Published on: April 30, 2013

Dear Friends,

13 04-4“Nathu has a question for me, mostly using sign language. Could I help to end his life? He had been making this request to Dr. Jitesh for weeks now, and Jitesh was not obliging. Could I?

I sit down again and hold his hands. That is not enough. Nathu is looking at me with pleading eyes. He wants an answer. I wish he could talk so that I could help him to unburden part of the suffering bottled up in him. But he cannot talk; nor can he write. Feeling very inadequate, I offer to pray that he lives with as little suffering as possible. A tear rolls down what is left of his cheek.

As I reach forward to wipe that tear, he grabs my hand and holds it close to his eyes and weeps. A minute of silence and then Nathu’s sobs subside. As we leave, his eyes smile at us, finally”.

Nathuram’s (not his real name) story is also the story of palliative care in Gujarat, India. Dr Rajagopal reports on the Palliative care project funded by well-wishers supporting Pallium India-USA and the remarkable work being done by Dr Jitesh Sarvaiah under the direction and initiative of Professor S.K.Agarwal of M.P.Shah Medical College, Jamnagar.

Please read the full report at E-hospice…

Helping hands from “Care and Share”

13 04-3Saptaswara is a Malayalam music band in Seattle, USA, focused on helping non-profit charity organizations to raise funds for their projects.

Every year they pick a cause in Kerala that requires attention, awareness and funding support and perform with live orchestra. As an added benefit the event nurtures local Indian music talents as well.

This is Seattle Malayalees favorite music event or “ganamela”, Ganolsavam. On 23 March 2013, they performed to support the rehabilitation of cancer patients and their families. The entire funds raised will be used through Care & Share to support Pallium India’s efforts in this field.

Thank you Saptaswara and thank you Mr Ashley Elanjickal and all at Care and Share.

View more photos…

From Jo’s friends, with love

13 04-2Professor Jo Eland (right) is a pioneer of pediatric pain relief working in the University of Iowa, who every year leads a group of undergraduate students to Trivandrum to learn palliative care over 3 weeks. Jo is also a great friend of Pallium India.

A group of Jo’s friends got together to honor her by creating a fund in Jo’s name to support Pallium India’s patients. The first wire transfer has just been made. What a noble way to show appreciation to a friend!

Thank you Jo and thank you Marsha and all Jo’s friends!

NDPS amendment

13 04-1We are waiting with bated breaths. Will the Parliament of India bring to fruition 18 years of our efforts? The bill for amendment of the Narcotics and Psychotropic Drugs and Psychotropic Substances (NDPS) Act is awaiting decision of the Parliament. It is tabled for the current session of Parliament, but there would be many bills waiting for action. We have approached all the Members of Parliament that we could reach, requesting that this matter be given priority, but if you know someone who can help by approaching the Secretary Generals of Lok Sabha and Rajya Sabha, (may be through members of Parliament?) that would be really helpful.

We have in these columns in the past thanked many people who contributed a lot towards taking this matter forward. We must also acknowledge the precious contribution of the lawyer, Ms Tripti Tandon, who belongs to the enormously successful “Lawyers’ Collective” led by Mr Anand Grover.

Thank you Tripti, and thank you Lawyers’ Collective, on behalf of the lakhs of Indians in pain who are going to be helped by your contribution. There is a lot more to do and we look forward to your support.

Novartis case and affordability of medicines: Supreme Court’s historic decision on section 3(D)

“After 2005 India started granting product patents on medicines. However, Section 3(d), one of the safeguards introduced by Parliament, seeks to prevent patenting of new forms of known substances unless they exhibit enhanced efficacy…. “

Read more about the Supreme Court’s landmark decision in the Lawyers’ Collective website…

Commonwealth scholarships and the Cardiff course

Applications are invited for the Diploma in Palliative Medicine course from the University of Cardiff which teaches best practice in pain management, symptom control, ethics, understanding and applying research evidence and effective communication skills as well as the psychological and social care aspects of patients with life limiting disease. The last date for submission of completed applications is 17 May 2013.

Dr Jo Hayes, the course tutor writes to say that up to 15 Commonwealth scholarships are available which will take care of the course expenses in full.

Students must complete TWO electronic applications – ONE for each of the following:

  1. The Commonwealth Scholarship Commission:
  2. Cardiff University:

All applications can be done on line – you will also need to have 2 supporting written references which can be faxed or scanned and uploaded.

