June 2017
Advance directive: Supreme Court leaves it to the Parliament:
On a public interest litigation filed in the Supreme Court by Girish Gokhale (lawyer), Raj Mani (intensivist), Srinagesh Simha (palliative care physician) and Roop Gurshahani (neurologist), the Supreme Court leaves it to the government.
“Keeping in view the sensitivity and importance of the matter, we allow the petitioners to express the grievances raised in the petition to secretary of ministry of health and family welfare,” the bench also comprising of justices D.Y. Chandrachud and S.K. Kaul said.
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A matter of supreme happiness: Congratulations, Khafi.
Two of our dear associates received the prestigious Florence Nightingale award for the year from the President of India on International nurses’ day,12 May 2017 – Mr Mohammed Khafi from Thanal Charitable Trust, Lakshadweep and Ms Sindhu S, from Malabar Cancer Centre, Thalasseri.
The palliative care service at Lakshadweep has been a matter of huge pride for Pallium India. It has truly been a privilege to work with the founder Maulana and to the nurse-doctor team, Khafi and Ali who spent 6 weeks with us in Trivandrum undergoing our course. On their return to Lakshadweep, the duo just got on to Khafi’s motorbike, hung a pack each of supplies over their shoulders, and started doing home visits. The mentors from the Hamrahi team in Australia, Odette Spruyt, Sarah Jose, Sofia Lam and more recently Dr Ann Broderick from Iowa have all been very impressed by the remarkable work undertaken in Lakshadweep.
Sindhu, palliative care nurse from Malabar Cancer Centre, Talasseri, Kerala is another winner of the Florence Nightingale award. We had the pleasure of hosting her in Trivandrum some time back and working with her in a pain-free hospital initiative in her Institute.
In the past, two other palliative care nurses – Rev Sr Merlin and Mr Suresh Thaliyaril from D Nip Care, Delhi had won this honor.
Dear Khafi and Sindhu, we are so very proud of you. Hearty congratulations.
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Dr Linge Gowda wins a prestigious award
Dr Linge Gowda, palliative care physician and director of regional Cancer Centre, Kidwai Institute of oncology, Bengaluru was honoured at the venue of the European Association of palliative care conference at Madrid on 20 May, 2017. European Journal of palliative care conferred the palliative care policy award on him.
Dr Linge Gowda was the prime mover of the Karnataka State palliative care policy.
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Theme for world hospice and palliative care day announced:
The WHPCA has announced the theme of this year’s World Hospice and Palliative Care Day:
“Universal Health Coverage and Palliative Care:
Don’t leave those suffering behind”!
It falls on 14 October 2017 (2nd Saturday of October). Please see the WHPCA website for more information:
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The second Palliative Care Nurses’ Conference opens to full house!
Full house as usual.
Would you believe it? In our tiny state of Kerala with only 1% of India’s landmass, the large hall is full with palliative care nurses on 13,14 May 2017.
This is at Calicut and the event, the second Palliative Care Nurses’ Conference. What an enthusiastic gathering! The participants were particularly aiming to concentrate on improving knowledge. Pallium India’s training coordinator Sheeba and nurses Ramya and Lekshmi participated in the program.
Congratulations Sini and team.
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MCI notification on drug prescription
As per the notification issued by MCI (MCI-211(2)/2016(Ethics)/131118) which has come to effect on 8th October 2016, every physician “should prescribe drugs with generic names legibly and preferably in capital letters and he/she shall ensure that there is a rational prescription and use of drugs.”
Please click here to read the Notification (pdf)
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National Cancer Grid (NCG) takes the bull by the horn
Dr Pramesh and team at Tata Memorial Cancer Centre cannot be complimented enough. What a phenomenal job!
As part of its second national meeting, a 24 member working group on palliative care met today to create an action plan for palliative care, particularly for integration of palliative care into cancer care in the country. Considering that the National Cancer Grid (NCG) has more than 100 member institutions providing cancer care, it is easy to be very very hopeful.
