It feels almost too trite to say that 2020 was an unforgettable year.
It brought with it so much darkness and despair, that at times it felt like an endless tunnel with no light in sight. But pinpricks of light did emerge. Slowly at first, then brightening steadily, till our vision was restored and colours re-emerged in the gloom.
At the Pallium India headquarters in Trivandrum, we are immeasurably proud of our team that refused to stall services even for a few hours. We did momentarily grapple with the initial confusion, unaccustomed to this magnitude of sudden chaos, but members of our team rallied together, held one another’s hand and made their way forward.
Eight of our dear team members came down with COVID19. We rejoice at their full recovery.
As older volunteers could no longer venture out and (very reluctantly) stayed home, we put out a call for young people between the ages of 20 and 40 who owned automobiles to come forward and help us bridge the service gap. We had to catch our breath in happy astonishment as 90 people signed up in 24 hours. After a brief orientation to palliative care, these incredible humans proceeded to travel significant distances to distribute medicines, supplies and food kits. A few amongst them who were trained as lab technicians collected blood samples and carried out BP checks. To watch these selfless youngsters in action was to have our faith in the future restored.
Right through the lockdown we remained in touch with all our patients and families through a helpline, and teams continued to be deployed to attend to the most frail and vulnerable.
World Palliative Care Day and World Disability Day celebrations have always been eagerly anticipated occasions for our patients – days when for many it is a rare chance to step out of their homes and meet other people. This year, the pandemic made it impossible to celebrate as we normally do. Rather than allowing it to get the better of us, we convened a virtual gathering over zoom. The upside to this was that family members who would not have participated in the program otherwise could also be a part of the gathering.
As technology became the new mainstay, we quickly learnt to adapt as well. We focussed our efforts to ensure that the courses we conduct do not get derailed, and took all our foundation courses online. 2020 saw 816 trainees (doctors, nurses, students, volunteers, allied healthcare workers) certified under various courses, with another 294 still undergoing training as you read this.
We formed an invaluable alliance with PalliCovid Kerala to create an online course and resource toolkit for healthcare providers to enable integration of palliative care in Covid-19 management. Faculty from across the country and abroad came together to deliver this course with impeccable expertise. Positioned as a response to a humanitarian crisis, this course was run free of cost. We are delighted to share that between the months of April and December, 1070 healthcare providers from all over India (with only two states yet to be covered) and 81 healthcare providers from 12 other countries (Bangladesh, Ghana, Indonesia, Maldives, Myanmar, Nepal, Oman, Philippines, Senegal, Sri Lanka, Singapore and UAE) have been certified under this programme. 4 Indian state governments went so far as to issue directives for their healthcare providers to participate.
We were also able to leverage technology to run several successful social media campaigns including one around Grief, End of Life Care and Death. These campaigns sparked important conversations among lay people, civil society as well as healthcare providers. One panel discussion with journalist Faye D’Souza has already been viewed around 20,000 times.
Another social media campaign in the build-up to World Disability Day highlighted perspectives of people with disabilities, and generated significant conversations around accessibility, employment, sexuality and self-care. We are tremendously excited about making 2 public toilets accessible in Trivandrum.
Through our former colleague and public health specialist Sumitha, we discovered the Coastal Students Cultural Forum (CSCF) – a group of dynamic young people who sprang into action to serve the needy after a brief online sensitisation to palliative care. They also found a nurse from within their team who was then temporarily employed by us. She performed the much needed task of attending to those within critical containment zones, upholding the value that we hold so dear – “to leave no one behind”.
At the Kerala state level, we had the privilege of joining hands with the Disaster Management Collective India (DMCI) and Hope Charitable Trust who organised food kits for about 1400 families of palliative care recipients – enough to tide them over this difficult time. We extend our heartfelt gratitude to the Indian Association of Palliative Care (IAPC), Kerala Chapter, who linked the DMCI with those in need through its district representatives. Our special thanks to Justice Kurien Joseph, Mr Manoj and the DMCI team, and to Mr Narayan Puthukudy, Mr Sreekumar and the IAPC (Kerala) team.
At the national level, Pallium India partnered with the National Health Systems Resource Centre (NHSRC) to initiate the integration of palliative care in primary public health care. We convened a team of technical experts to create modules for around 4.5 lac providers to implement services through approximately 50,000 Health and Wellness Centres. These numbers will ultimately reach 12 lac and 1.5 lac respectively. Another team of experts has already created content and overseen the training of national and state level trainers who will capacitate healthcare workers to provide palliative care at the grassroots level. We hope to nourish and strengthen this collaboration to continue improving quality of services nationwide, and are grateful for the opportunity to affect such vital change.
At the threshold to a hopeful 2021, we received news from the IAPC President Dr. Sushma Bhatnagar that the National board of Examinations has approved of the Diplomate of National Board (DNB) examination in palliative medicine. Another huge step forward.
On the international scene we were gratified to see that the 73rd World Health Assembly in May 2020 made a recommendation to all countries to include palliative care in their COVID19 strategy. World Health Organization (WHO) also announced the pain management guidelines for chronic pain in children – a process in which one of us had the privilege of being a member of the guideline development group.
Manjuthulli, an annual exhibition and sale that is organized every year by Pallium India’s volunteers, went online.
As this unprecedented year of challenges comes to an end, we raise our hats to all the healthcare workers and their families across the world who sacrificed so much to see the world through one of its darkest periods. We stand in solidarity with every single person who is still fighting insurmountable odds to be of service. We salute all our patients and their caregivers who continue to teach us that life is about meaning and dignity.
We wish for the coming year to be one of hope, recovery and healing, and that you encounter compassion, and rise resilient and strong.
From all of us at Pallium India, to all of you – a healthy, safe and happy new year.
May the light always find you.