Dr Zinia Nujum, Professor of Community Medicine in Kollam Government Medical College, wins the best paper award from the Journal of Indian Public Health Association. It was Pallium India’s privilege to work with her on this study and in palliative care delivery.
The Zinia Nujum et al study is significant at least in two ways. One, it addresses suffering – not a disease, which is unusual for the healthcare system. Two, it chooses an inexpensive way of achieving this. If you go to PubMed, you will see a few articles like this; but almost all of them confine themselves to expensive solutions that can be offered (which are also possibly much less effective). Dr Zinia has gone for efficacy, safety and pragmatism.
The challenge that lies ahead is to make practical use of this knowledge. Indeed, this is a challenge that the medical profession always faces. Sadly. Research happens, information is shared, but fails to get translated to action. Will the healthcare world, particularly in low-and-middle income countries sit up and take notice? Not only in this context, but in many situations where it is the rule rather than the exception not to have access to anesthesia. Installation of local anesthetic itself may be enough to reduce a considerable extent of suffering.
And when we do this, please remember; let us go for the least expensive options, like lignocaine. Let us not add to the numbers of Indians (more than 55 million in India annually) who are subjected to catastrophic health expenditure.