Opioid Access in India: Is the problem solved?
When the NDPS Act was amended in 2014, people asked us, “Is the problem solved?”
The answer is ‘no’; but the situation is improving, albeit too slowly.
Here are the figures for morphine consumption in the country. Unfortunately, we still have not reached the pre-NDPS-Act-1985 consumption of about 600 Kg.
Release of Palliative Nursing Module & Self-learning Program
On 13th May, 2023, Dr Mohanan Kunnummal, Vice Chancellor, Kerala University of Health Sciences, launched Essentials of Palliative Care-India (EPCI – an online Self learning module for Doctors and Nurses).
Essentials of Palliative Care-India (EPCI) is an Indianized training module of the Center to Advance Palliative Care (CAPC) of USA. This is specifically designed for Indian healthcare professionals and organizations. It includes culturally relevant content and case studies, and addresses the unique challenges and opportunities for palliative care in India.
This course can be accessed here: https://palliumindia.org/essentials-of-palliative-care-india
Dr Mohanan Kunnummal also formally released the Palliative Care Nursing Module (20 hours mandatory module on palliative care for B Sc Nursing as recommended by Indian Nursing Council), in the presence of Dr M R Rajagopal, Chairman of Pallium India and Dr Sunil Kumar, Additional Director, Trivandrum Institute of Palliative Sciences and Pallium India team members who joined in person or via zoom.
The Palliative Care Nursing Module can be accessed here: https://palliumindia.org/2023/05/palliative-nursing-module-bsc-nursing
Are you searching for a palliative care course that you can learn at your convenience, without attending classroom- or zoom- based sessions?
Pallium India presents an online self-learning course for nurses & doctors in Palliative Care – ‘Essentials of Palliative Care – India (EPCI)‘ – a course designed to help you learn at your convenience. You have 4 months to complete the course.
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Join the course: https://palliumindia.org/essentials-of-palliative-care-india
Contact: firstname.lastname@example.org / + 91 85890 21637
Follow Pallium India on Social Media
Please join the musical event “Sangeet Sandhya”, organized by Relief From Cancer, with world-renowned bhajan and ghazal singer Anup Jalota and his orchestra at ICC in Milpitas, California, on Friday, July 14th, 2023.
The funds raised from this event will benefit cancer patients in India through CanKids India and Pallium India.
Read more: https://www.relieffromcancer.org/anupjalota
Contact: Sandip Jariwala at (510) 381 7221 or email@example.com
Sreekanth A P, Community Social Officer, Pallium India, writes:
“The camp should be at least one week long.”
“Three days is too short. Can we not stay here for just one more night?”
These responses from the children on the last afternoon of Kuttikkoottam say it all.
Kuttikkootam summer camp 2023 for children was organised from 18th to 20th May 2023. Around 40 children participated in the 3-day residential camp at Jubilee Memorial Animation Centre, Vellayambalam, Thiruvananthapuram. Kuttikkoottam 2023 was inaugurated by Mr T K Rajeev Kumar, the renowned director in the Malayalam film industry. The inauguration was followed by a drawing session by famous artist Mr Binu Kottarakkara.
Day 1 had fun activities for the children like ice-breaking session, indoor and outdoor games etc. The children and the volunteers were keen to attend the awareness class on cybercrimes and cyber security conducted by Cyber Police.
The children were looking forward to the second day with a great deal of excitement, as it was the day of the outing.
Visit our Facebook page to see photos from the event: https://www.facebook.com/media/set/?set=a.624934843002903
Pallium India supports the education of children, many of whom had been on the verge of dropping out of school, after their families were ravaged by illness or death and they were financially destroyed. Thanks to constant support and donations from our well-wishers, Pallium India has been able to keep their education uninterrupted, as much as possible.
During the experience-sharing on the last day, a 17 year old said, “I never thought I would get to see the inside of that mall till some day when I get a job and start earning. And we also got to see a movie in a theatre in the mall! My first movie in a theatre!” We were to learn soon that many of the children between 13 and 17 had never been to a movie theatre.
Think for a moment about these children and their grey lives. You can support them: https://palliumindia.org/donate/support-a-childs-education
For more information, please contact: 97467 46527 / firstname.lastname@example.org
Video of the Month
Palliative Care and the Motives of Medicine
Watch the recording of Dr M R Rajagopal’s inaugural talk at Harvard Medical School’s Palliative Care Series on May 24, 2023:
Click here to watch: https://youtu.be/H8Hv1sps-Ag
Subscribe to Pallium India’s youtube channel for videos related to palliative care and our activities. You can watch previous webinars and training sessions, as well as listen to caregivers, survivors and others sharing their experiences.
