The Freedom We Must Claim Next
On 15th August, India celebrates its independence. Yet, for millions of Indians living with terminal illnesses like cancer, organ failure, neurological conditions, or other life-limiting illnesses, another kind of freedom remains out of reach. The freedom to live without needless pain. The freedom to spend time with family instead of travelling hundreds of kilometres for care. The freedom to receive treatment without exhausting life’s savings. The freedom to die with dignity.
This is the freedom that palliative care strives to protect.
How far have we come?
Over the past three decades, Kerala has demonstrated that palliative care is not merely a hospital service, it is a community movement. Volunteers, nurses, doctors, social workers, local governments, and neighbours showed that care belongs where people live.
We have also made significant progress in improving access to essential pain medicines, developing national policies, integrating palliative care into health programmes, establishing training pathways, and creating centres of excellence that now mentor professionals across the country.
Thousands of healthcare workers have been trained. Community-based programmes are growing. More institutions are recognising that palliative care should begin early and not only at the end of life.
These are milestones worth celebrating. But they are only the beginning.
The unfinished journey
Despite this progress, palliative care remains available to less than 4% of Indians who need it. Every year, millions of people experience serious health-related suffering that could be prevented or relieved through timely palliative care.
Many patients still die in severe pain. Families continue to shoulder overwhelming emotional and financial burdens. Healthcare professionals often lack formal training in symptom management or communication. Entire districts remain without organised palliative care services.
For many, where they live still determines whether they receive basic healthcare services, let alone compassionate care.
Pain relief should never be determined by a postcode.
Freedom means more than pain relief
Those of us working in palliative care believe that a patient’s suffering may not only come from physical illness. It could also come from losing livelihood, from worrying about children’s education, or from loneliness.
This is why palliative care addresses what Dame Cicely Saunders called “total pain”: physical, emotional, social, financial, and spiritual suffering.
Freedom from pain therefore means far more than prescribing medicines. It means restoring dignity, preserving relationships, ensuring that no one has to suffer alone.
The ‘Kerala Model’ has taught the world that palliative care cannot be built by doctors alone. Communities matter. Volunteers matter. Nurses matter. Physiotherapists, psychologists, dentists, social workers, caregivers, students, policymakers, philanthropists, and local governments all have a role.
Every home visit, trained healthcare worker, volunteer who sits beside a patient, donor who supports a family, institution that embraces palliative care; together, they become a national movement against needless suffering.
The road to 2030
Pallium India’s vision is ambitious because the need is immense: To reach 10 million people by 2030.
This is not a target that one organisation can achieve alone.
It will require partnerships across governments, hospitals, educational institutions, civil society organisations, professional bodies, communities, and citizens; training thousands more doctors, nurses, and allied health professionals.
It will require strengthening community-based care so that support reaches people where they are, not only where hospitals exist. And, it will require making palliative care an integral part of universal health coverage rather than an optional service.
Most importantly, it will require changing the way society understands care – not as something that begins when cure ends, but as something that begins with diagnosis of a serious illness.
The freedom we owe one another
Independence is often measured in economic growth, scientific achievements, and national progress.
But perhaps it is also measured by something quieter. How we care for those who are most vulnerable, how we respond when cure is no longer possible, and how we ensure that suffering is neither ignored nor accepted as inevitable.
This Independence Month, let us broaden our understanding of freedom.
Let us imagine an India where no person is denied relief because of where they live, what they earn, or what illness they face.
An India where compassion is woven into every community, where freedom includes freedom from needless suffering.
And together, it is a future within our reach.
~ Editorial Team, Pallium India
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