Published on: December 31, 2022

Dr Sangeetha Suresh, Senior Palliative care Physician at Pallium India, writes:

One fine day Pallium India’s executive director, Mr. Manoj G S called me and asked… ”What is the future of our paediatric Palliative care service that you see?”

Ken Ross and Sangeetha Suresh

I was blank for a moment. Why this question all of a sudden! I asked him “Is everything OK…what happened?”

“Just tell me what you think.”

I replied, “We are leading Palliative care experts in adult palliative care. But when it comes to paediatric palliative care (PPC), we are in a budding stage. My vision is to establish PPC of international standards at TIPS (Pallium India’s Trivandrum Institute of Palliative Sciences). And to achieve that, we will have to dedicate 2 years and work on it.”

He then asked me, “Sangeetha, do you have a valid passport?” I said, yes.

He then conveyed the full story – that I have been selected for Elisabeth Kübler-Ross (EKR) Foundation‘s Fellowship in paediatrics for a duration of 2 years starting with one week in Singapore, in 2 weeks’ time.

Omg! I didn’t have time to process it. Back-to-back emails and calls…along with my regular duties; I had to do apply for visa and book tickets. Everyone at Pallium supported me in the preparation. It was my first time traveling abroad alone. I was a bit scared too.

Finally my adventure began on 18th November, 2022. I landed at the Lion city at 6:30 am. Waiting at the airport was Pallium India’s friend and palliative care nurse Amy who works with Star PALS HCA hospice. A loving, kind, simple human being with a beautiful smile. She was my goddess-mother. I started calling her mummy later on.

EKR and Ken Ross

She dropped me in K2 guest house at Haw Par Villa. There I met 2 of my colleagues in fellowship program, Dr. Amrita Shrestha from Nepal and Dr. Lianda Tamara from West Borneo, Indonesia. After a quick refreshment we headed up to Halton to meet Ken Ross, the son of the great Elisabeth Kübler-Ross (EKR). I could not wrap it around my head – having breakfast with EKR’s son! But he was a very unassuming person and shared memories of his mother – a Swiss-American psychiatrist, a pioneer in death and dying studies.

His memories of her came flooding. Adventures, misadventures, difficulties setting up palliative care, and even close calls with death when their home was set on fire for treating AIDS patients!

These 10 days at Singapore were a wonderful learning opportunity for everyone in the program. We were the first cohort of 9 people in the fellowship program – from Nepal, Bangladesh, Philippines, Indonesia, Turkmenistan and Lebanon. Saritha and I were from India.

We could learn from esteemed global experts like Ms. Joan Marston, Ms. Liese Groot-Alberts, Dr. Katie Eastman, Professor Quah Chong, Dr.Komal Tewani, Dr.Siti Nur Nanim and Dr.Chong Poh Heng.

EKR fellowship team at Singapore

We discovered one another’s worlds. The majority of us provided palliative care on their own or with help from volunteers at their facility. None had any government assistance, and occasionally even their institution was unwilling to support this. We spoke about the issues, enjoyed learning about the programmes available for children and their families, including bereavement support, educational opportunities, and vocational rehabilitation. We try to empower families, and try to give them the confidence to face life with courage.

The importance of Pallium India’s telehealth services and of encouraging and supporting other organisations to establish palliative care, giving them training and support to begin were all mentioned as part of our efforts to reach individuals with health-related suffering throughout India. Afterwards, one of them questioned me, “How do you do all these?”

Sangeetha Suresh at Singapore

I grinned and responded, “Most of us at Pallium India consider our work to be much more than just a job. It is a commitment to making an impact on the lives of the patients and their families we care for. We are all just walking each other home!”

Being a Pallium India representative made me feel honoured since, in comparison to other nations providing palliative care, we do a phenomenal job.

It was a real eye-opener for me to learn how much stress a palliative care professional experiences and how crucial it is to deal with it. Compassion fatigue, a word used to describe the physical, emotional, and psychological effects of helping others, is a problem for health care professionals working in the end-of-life sector and may impede them from providing comprehensive treatment.

We could attend a conference on “Wellness to Wholeness: Compassionate Care for Individuals, Teams and Organizations in Palliative Care” which further highlighted the above points to me.

Singapore has one of the most effective healthcare systems in the world, both in terms of financial efficiency and the outcomes attained in terms of population health. Hospice, adult day care facilities, cancer patient rehabilitation facilities, and organisations for individuals with disabilities are all widely available. These initiatives have good backing from the government.

Wellness to Wholeness: Compassionate Care for Individuals, Teams and Organizations in Palliative Care

I will never be able to express my gratitude to Dr. Basi from Hong Kong who watched over me like a parent from a distance, while I was travelling to Singapore. Despite the fact that we have never met in person, he helped me out while I had some difficulties. In Singapore, he introduced me to Mr. Joo Kwang (Jake). That day, we had a delightful talk, and he guided my exploration of Singapore’s National University Hospital (NUH).

The whole programme was organised by Dr. Ann Toh Ying Pin, paediatric palliative care physician who collaborates with StarPALs HCA Hospice and is a member of the EKR foundation’s advisory committee. Whenever we ran into problems, she and her family were always there to support us.

Finally, my new-found mummy Amy drove me to Changi Airport on November 26 so I could catch my return flight. We enjoyed Japanese food while touring Jewel Changi. I got several pearls of motherly wisdom about life from her. We said goodbyes with aching hearts and I boarded my aircraft with many wonderful memories to keep and obligations to fulfil. The woods are lovely, dark, and deep, as sung by Robert Frost, but I have a long way to go before I sleep, and commitments to keep.

One response to “Singapore Diary – Lessons in paediatric palliative care and life”

  1. Dr.Jayachandran.D says:

    More such initiatives are required