World Hospice and Palliative Care Day – 14 October 2023
This year World Hospice and Palliative Care Day (WHPCD) will be observed on Saturday, 14 October 2023, with the theme: Compassionate Communities: Together for Palliative Care. WHPCD is an annual unified day of action to celebrate and support hospice and palliative care around the world. Read to know more about the day and how to get involved: https://www.thewhpca.org/world-hospice-and-palliative-care-day
Integrating Palliative Care into Tuberculosis Treatment
A 5-day training programme on capacity building in palliative care in TB under the iDEFEAT TB project by The Union (International Union Against Tuberculosis and Lung Disease) was held at the Government Hospital of Thoracic Medicine (GHTM) Tambaram Chennai (TN) from 15th to 19th May, 2023 with Pallium India as their Education & Training Partner.
Gracing the inauguration of this first of its kind initiative were Dr Gowri Sen Gupta (Deputy Director General, Mental Health, Elderly Care & Palliative Care, MoHFW India), Dr P M Ramesh (Medical superintendent), Dr Suma Shivkumar (NTEP Consultant, WHO), Dr Rakesh PS (Senior Technical Advisor, The Union), Dr Amar Shah (Senior TB Advisor, USAID, India) and Dr Asha Frederick( State TB Officer, Tamil Nadu). The need for a scientifically structured humane approach for people suffering from DR-TB was echoed by all dignitaries.
International Nurses Day – May 12, 2023
We celebrated International Nurses Day on May 12, to express our heartfelt appreciation and gratitude to our nurses for their selfless work.
We are able to carry on taking care of the people who need our support, thanks to you all.
International Nurses Day is celebrated annually around the world on 12 May – the anniversary of the birth of Florence Nightingale.
IAE National Conference
Dr. Preeti Chauhan (Head-National Policy, Pallium India) represented Pallium India at the National Conference of Indian Association of Epidemiologists (IAE) organised by Ministry of Health and Family Welfare (MoHFW) with IAE and World Health Organization (WHO), held in New Delhi on 29 & 30 April, 2023.
Shri Vishal Chauhan (Joint Secretary, MoHFW) announced that the National Programme for prevention & Control of Cancer, Diabetes, Cardiovascular Diseases & Stroke (NPCDCS) has been renamed as ‘National Programme for Prevention & Control of Non Communicable Diseases’ (NP-NCD). Dr. Rajesh Bhushan (Union Health Secretary) and Shri Atul Goel (Director General of Health Services) were also in attendance along with NP-NCD Director Shri Sudarshan Mandal and DDG policy Shri Anil Kumar.
Palliative Care & Neurology
For more than a year, Pallium India and Dept of Neurology, Medical College Hospital (MCH), Trivandrum, have been collaborating to relieve the serious health-related suffering of patients and families who are affected with stroke. Pallium India provides rehabilitation of these patients including physical and psycho-social rehabilitation.
In this regard, two sensitisation programs were organized at Department of Neurology, MCH Trivandrum with the objective of integration of palliative care into Neurology. A session for nurses and research associates of neurology ward was conducted on May 10, 2023, and for PG residents on May 24, 2023.
The sessions, facilitated by Dr. Amirtha Thampi (Head-Clinical Services, Pallium India) and Mr. James Das (Head, Physiotherapy Department, Pallium India), were aimed at spreading awareness about the Half way Home Facility at Pallium India for rehabilitation of patients with neurological illness.
Pallium India organized an online opioid availability workshop for Haryana, Punjab, J&K, Himachal Pradesh and Chandigarh, facilitated by Dr M R Rajagopal (Chairman of Pallium India), on May 9th, 2023. The objective of this workshop was to ensure pain relief to the suffering patients in the states & UTs of Haryana, Punjab, Chandigarh and J&K.
Mr Manmohan Taneja, State Drug Controller Haryana, Mrs Lotika Khajuria, State Drug Controller J&K, Mr Sunil Chaudhary Drug Controller UT Chandigarh, Mr Amit Duggal, Assistant Commissioner FDA (Dept. of Food & Drug Administration) Punjab attended the workshop. It was for the first time that the State Drug Controllers (SDC) of four states/UTs came together at one online platform to discuss access to opioids.
