November 2015 Newsletter

2015 November 1
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Dear Friend,

We are glad to start with some good news.
For many years, we have been trying to make methadone available for pain management in India. We had the paradoxical situation where this medicine was being manufactured for export to other countries while our own people were denied it. A few years back, it was approved for sale in India for treatment of drug dependence; but not for pain management. As morphine is currently the only oral opioid of step III of the analgesic ladder for pain management, we have had no second line opioid for those who do not tolerate morphine well. For all practical purposes, opioid switching was only a dream in India.
Things are looking up, however. On 27 October 2015, a subject expert committee meeting was held by Central Drug Standard Control Organization. Though the committee members had misgivings, Dr Sushma Bhatnagar was able to present the facts systematically, supported by documentary evidence, which has convinced them. The committee has recommended that the drug should be available for the management of persistent pain.

Rendezvous with the Ocean on World Palliative Care Day

Ashla Rani, a volunteer, writes:

Pallium India organized a get-together of patients and families on World Palliative Care Day, October 10, at Shanghumuham beach, Trivandrum. The program was attended by patients, families, volunteers, well-wishers and many others. A group of 20 volunteers from Government Model School were present, in addition to Pallium India’s own team, to make sure everyone was comfortable. State Bank of Travancore Chief General Manager E. K Harikumar and Pallium India’s patient Manoj inaugurated the event. Pallium India CEO Mr Manoj G.S., Chairman Dr M. R. Rajagopal and others spoke on the occasion.

Naushad, a cancer patient, described how the nurses, whom he referred to as ‘angels on earth’, look after him lovingly while taking care of his every need. His words expressed clearly that care delivered with love and not as a ‘duty’ significantly improves the quality of life of a patient and allows him to live with dignity.

Everyone began to mingle, and share stories and experiences. There were also dance, song and skit performances to entertain the audience.

A couple of us discussed how we can help more people who are confined to the four walls of their house. There are many who are not even aware of the facilities that are available. How do we find them, how do we ensure that they get the care they need? If everyone could find people in their own neighbourhood who are bed-bound or wheelchair-bound, there would not be so many ‘hidden’ patients in our country!

After the programs, everyone went for a rendezvous with the waves. Then we parted, with a promise to meet again next time.
Click here for the photos of the event.

Mr Keshav Desiraju joins Pallium India as a Trustee.

Keshav-DesirajuWe are proud to announce that Mr Keshav Desiraju has joined Pallium India as a trustee.

Mr Desiraju is an officer of the Indian Administrative Services of 1978- batch and an alumnus of the Universities of Bombay, Cambridge and Harvard. He has made his mark in many positions in the Government, including that of the Union Secretary of Health & Family Welfare. Mr Desiraju has been described as a visionary and a man of action with enormous capacity to articulate complex ideas. He was the deciding factor behind the creation of India’s National Program for Palliative Care (NPPC).

Mr Keshav Desiraju, it is an honour to have you on board with us.

Wanted Medical Officer for Palliative Care Services at Jaipur

  • Qualification: MBBS
  • Salary: INR 40000 per month
  • Type of appointment: Contractual for One Year, can be extended for two more years
  • Upper age limit: 65 years
  • Preference to candidates with palliative medicine or Oncology exposure
  • Computer familiarity desirable


Contact or Apply to:

R. K. Birla Cancer Center, SMS Medical College Hospital, Jaipur
Dr Hemant Malhotra
Dr Ashwin Mathur 09829038756


For more openings, visit our Careers page.


QOD index - with India markedLien Foundation is shaking us and asking us to wake up.

Do you take pride in the quality of health care in India? See the report that the Singapore-based Lien Foundation has published, ahead of the World Palliative Care Day, which falls on October 10th.

India ranks 67th among 80 countries. Reporting this, the Times of India says “India isn’t the best place in the world to die.” Also read the report in ehospice.

See the list of countries and quality of dying. (Click on the image to enlarge). For the complete report, please visit


Call for Nominations – IAHPC Board of Directors

The International Association for Hospice and Palliative Care (IAHPC) calls for nominations to 3 seats in the IAHPC Board of Directors to serve for the 2016-2018 term. IAHPC members can nominate health professionals actively working in hospice and palliative care with demonstrated interest in the development of international palliative care initiatives and issues.

Deadline for nominations is November 30, 2015.

Nomination rules: Nominators may nominate one candidate only. Self-nomination is not allowed. Nominees have to be nominated by another IAHPC member. Click here to complete and submit a nomination form.

