August 2020
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To ease the suffering in COVID-19
On 20 May 2020, the World Health Assembly (WHA73) asked all member countries to include palliative care in their COVID strategy. In collaboration with PallicovidKerala, we conduct online courses for healthcare professionals. Every course starts on a Monday and finishes on Friday, participants attending sessions on each day from 3 PM to 4.15 PM.
453 healthcare professionals have attended the course so far. 425 came from from 25 different Indian states and 2 Union Territories. 28 came from other countries – Bangladesh, Ghana, Indonesia, Maldives, Myanmar, Nepal, Oman, Philippines, Senegal and Srilanka.
We have reason to be happy about this, to be able to feel that each of the attendees would ease some pain and suffering in their places of work.
And the long term impact is significant too. Already several of them have signed up for our ECHO Foundation Course in Palliative Medicine. For many, it’s the first time that they are undertaking training specifically in Palliative Care.
Definition of Pain Updated for the First Time Since 1979
After 40 years, a multi-national, multidisciplinary Task Force of the International Association for the Study of Pain (IASP) developed a revised definition of pain that was published today in the journal, PAIN, along with the associated commentary by President Lars Arendt-Nielsen and Immediate Past President, Judith Turner. The revised definition included input from all potential stakeholders, including persons in pain and their caregivers.
The IASP Task Force crafted the revised definition, along with the six notes, to better convey the nuances and the complexity of pain in hope that it leads to improved assessment and management of those with pain. Read more: https://palliumindia.org/2020/07/iasp-pain-definition-updated
Availability of ICEMs in the COVID-19 Pandemic
The most prevalent symptoms in COVID-19 are breathlessness, cough, drowsiness, anxiety, agitation, and delirium. Frequently used medicines include opioids such as morphine or fentanyl and midazolam, all of them listed as Internationally Controlled Essential Medicines (ICEM).
In a paper titled Availability of Internationally Controlled Essential Medicines in the COVID-19 Pandemic, published in the Journal of Pain and Symptom Management (Volume 60, Issue 2, August 2020), authors Katherine Pettus, James F.Cleary, Liliana de Lima, Ebtesam Ahmed and Lukas Radbruch describe the issues related to the lack of availability and limited access to ICEMs during the COVID-19 pandemic in both intensive and palliative care patients in countries of all income levels and makes recommendations for improving access.
Click here to read the article
Palliative Care Helpline
We have opened a helpline for our registered patients in and around Trivandrum. We hope to expand the services to other areas and to the public, soon.
Helpline Number: 8606884889
IAPC’s online training program
An important initiative was launched on 29 June 2020 by the Indian Association of Palliative Care (IAPC). IAPC, led by Dr Sushma Bhatnagar as president and Dr Savita Butola as secretary, have initiated weekly online academic programs for doctors.
Click here to know more about the course. Congratulations, Dr Sushma Bhatnagar and IAPC team!
IAPCON 2021 postponed to October
Indian Association of Palliative Care (IAPC) has announced that, due to the uncertainty posed by COVID-19 pandemic, the Annual International Conference of IAPC (IAPCON) has been postponed to October 2021. Read more in IAPC’s website.
World Hospice and Palliative Care Day
This year, World Hospice and Palliative Care Day (WHPCD) falls on October 10, Saturday. Read more about the day and how you can get involved: http://www.thewhpca.org/world-hospice-and-palliative-care-day
The world has been thrown into a collective state of grief with the COVID-19 pandemic. Whether it has been losing a loved one, losing a career, or just a general sense of feeling defeated, people are struggling with how to process their grief. This has also coincided with Elisabeth Kübler-Ross‘s birth and death anniversaries (July 8 and August 24, respectively). For those who aren’t aware of Kübler-Ross’s work, she is a seminal author on grief, death, and life. To tie these together, Pallium India has been running a campaign on its social media pages. Through this campaign, we are breaking down what grief means, how to deal with it, answering questions, and sharing resources – we’ve got you covered! We also have some exciting events coming up in August. Follow us on Facebook, Twitter, and Instagram to know more.
Video of the Month
Q & A with Smriti Rana
Listen to Smriti Rana, Pallium India Programmes Director, as she answers a question on Grief, Death and Dying – how important is it to show the world that we are grieving?
This is an ongoing series. Subscribe to Pallium India’s youtube channel for more videos.
Global Palliative Care – by Dr Katherine Pettus
Katherine Pettus carries painful memories of her mother’s suffering in distress – more than 30 years back – as she says, “when doctors and nurses didn’t know any better”.