The meeting closed on 21st of May 2017.
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Delightful visit from Gandhi Fellows
Sumitha.T.S, Pallium India’s project executive writes:
“Doctors carry bags of medicines and supplies to patients homes! They talk to the patient on matters other than the disease and medicines! They interact freely with the families, with the nurses and other staff!”
“Volunteers from the community are actively engaged in patient care; they get no payment at all except for the satisfaction of helping others.”
“The concept of ‘Care beyond cure’ is most appealing!”
“It works. The empathetic approach does keep away the patient’s pain and other related suffering”.
“There is such a friendly atmosphere between the team members. They are passionate in promoting palliative care.”
More than half of India’s population is below thirty-five. Grooming them into change makers through Gandhi Fellowship program is one of the most appreciable works undertaken by both Kaivalya Education Foundation and Piramal Foundation. We at Pallium India became energized by spending two productive days with ten Gandhi Fellows from different parts of our country. They were introduced to our activities – outpatient service, inpatient care, home visits and some of our national projects. In the end, we were very excited to hear their feedback, some of which are given above.
Many of them were hearing about palliative care and Pallium India for the first time. Some of them believed palliative care was meant only for elderly. There were other common misconceptions as well, among them. But after reaching here, seeing our work, those myths were dispelled. They confessed to being inspired by seeing palliative care in action.
Their wonderful suggestions are also important to us as an organization looking for higher standards in healthcare. They are:
- Digitalization of data, including the entries made during home visits.
- Avail of the use of modern equipment, for example, use digital blood pressure monitoring apparatus rather than mercury sphygmomanometer. This could save time and energy.
- Initiate marketing strategies through various websites so as to reach many minds.
- Extend effectively to other states through government or other well-wisher’s participation.
- Improve emergency service.
Precious suggestions; thank you dear Gandhi Fellows. Help us to achieve them. While winding up the two days, it seems obvious to us; the two days have made you “Gandhi Fellows for Palliative Care”.
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New book on establishing palliative care organisation and delivery worldwide
Kate Jackson from e-hospice writes to inform us about the launching of the book, “Building Integrated Palliative Care Programmes and Services published by former members of the Technical Advisory Group supporting the World Health Organization Palliative Care Initiative. The book was launched at the 15th World Congress of the European Association for Palliative Care at Madrid.
The book is available for free download: http://www.thewhpca.org/resources/category/building-integrated-palliative-care-programs-and-services
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Video of the month
Do you have four minutes to spare? Watch this video from the Open Society Foundations:
“Bringing Palliative Care to India” on YouTube
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Donate to Pallium India
The money you give will pay for essential free medicines for the poor, for their travel to the clinic or for schooling of their children, or other forms of care. Please give whatever you can. No amount is too small.
To donate, please visit: palliumindia.live-website.com/donate
Write to us: info@palliumindia.live-website.com / 9746745497
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‘Only 3% patients in Madhya Pradesh get palliative care’
Barely three percent of patients in need of palliative care are being served. The care for the terminally ill and counselling of the their families is considered a new frontier in medical care that ensures that the patient is free of pain and symptoms, said experts at a CME on ‘End of Life Care – Ethical Issues’ in Bhopal.
Palliative care should ensure that the patient is free from pain and symptom, with full control of what is happening, with the necessary emotional and spiritual support, at a place of one’s choice and is also able to leave when the time has come, without pointless prolonging of life, said Dr Ravi Gupta, onco-surgeon of Lake City hospital.
Going by estimates only, three percent of the patients across the country get palliative care and nearly all the patients receiving palliative care are in Kerala and other states in the south.
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Paralysed and confined at home, here’s how these Kerala men and women are finding their sunshine
Paralysed as they are, these men and women may not have the pleasure of sinking their feet in wet earth when the monsoon hits Kerala in the coming weeks. But that doesn’t stop them from eagerly looking forward to the coming rains.