The new directors will be elected by a vote of the current Directors and will be announced in December 2015. For more details and to nominate, please visit this link.

Upcoming Courses

TIPS, Trivandrum, Kerala

2-day Volunteers Training Program is conducted at Trivandrum Institute of Palliative Sciences, Arumana Hospital, Trivandrum. Anyone interested in learning about palliative care can attend.

Contact:,  +91 471-2468991, 9746745497.

GCRI, Ahmedabad, Gujarat


MNJIO & RCC, Hyderabad, Telengana

Contact:, +91 91772 38901

BMCHRC, Jaipur, Rajasthan

Contact: Dr Anjum Khan Joad.

For more details on the courses we offer, please visit:

From rejection to foundation stone – reflections on a nursing development in Kerala

Plans for a new fellowship in palliative nursing are underway in Kozhikode, Kerala. Its first cohort of students has been recruited and will help to shape and test the proposed programme. Read the news in

Award for Project Hamrahi

HamrahiIt was sheer pleasure to receive the certificate from Palliative Care Australia to Project Hamrahi for Innovation in Palliative Care.

In Project Hamrahi, a group of about a dozen each of doctors and nurses from Australia and New Zealand join together to support palliative care in India. A doctor-nurse team gets an attachment with one palliative care team in India. They would visit for at least one week every year and the relationship lasts for many years.

Congratulations to Odette Spruyt, the innovator and the person who received the award from Palliative Care Australia, on our behalf too.

Are doctors more afraid of death than “normal” people?

It was interesting to read two articles, one after the other. In The Washington Post of 26 October 2015, Aaron Kheriaty writes about how doctors use euphemisms and avoid the word ‘death’. Doctors say “declaring a patient” when they mean “declaring death”. Doctors say someone “expired” as if they are talking about a cough medicine, rather than “died”.

The Independent of 6 October 2015 quotes several people who know they are going to die of some disease or other, and talk about the experience. Interestingly, none seems to be afraid of the word “death”. There is one person who says, “I told my doctor I wanted to switch to palliative care and discontinue all chemo. And it changed my life……. This time last year, my life was already gone. And somehow, amazingly, I have it back.”

The Washington Post hastens to add that gradually non-doctors also are getting to be more and more afraid of the word “death”, we becoming a death-denying society. The article asks us to re-learn the art of dying and of tending to the dying.

Seeking Experienced International Physicians

Pallium India seeks clinically experienced international physicians who are able to practice and teach in a variety of settings, include home visits, outpatient visits, and the inpatient unit. They must be adaptable to new environments and be able to commit to over 3 months. Pallium India will provide translators as most patients will prefer to speak Malayalam. Teaching will be done in English.

For more details, please visit: International Visitors

If you are interested, please write to us:

Donate Toys for children!

We are happily accepting toy donations for our weekly children’s palliative care clinic. Certain specifications need to be considered before sending the toys across, due to the nature of the children’s illnesses.

Kindly avoid toys with small breakable parts, anything with batteries, toys with sharp edges, regular sized Lego pieces, jigsaw puzzles with small pieces, games involving liquids (like the ones that shoot rings onto sticks at the press of a button), stuffed toys that have fine hair and fluff, etc.

If you are interested in sending something across, do call us (+91-9746745497) or write to Thank you very much!

Palliative Care Information Centre

Contact Pallium India’s Information Centre (9 am to 12 noon, except on Sundays & National Holidays) for information related to palliative care and about establishments where such facilities are available in India.

Telephone: +91-9746745497 E-mail:

Address: Pallium India, Arumana Hospital, Perunthanni, Trivandrum

For more details, please visit:

Sahayatra Malayalam Newsletter

SAHAYATRA, Pallium India’s Malayalam print magazine,  is meant for anyone interested in palliative care – patients and families, palliative care professionals, volunteers and well-wishers.

Click here to read the latest issue:

To subscribe to Sahayatra, please send your complete postal address to The yearly subscription rate for Sahayatra is Rs.150/- However, we send Sahayatra free of cost to patients and families.

Connect with us:   Facebook  Twitter  Linkedin  Google+

New WHO infographic on palliative care


The WHO has released an infographic on the importance of implementing the World Health Assembly’s resolution on palliative care.

Using easy to understand pictures, the infographic sheet explains what palliative care is, when it is needed, and who it is needed by. Click here to view the infographic.