Grant Applications Due: IASP Trainee Fellowships

Turn in your application materials by May 15 to be considered for these awards:

2013 IASP John J. Bonica Trainee Fellowship

  • Established in 1998 in memory of IASP’s founder, the John J. Bonica Trainee Fellowship supports training in various aspects of pain research to a trainee who is in an early stage of his or her career. This fellowship offers a stipend of up to US$50,000 per year for 2 consecutive years (up to a total of $100,000). To be considered for this fellowship, mentors and trainees must have been members of IASP for at least one year before applying.

2013 IASP International Trainee Fellowship

  • Established in 2006, this fellowship supports training in pain research, and offers a stipend of up to US$50,000 for one year of training. To be considered for this fellowship, mentors and trainees must have been members of IASP for at least one year before applying. For complete award information, eligibility requirements, and application instructions

Go to the IASP website:

Dr Roger Goucke teaches “Essentials of Pain Management”

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Ideally, pain management and palliative care should happen as a partnership between the patient and family, the community in which they live, and health care workers.  Everyone needs to be aware that pain can be relieved and also that access to pain relief is their right. Dr Roger Goucke from Australia, the founder of the “Essentials of Pain Management”(EPM) program will be in Trivandrum teaching members of the public not only the essentials of pain management but also how to teach about it to others.

On 7th and 9th of May 2013, Dr RogerGoucke will work with Pallium india and with the Trivandrum city branch of Indian Society of Anesthesiologists to conduct the EPM program to laymen. He will also conduct a “Training the Trainers” program on the same on the 8th of May.  The program will be conducted in Pallium India’s Bruce Davis Training Center at Pattom, Trivandrum.  A limited number of seats are available for the program on the 9th of May on first-come-first served basis.

Please email for information.

Curriculum workshop at Trivandrum

We have in the past informed you about the Government of India formulating a palliative care strategy and subsequently, thanks to the support of WHO (India), Pallium India organizing a workshop in Trivandrum in January 2013 to prepare a framework for implementation of the strategy. Pursuing the same, Pallium India’s WHO Collaborating Centre in Trivandrum, in collaboration with Indian Association of Palliative Care (IAPC) and the WHO Collaborating Centre at Calicut, organizes a four day workshop at Trivandrum from 06 to 09 May 2013.

At this workshop, invited palliative care experts from all over India will work with educationists to prepare curricula for undergraduate training in palliative care. Dr Vinod Shah from CMC Ve[lore, Dr Max Watson from UK, Professor Jo Eland from USA and Dr. Jochen Becker-Ebel from Germany will be the invited experts.

CME on pain

Trivandrum branch of Indian Society of Anesthetists lays emphasis on pain management by holding an one-day Pain Update and Workshop on 10 May 2011. Dr Roger Goucke will be among the faculty members. The ensuing two day conference also will lay a significant stress on pain management.

Contact: Dr D. Gopakumar on 98476 39616 or email him at

Bereavement support group honors Thankappan Chettan

13 04-5“Unarv” (meaning awakening) is Pallium India’s self-support group for bereaved family members.  On Unarv’s third birthday in April 2013, a very important person was honored – Thankappan Chettan (Chettan in Malayalam means elder brother) who came for the first meeting 3 years back when he had just lost his son, and never failed to attend except the one time when he was confined to home after cataract surgery. Thankappan Chettan gratefully remembers that his fellow members of Unarv had arranged for free eye surgery for him as he could not have afforded it.

In the picture, you see Professor Sara Varghese (a fellow member) honoring him with a “ponnada” (golden cloak).


52 year old Mr Li (not his real name) sat in his wheel chair looking into himself. Since the age of 13, he had been suffering from the very painful condition called Systemic Sclerosis. A cruel incurable auto-immune disease, it is relentless in its progress. Once long back, he was given three years to live, but he is going on, thanks to the help of the pain management team at Singapore General Hospital.

The story of his suffering is unbelievable. He got no pain relief from doctors, and then elders advised him to find opium on the streets. That gave him some relief, but the police caught him at the age of 18 years, with opium in his possession. Who was at fault, he or the medical system? He went through two years of hell in a prison. Now he lives alone.

His pain physician, Dr Jane George, introduced him to participants at the five day “Pain Management Camp” in Singapore (28 April – 02 May 2013). Under the overall leadership of Dr Fernando Cervero, President of International Association for Study of Pain (IASP) and guided by Dr Cynthia Goh, six faculty members from six different countries (Pallium India was privileged to be a part) spent these days with 28 participants from 10 countries in the region.

Most of them, we sincerely hope, will become leaders of pain management in the region, bringing relief to thousands of people like Mr Li. Thank you, IASP.

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