After all, as for many others, the coming rains are important to the livelihood of these paralysed umbrella makers spread across the state. Confined to their beds and with few opportunities for a much-needed livelihood, these men and women have turned to Kerala’s famed umbrella-making trade.
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The distinction between “prescribed opioids” and “prescription opioids”- lesson for India from Willem Scholten.
“Prescription opioids are intended to be prescribed as medicines. Prescribed medicines are actually prescribed by a physician and dispensed by a pharmacy.
About 75% of fatal overdoses from prescription opioids in the U.S. occur in people who have not been prescribed opioids during the three months preceding their deaths. Thus, the majority must have obtained these prescription opioids on the black or gray market.”
Please read the blog by Mr Willem Scholten: Better Analysis Needed on Non-Medical Use of Opioids
His recommendation: “Optimal public health outcomes can only be attained when policies to minimize non-medical use are balanced with policies to maximize access to adequate pain management”.
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End of life care has been confused with euthanasia: Dr Raj K Mani
The issue in India has been under debate for close to two decades but not much progress has been made. This is because of the great confusion in terminologies relating to end of life care and the principles and policies that are yet to develop.
Against this background there was a meeting consisting of multispecialty and multi-professional participants and the proceedings were designed in a way to generate brain storming on various contentious and ambiguous issues in our midst. For an issue of such public importance, a broad consensus, participation and capacity building is required. So the agenda consisted of certain essential needs of the terminally ill person that need further exploration.
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Upcoming Events
June 2-4, 2017: Painting exhibition at Museum Auditorium, Trivandrum. Contact: info@palliumindia.live-website.com / 9746745502
June 5, 2017: One month certificate course in Pain and Palliative Medicine for Doctors, Nurses, Social Workers and Volunteers in Hyderabad, Telengana. Contact: mnj.palliative@gmail.com
June 5, 2017: 10 days Foundation course in Palliative Medicine for Doctors. Contact: info@palliumindia.live-website.com
June 29-July 2, 2017: Rehabilitation products sale at Saphalyam Complex, Trivandrum. Contact: info@palliumindia.live-website.com
October 14, 2017: International conference on Peri-operative Cancer Care at Jawaharlal Nehru Auditorium AIIMS, New Delhi. Register: http://www.irchoncoanaesthesia.com/
For details on these programs, contact: info@palliumindia.live-website.com. Find out more at: https://palliumindia.org/courses/
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Palliative Care Information Centre
Contact Pallium India’s Information Centre (9 am to 12 noon) for information related to palliative care and about establishments where such facilities are available in India.
Telephone: +91-9746745497 or E-mail: info@palliumindia.live-website.com
Address: Pallium India, Arumana Hospital, Perunthanni, Trivandrum
For more details, please visit: https://palliumindia.org/info-centre/
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PARTING SHOT
This is Sulthan of Murukkumpuzha, Trivandrum, age 14 years. He has just completed his 8th std in school. He lives with his mother (the only earning member in the family, she is employed as a coolie), sister (in 6th std) and Grandmother (a patient).
Sulthan is crazy about cricket and attends cricket coaching class. It is his desire to become a great cricket player that prompted him to take up newspaper delivery as a means to pay for his cricket coaching fees.
His day starts at 5a.m. and for 3 hours, he delivers newspapers to 180 homes. After a small break, he is off to tuition class for the next 1.5 hrs.
Thereafter he attends school from till 4 pm, after which he goes to play cricket. He earns ₹2,200 pm delivering newspapers of which he retains ₹200 for his cricket coaching fees and hands over ₹2,000 to his mother.
He can also play the chenda (drum) which he has learnt for 2 years. By the way, he also finds time to read newspapers.
You are truly inspiring, Sulthan, and will go a long way in life. Keep up the good work.
(This photo of Sulthan was taken at Pallium India’s 3-day Kuttikkoottam summer camp for children, held in April. For more photos of Kuttikkoottam Summer Camp, please click here.)