it relate to drug control?
  2. What is the scenario regarding the availability of these opioid drugs in India?
  3. Can you explain what these regulatory procedures are?
  4. You have been working in this area for over twenty years. Can you share some of your experiences and some good practices that are being followed?
  5. What do you think needs to be done further to increase availability of opioids for palliative care?

Read the full interview & answers to these questions on the UNODC blog…

Note the Change in Date: Course at Trivandrum

abOdE of LoRD VisHNu...The next six weeks’ certificate courses in palliative medicine, palliative nursing and palliative care instead of starting as usual on the first Monday of the month, will start on 16 May 2011 and will end on 25 June 2011.

The subsequent course, as scheduled, will start on Monday, the 4th of July.

Those who wish to apply for the courses, please apply using the application forms here:

Major Development in Hyderabad: Pediatric Palliative Care Training Program

In 2006, Pallium India had the privilege of working with INCTR, the American Cancer Society and MNJ Institute of Oncology to develop a palliative care training center in Hyderabad. In addition to developing short courses, the training center has also developed a pediatric palliative care program.

Now the center announces the first major pediatric palliative care training program in the country – a one year fellowship.  Please see the details below and download the application form:

International Fellowship in Pediatric Palliative care

AV17-34 World BankMNJ Institute of Oncology (MNJIO) in collaboration with the International Network for Cancer Treatment and Research (INCTR) and Pallium India calls for applications for one year integrated International Fellowship in Pediatric Palliative Care.

About the course

It is a one year program. Most of the year training will be carried out at MNJ IO. During the fellowship the stipend will be paid as per the hospital regulations.

The training aims to provide the skills, knowledge and attitudes required to practice palliative care for children with cancer, HIV and AIDS and other life threatening illnesses. The program will be conducted under the supervision of renowned national and international faculty. The fellow will also get an opportunity to spend a period of training at the Institute of Palliative Medicine (IPM) at San Diego Hospice, USA.


The candidate should have a M.B.B.S degree with permanent registration with medical council and MD or post graduate diploma in clinical specialty and a long-term commitment to palliative care. Preference will be given for post graduate qualification in pediatrics. Preference will also be given to a candidate applying from the state of Andhra Pradesh.

  • Date of commencement: 01-05-2011
  • Number of seats: one


Contact for more information:
Course coordinator, Department of Palliative care
MNJIO, Red hills, Hyderabad-500004
Phone: 040- 23397000, 23318424, 09177238901

New Issues of Sahayatra Malayalam Newsletter

We are happy to announce that the February & March 2011 issues of SAHAYATRA, our monthly Malayalam newsletter, are now available for download here…

Kathy Holloway on the Frightening Facts About Use of Medicines

Dr. Kathleen Holloway, Regional Adviser in Essential Medicines WHO South East Asia Regional Office, gave an illuminating talk during the National Initiative in Patient Safety workshop at India Habitat Center, New Delhi on 8 April 2011.

During her talk on Safety in Drug Use, she quotes from the World Health Organisation’s Rational use of medicines:

Rational use of medicines requires that patients receive medications appropriate to their clinical needs in doses that meet their own individual requirements, for an adequate period of time, and at the lowest cost to them and the community.

That being the ideal, she points out the global estimated reality today:

  • More than half of all prescriptions may be incorrect
  • More than half of all patients fail to take them correctly
  • In primary care, less than 40% of patients cared for by health professionals in the public sector and less than 30% in the private sector are treated in accordance with clinical guidelines.
    (Source: WHO 2009)

It is almost unbelievable!

You can find out more on this topic at the WHO’s Rational use of medicines website…

What Should an Ideal Palliative Care Curriculum Include?

The goal of training is to change practice; not simply acquire knowledge yet too often curriculums and assessment focus on knowledge and skills.

A quote from Dr Mhoira Leng‘s paper, Networking and training in palliative care – Challenging values and changing practice, for the Indian Journal of Palliative Medicine.

To illustrate this point, she quotes the following responses from participants of palliative care training programs:

  • ‘I will be a better doctor now’
  • ‘This palliative care course has reminded me why I came into Medicine in the first place.’
  • ‘I feel better equipped to help people and their families.
  • This will help my practice from tomorrow.’
  • ‘I have learned to listen.’
  • ‘I now understand what palliative care means and there will be a palliative care team in my hospital from this year’.

No doubt, a change in attitude is as important as knowledge and skills!

You can read the full article (free access) on the IJPC website (Vol 17, issue 4, pages 33-35):

“Networking and training in palliative care – Challenging values and changing practice.”

You can also read about Mhoira’s recent “Whirlwind Tour” of India on her blog.

Stop Torture in Health Care Campaign

What Is Torture in Health Care?

  • A young man is left to die in pain because of archaic restrictions on medicines.

  • A woman is sterilized without her consent because she has HIV.

  • A teenager with a drug problem is locked away in a “treatment” center where he is beaten and abused.

International Federation of Health & Human Rights Organisations (IFHHRO) in collaboration with Open Society Foundations and other NGO partners, is spearheading a initiative to stop cruel, inhumane and degrading treatment in health care settings. The main issues this initiative focuses on are forced/coerced sterilization, denial of pain relief or the non-accessibility of palliative care and detention for treatment.
This global effort builds on the recent groundswell of civil society activity to protect and advance human rights in health settings. The Campaign seeks to hold governments accountable for the most egregious abuses perpetrated against citizens in the name of health care.