This combined Opioid Availability workshop was organized to discuss the challenges faced by patients and medical institutes in accessing essential drugs for pain relief. The SDC answered their queries, clarified their apprehensions and promised their support for providing certificates to the eligible institutes. The objective of this workshop was to ensure pain relief to the suffering patients in the states & UTs of Haryana, Punjab, Chandigarh and J&K.
In presence of the medical fraternity of the Punjab, Haryana, Chandigarh, J&K and Himachal Pradesh, the Drug Controllers discussed in detail about the process of procuring opioids by medical institutes of this northern region. Patients from HP, Punjab, Jammu and many neighboring regions come to far off tertiary hospitals like PGI Chandigarh to get pain relief medications.
There was a total of 81 participants including 74 doctors and paramedical staff from Haryana, Chandigarh, Punjab, J&K and HP. Shalini AJ & Rajendra Dutt Bijalwan represented Pallium India.
Mr. R D Bijalwan (Regional Coordinator – North, Pallium India) & Dr. Haren Chandra, NPPC in-charge officer from the Govt. Of Jharkhand visited Koshish Hospice, Bokaro, Jharkhand, on 24 May, 2023. Discussions included the nuances of Palliative care services in Jharkhand along with formulation of plans for the path ahead.
They also accompanied the Koshish home care team to the villages.
Lucy Watts Obituary
“My friend Lucy Watts, who has died aged 29, lived with the knowledge that her life was going to be short, and that became the driver behind everything she accomplished.
“Her work attracted the attention of Tedros Adhanom Ghebreyesus, director general of the World Health Organization, and they formed a lasting friendship, driven by a mutual desire to make access to good palliative care available to all who need it. “
Like Coming Home
“Coming to hospice is like coming home“, says a patient treated in the Ugandan hospice set up by Dr. Anne Merriman.
When she started working in Uganda, there was no access to inexpensive oral morphine. So she set up a room to manufacture oral morphine syrup and ensured distribution across sub-Saharan African countries.
Congratulations to Dr Kalpana Balakrishnan, who heads palliative care at Adyar Cancer Institute, Chennai, for being conferred the Dame Cicely Saunders Vocational Excellence award.
Thank you for being a beacon Dr Kalpana, and best wishes for all success.
“I came to know of this very beautiful book from the International Conference of Indian Association of Palliative Care held in NIMHANS, Bangalore in 2023. Me and my wife Anasuya met Dr M R Rajagopal sir there in person. We were very amazed at his dynamic yet so humble personality. ‘Walk with the Weary’ describes his journey into palliative care and as we go deep into the book, our journey also takes us deep into the intricacies of palliative care. Thus, the walk is a memorable one for both the reader, the persons receiving palliative care and the palliative care practioner. I, myself being a pain & palliative care consultant, really feel grateful to have met Dr Rajagopal sir and furthermore came to know of his journey through his very illustrated yet genuine representaion in the above mentioned book.” – Manish D reviews ‘Walk with the Weary’ on Amazon
In Walk with the Weary: Life-changing Lessons in Healthcare, Dr Rajagopal knits his own experiences as a doctor with stories of the unique lives of his many patients, asserting that medicine can bring comfort and security to those at their most vulnerable and provide them the opportunity to not only live healthy lives but to die with dignity.
Get your copy of “Walk With the Weary” here:
If you have already read the book, please leave a review on the website or email it to us: email@example.com
Palliative Care: Helping people live better and happier
When you hear the term palliative care, the first thing that comes to mind is ‘hospice’ or ‘end-of-life care,’ but that’s a misconception. There is so much more to palliative care than we’re aware of. It is an approach that focuses on improving the quality of life of adults and children living with health-related severe complications brought on by life-limiting or life-threatening conditions.
What is palliative care?
According to the World Health Organization (WHO), palliative care prevents and relieves suffering through the early identification, correct assessment, and treatment of pain and other problems. It addresses suffering and involves taking care of issues beyond physical symptoms. More recently, it has been reframed to mitigate health-related severe suffering.
Prolongation of life or stretching out the suffering during the dying process?
There seems to be no end to the cruel suffering meted out to dying people with inappropriate life prolonging interventions during end-of-life. Please watch this video from Dr Todd Wolynn, a pediatrician.
We would agree with most of it in the Indian context though we would argue that more than profit motive, the mistaken perspective of doctors that they have a duty to prolong the heart beat at all costs, is the problem.
What do you think?
Patients and families from anywhere in India can call Pallium India’s Telehealth helpline. Health care professionals who need advice on palliative care or pain management can call our numbers.