It also illustrates the global need for palliative care, as well as the gaps in and barriers to access.

Click here to read more.

Narratives on Pain and Relief: Giving voice to the voiceless

In another step forward, the Journal of Pain and Palliative Care Pharmacotherapy now has a page on the website where all the narratives published so far can be accessed.

If you are in any way connected with palliative care, you must be having a story in you, that touched your heart. Do please put it in writing and send it to us: You get an indexed publication to your credit. And also the satisfaction of having helped the cause. Read more here.

Here are some of the narratives that have been published:

Through the Eyes of Child: Mary Macey’s reflection on her childhood and adolescence, after losing her mother and how palliative care brought her experience into focus.

When Two Worlds Meet: Lyndsey Brahm writes about the cultural immersion that she experienced when she visited the east from the west.

They Suffer in Silence: Savita Butola writes about the intensity of grief, related to life-limiting disease in the developing world.

Pain – When It Affects the Person: the impact of pain on the body and mind, written by Edassery Divakaran

We need your help

With rising costs, our Trivandrum Institute of Palliative Sciences is struggling to make ends meet.

We have an educational support program for the children of our patients. These children have been forced to drop out of school when disease ravaged the family. We provide financial support to complete their education, till they qualify from a course that helps them earn for their family.

For this year, we need ₹ 15 Lakhs (US$ 22,800). For example, right now, we have two girls who need to start on their nursing education, next week, and we need your help.

Whatever you can give, however small, will make a difference.

Those who are willing, please contribute:

  • For transfer from within India:
    State Bank of India
    Branch: Pattom, Trivandrum
    Beneficiary: M/s Pallium India Trust
    Account No: 30086491915
    IFS Code: SBIN0003355
    MICR No: 695002007
  • For transfer from abroad:
    Dhanlaxmi Bank
    Branch: Vazhuthacaud, Trivandrum
    Beneficiary: M/s Pallium India Trust
    Account No: 003700900000036
    IFS Code: DLXB0000037
  • Please send cheques and drafts to: Pallium India
    Address: Arumana Hospital, Airport Road, Subash Nagar, Vallakadavu P.O. Thiruvananthapuram – 695 008, Kerala, India.

For more information, please write to us:

News from around the world

Palliative Medicine accepted as a medical specialty in Bangladesh

Human rights report highlights inequalities in access to palliative care

Quality Of Death: UK Tops, India 67th, Above China

Right to pain relief: 5.5 billion people have no access, warn UN experts

The case for palliative care advocacy: Much ‘more’ to be done

Vulnerable communities, education and healthcare policy – news from IAHPC

A cure may not always be possible; but care always is.

Submit Abstracts to IAPCON2016

Free “Introduction to Palliative Care” Online Course by LCPC, Singapore

Hospital workers find solace in pausing after a death

Why people with kidney disease opt for palliative care over dialysis

Two accidents, a wheelchair and a National award from APJ Abdul Kalam: Shivani Gupta’s heroic tale

Pharmacists Can Improve Palliative Care

Making Friends With Death

A nurse by herself. At the end of a life.

Medical students use self-reflection to improve patient care


Should old age be “branded” and “sold”??

“How does old age come into the purview of palliative care?” The question was raised by a final year medical student from the USA who is spending a few months with us, helping us as well as undertaking a research project on psycho-social issues.

Her question was based on one of the patients in Pallium India’s inpatient unit, Shantha (not her real name), an elderly, bed-ridden woman whose family is abroad and who is cared for by a home nurse and our team. How does Shantha come into the purview of palliative care? By the World Health Organization’s definition, palliative care is for life-threatening diseases. Shantha has no disease; there is no diagnosis except old age.

Pallium India has always looked at the phrase “life-threatening” with the presumption that “life” means more than mere existence; that life confined to a bed or limited by four walls does threaten “life” in its real meaning. Unable to sit up by herself or even turn to a side, Shantha in her old age has her life threatened and reduced to mere existence. Does she not deserve physical, psychological, social and spiritual support? Treating her delirium alone improved her quality of life remarkably. What would be the justification in denying that care to her?

Perhaps the problem is that many diseases including cancer have been “branded” and they “sell” well. There is nothing glamorous about plain, simple old age, with physical debility. In this era of “business”, will the elderly have no support till their problem is “branded and sold”? If so, would some management experts come forward and advise us how to “brand” old age with debility and “sell” it well enough so as to get care across to the needy?

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