We encourage you to support this important initiative!

Go to & follow @carenottorture on Twitter.

Visit our blog to see more videos from the campaign…

POLL: Is Leprosy Still a Problem?

Broadcast recently in the UK on Channel 4 foreign affairs series Unreported World, India’s Leprosy Heroes, highlighted the problem of leprosy in India. The report reveals the numbers of new cases in some areas could be much higher than previously estimated, despite the Indian Government’s claim that the disease has been eliminated.

Reporter Seyi Rhodes travelled with ‘local hero’ Vagavathali Narsappa from Shanti Nagar colony in Ranga Reddy District, Andhra Pradesh to the Niani Leprosy Hospital, Allahabad, Uttar Pradesh. Along the way meeting other leprosy sufferers and confronting the stigma that surrounds the disease.

So, has leprosy really been eradicated, and are we only seeing the residual problems from earlier incidence of the disease?

Free Resource: Guide to Pain Management in Low Resource Settings

The Guide to Pain Management in Low Resource Settings from the IASP Press (International Association for the Study of Pain) is now available as a free download.

The guide is edited by Andreas Kopf and Nilesh B Patel, with multi-specialty, multinational authors.

Download the guide here… (PDF)

Happy reading!

The editors would value your feedback on the Guide, please take a moment to answer a short survey…

Opportunity for Young Palliative Care Physicians

Are you a palliative care physician from a low-middle income country, with at least five years of experience and desire to do more?

Here is an opportunity to attend the International Palliative Care Leadership Development Initiative (LDI) organized by the Institute for Palliative Medicine in San Diego, California. Read and hear what previous LDI Participants have to say:

“Being part of the Leadership Development initiative has really opened closed doors within me. Through being made aware of the closed doors and opening them, I am becoming a better leader who is not just focused on developing herself only, but others working with her. I have learned that I can develop the potential within me and also the potential within the other team members, thus making them effective leaders as well. This way, our organization is able to exhale,”

Applications are now being accepted (DEADLINE: April 30, 2011) for Cohort 2 from January 2012 to December 2013:

Growing Global Leaders… Advancing Palliative Care

We are delighted to announce the second Cohort of The International Palliative Care Leadership Development Initiative (LDI).

Cohort 2 will run for two years from January 2012 to December 2013. The LDI is for palliative care physicians who wish to develop critical leadership knowledge, skills and behaviors that will help them to advance palliative care capacity locally, nationally and internationally.

The ultimate goal of the LDI is to increase world-wide access to excellent palliative care for those who need it.

Through three (3) residential courses (2 weeks in February 2012; 1 week in November 2012 and 1 week in November 2013), inter-session leadership activities and expert guidance from global palliative care and other leaders, participants will develop increasing confidence and have powerful leadership experiences. Conceptual and practical tools and instruments will be used to enhance self-awareness and leadership skill building.

Six focus areas are built into the LDI curriculum:

  • Core leadership skills
  • Presentation, facilitation and mentorship skills
  • Strategic planning and implementation skills
  • Organizational leadership skills (local, national, international)
  • Academic leadership and research skills
  • Community organizing, communication campaign strategies, policy craft

Eligibility Criteria

To be considered for the LDI, eligible applicants must be:

  1. Physicians with a minimum of 5 years of practice in palliative care
  2. Preferably living and working in a low or middle income country (as defined by the World Bank…)
  3. Capable of reading and speaking conversational and medical English fluently
  4. Currently working in a clinical, educational, research or advocacy activity with a primary focus on palliative care
  5. Committed to continuing to work in palliative care throughout the two years of the LDI experience, and afterwards
  6. Able to demonstrate leadership activities beyond the delivery of palliative care to patients and families
  7. Able to demonstrate the potential to increase palliative care capacity
  8. Self-motivated with the desire to lead – locally, nationally and/or internationally

DEADLINE: April 30, 2011 by 24:00 hours in San Diego, California (Pacific Time = GMT -8hrs) without exceptions – Successful applicants will be notified in August 2011

Why Did We Ask for Your Narratives?

When someone talks about pain or suffering related to disease, what is the personal experience that comes to your mind first – as a patient, as a relative or as a health care professional?

new penIn the November 2010 issue of our newsletter, we had requested your submissions for a new “Narratives” feature in the Journal of Pain and Palliative Pharmacotherapy (JPPCP).

We seek not only stories of pain and suffering but also of palliative care and relief – please share your story with us…

Why should you?

Please take a few minutes to read this recent article in JPPCP, asking:

We’d like to thank Informa Healthcare for providing free & open access to this article for everyone, and thanks to JPPCP’s Editor, Arthur Lipman, for starting the “Narratives” feature.

Be an early bird and save money!

The last date for early bird registration has been extended to 25th April for the Asia Pacific Hospice Network‘s 9th Annual Conference on July 14-17, 2011 in Penang, Malaysia.

For details, please visit


And to conclude: let us quote Dame Cecily Saunders, the founder of modern palliative care movement:

‘…if we can come together, not only in our professional capacity, but also in our common vulnerable humanity, there may be no need of words on our part, only of respect and concerned listening…’