The service is FREE and available in English, Hindi, Malayalam and Tamil.
Our lines are open from Monday to Saturday 9:30 a.m. to 4pm
Call: +91 964 588 4889 / +91 860 688 4889
In case of queries, please write to us: firstname.lastname@example.org
Pallium India maintains a state-wise directory of institutions offering palliative care services in India. The list includes palliative care providers from community-based organisations to tertiary care institutions and cancer care centers.
The directory covers critical information like contact details including phone numbers and email addresses, availability of In-patient, Out-patient and home care services, availability of morphine, etc.
If anyone you know needs palliative care support, our directory will help you find the centre closest to you. Do take a look at Pallium India’s Palliative Care Directory and let us know (Email: email@example.com or Contact us) if any centre near you is missing.
CAREERS / OPENINGS
For more openings across the country, visit our CAREERS page:
In case of queries, please write to us: firstname.lastname@example.org
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4 September 2023
6 weeks Certificate Course for doctors and nurses (CCPPM & CCPN) – at Trivandrum
Doctors and Nurses, join this six weeks certificate course in pain management and palliative care, at Trivandrum.
Start Date: 4 September 2023 (Monday)
CCPPM: M.B.B.S or BDS with permanent registration with medical / dental council.
CCPN: Any nurse holding a recognised degree or certificate in nursing.
Venue: Pallium India, Aisha Memorial Hospital Building, Paruthikkuzhy, Trivandrum.
Contact us: firstname.lastname@example.org / (+91) 85899 98760
5 June 2023
Register: Foundation Course in Palliative Medicine
19 June 2023
Donations from US can be made online on http://palliumindiausa.org/
For DOMESTIC Transfer:
Beneficiary: Pallium India Trust
Account No: 30086491915
State Bank of India
Branch: Pattom, Trivandrum
IFS Code: SBIN0003355
MICR No: 695002007
For FOREIGN donations:
Account Name: Pallium India Trust
Bank: State Bank of India (code: 00691)
Account No: 40098265669
IFSC Code: SBIN0000691
SWIFT Code: SBININBB104
Queries? Write to email@example.com or call 97467 45504
After you make a donation, please write to us at firstname.lastname@example.org for the receipt. Kindly provide your name, PAN number, contact number and address for us to issue the receipt.
Follow us for palliative care news, views and updates – as & when they happen
Sahayatra, Pallium India’s monthly print magazine in Malayalam, is meant for anyone interested in Palliative Care – patients, families, palliative care professionals, volunteers and well-wishers.
Yearly subscription rate for Sahayatra is ₹200. (Only ₹500 if you subscribe for three years.) However, we send Sahayatra free of cost to patients and their families.
To receive Sahayatra monthly magazine by post, please send your complete postal address to email@example.com. Contact: 97467 45504
Read previous issues of Sahayatra online: https://palliumindia.org/sahayatra
“We emerge deserving of little credit; we who are capable of ignoring the conditions which make muted people suffer.” (Hinton, J, Dying, 1972)
Vandana Mahajan, a friend of Pallium India, writes: “Some days are emotionally draining . Yesterday was one such day! I thought I wouldn’t write but writing helps, so here I am…!
“I have known this young man for nearly 4yrs! Now he can’t speak as he is on oxygen support, his sweet wife ( just been a year since they got married) speaks to me regularly. They live in a village from where the nearest city that can offer cancer care is 200km away.
“This young man is at EOL, very symptomatic and in severe pain. ‘dolo/ narcodol ‘ is no good. He needs morphine. How could I arrange for the same when I am sitting miles away?
“There’s always a way if we try …..and try we must !
A Journey Together…
In times of strife and pain,
When illness threatens to drain
Our strength and will to carry on,
We turn to family, friends, and community, to lean upon.
Palliative care will offer the respite,
And support of loved ones makes life bright,
We can’t avoid the end that’s nigh,
But we can be prepared and say goodbye.
Why not build a strong foundation,
Of resilient families and close-knit communities,
To cope with the challenges of life,
And ease the burden of our last goodbyes?
Let’s cherish the moments we have,
And create memories that will last,
For when our time comes to depart,
We can find solace in the love in our hearts.
Let’s come together in empathy,
For those in need of our company.
Make memories to cherish the most,
And find comfort in the love that’s never lost.
Written by Dr. Punithavathy D
(Asst Professor in KMCH Medical College and a fellow in Pallium India’s Global Fellowship in Palliative Medicine program)
Thank you for reading our newsletter. Read previous issues here
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