Then she became a hospice volunteer, and in 2010 wandered into a palliative care conference organized in Fresno, California, organised by Dr Nancy Hinds. What she heard there, and her subsequent learning at a leadership development program organized by Dr Frank Ferris and team at San Diego, gave her a sense of direction and she decided to engage in international advocacy for access to palliative care. Now she is advocacy officer for the International Association for Hospice and Palliative Care (IAHPC).
Katherine’s book, Global Palliative Care: Reports from the Peripheries, describes this entry to palliative care and subsequent travels in body and spirit through the world and through the realms of life and death. It describes what she learnt during her travels through Africa, India and Latin America, and what she learnt during her advocacy at Geneva and elsewhere. The book also takes us along with her intellectual travels through health, faith and spirituality.
In short, reading the book is quite an enjoyable intellectual feast. Purchase this book on Amazon (available as paperback and Kindle ebook): https://www.amazon.com/dp/B089D3SC55
How the community helped Pallium India to care for people during the lockdown
“As an organisation serving the cohort most vulnerable to COVID-19, the old, frail and the chronically ill, Pallium India is aware of its added responsibility to care for its patients and families in these uncertain times. It was this feeling of collective responsibility amongst staff members that motivated us to remain functional on all days while nearby hospitals and palliative care centres were closing down.” Dr Vijesh V V, Pallium India’s Coordinator-National Outreach Programme, writes about Pallium India’s activities during and after the lockdown.
In other news…
“Prolonging pain on ventilators can be replaced by physical and mental comfort”
Conversations on living wills, death no longer off the table during pandemic
What Not To Say To Someone Grieving During The Coronavirus Crisis
Obituary: Vijayakumaran Nair
About 14 years back, in the early days of Pallium India in Trivandrum, we had the occasion to treat Ms Rajeswary for advanced cancer with pain. From her sick-bed she continued to look after her philanthropic activities.
The day after her death, her husband Mr Vijayakumaran Nair got “Rajeswari Foundation” registered, primarily as a palliative care institution, but also providing primary care to the people in the locality. It grew to a successful institution providing inpatient care and long term care later. It was Pallium India’s privilege to be Rajeswari Foundation’s fellow-traveler.
At 1.30 AM on 02 July 2020, Vijayakumaran Nair succumbed to advanced cancer with only weeks between diagnosis and demise. Our condolences to his children, Malini, Shalini, Rajesh and to their families.
Support our activities
Make a donation to ensure that our programs continue and extend to all who need them throughout India. Click here to know more about our activities. In case of queries, contact us: https://palliumindia.org/contact
Best wishes Amy Lim and all nurses of Singapore on August 01, Singapore Nurses Day!
An epitome of humility and compassion, Amy Lim has been one of the valued friends that we have been blessed with since many years. And a valued guest that Pallium India has been honored with. She and her friend (and our friend) Lily from Malaysia spent a few days with us in Trivandrum in 2019. [Image: Amy (right) and Lily]
Please read this report in “Salt & Light” – “Less of me and more of You”: A nurse’s journey from aesthetic medicine to end-of-life care – on how she changed from Prada shoes to ill-fitting borrowed slippers, rather symbolic of her change of jobs (50% pay cut!) from a spa-like aesthetics clinic to palliative care. And what she got out of it.
PARTING SHOT
My Journey with Pallium India, and Life Beyond
Dr Saima Furqan writes:
When I completed my medical degree, I found myself unsure of what to do next. Some advised me to set up a private clinic, some encouraged me to continue with a hospital job, while others suggested I pursue an MD.
Well, as confused as I was, they all seemed like good suggestions, so I worked at a charitable clinic, took up a job in a hospital and also began preparing for an MD, but I couldn’t shake the feeling that something was missing. But no matter how much I tried, I couldn’t quite figure out what that “something” was. As I was going through this turmoil, I wondered why I was waiting for someone to get sick to come over to me? Why couldn’t I go to them instead and do something about improving their wellbeing? This made me realize that I was really a public health enthusiast, and went after a Masters Degree in Public Health.
This however, did not put an end to the confusion and sense of restlessness, which continued unabated even after securing the MPH qualification. I knew I wanted to do something for the community but considering the public health structure of India and what needed to be done I wasn’t sure what exactly I should opt for.
People say you plan and God plans, but God’s plan is always the best for you and that things happen according to what He plans. I guess I was chosen by God for a particular purpose and that is why He brought Pallium India into my life…
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