Page 1 of 2 the Hindu Business Line : Making Every Moment Better 5/18

The Hindu Business Line : Making every moment better Page 1 of 2

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z Investment World z eWorld z Brand Line z Mentor www WGU edu AdsbyGoogle z Life Stories in this Section z Brand Quest Hitting the right note z The New Manager Caregiving:Cipla's palliative care centre, at Warje, near Pune. Making every moment better z BL Club Two trains z Smartbuy P.T. Jyothi Datta z Books z Gallery Ambition peaks at 53! There are no bed numbers here, inmates are known by their names. The doctors and nurses are not in uniform. And there is no smell of cleaning agents, familiar in a hospital environment. Stocks Pilgrimage to Patan In fact, paintings adorn the walls of corridors and the soothing sound of running water and an eye-full These fruits of labour last z Quotes of greenery greet you at every level. And it was the greenery that made the late Vinod D'sa longer z SE Diary comfortable at Cipla's palliative care centre, at Warje, near Pune. “He loved plants,” and saw this z Scoreboard place as his “holiday home”, recalls his wife, holding back emotions. Victory and honour z Open-End Mutual Fund His favourite phrase was “top of the world,” she says of her 78-year-old husband who passed away late last year from cancer. “I wish all hospitals think of the patient, rather than money”, she says, Foreign Exchange emphatic that palliative care at the Centre helped her family through the illness and after it. And yet, this form of care remains on the fringes of healthcare delivery in India, unlike other parts of the developed world, where it is popular. z Rates

Mental blocks Shipping Palliative care involves the total management of pain, where the person suffering from an illness is z Ports supported physically, socially and spiritually, explains Dr Priyadarshini Kulkarni, Medical Director at the Cipla centre. In fact, in some parts of the world, palliative care specialists sit with doctors charting out the treatment of a person from the time the illness is diagnosed, she says, adding that such care Archives often extends to helping family members cope even after the passing of a loved one.

z Yesterday But palliative care is still to become an integral part of healthcare management in the country, say z Datewise administrative staff at the Cipla centre, citing the example of their 50-bed facility that is only half-full, z Resources though it has been in existence for about 12 years and is free. z In Focus z In Depth The low occupancy is stranger still, given the need. In India, there are 2.5 million cases anytime with z Events 2007 cancer and 70 per cent are detected when they are advanced. Only 0.4 per cent, though, have access to palliative care in India and 99 per cent are deprived of it, says Dr Kulkarni.

There is a mindset problem, observes Cipla's Head of Human Resource, S. V. Iyer, as people from

well-to-do backgrounds do not like taking a family member to an institution that provides free care. In fact, only one-third of their land at Warje has been developed, and the facility can be expanded if more patients used the service, he says. Search Answering a question often put to them, he says the centre decided to not have paid services for Group Sites special wards or individual care for those who can afford to pay, as it increases the “cost of cancer”. But the centre does extend home-care support to locations within a 40-km radius of the centre, Dr Kulkarni said, adding however, that they do not treat patients, and work instead alongside ongoing z The Hindu treatment. z The Hindu ePaper The mind-blocks to palliative care are often witnessed in the medical community as well, though it z Business Line may not quite be because of lack of trust in supportive pain management and care, say the centre's z Business Line administrative staff. ePaper z Sportstar z Frontline With new drugs pushing up life expectancy to 76 years, death is seen as a “treatment failure”, says z The Hindu Dr Kulkarni. As a medical student, there was just one line in the curriculum on palliative care, she eBooks recollects, having herself made the transition from anaesthetist to palliative care specialist about 10 z The Hindu years ago, after a personal incident. Images There is the dilemma of how long do you treat with the aim of curing, as medical treatment is all about saving lives. There are also issues related to access and transportation of pain-medicine morphine, she explains.

There can be use and abuse of morphine unless it is administered by a medical practitioner trained to do so, agrees Dr M. R. Rajagopal, Chairman of Pallium India, a charitable trust. “All pain does not respond to morphine,' he says, adding one-third of the different types of pain do not respond to morphine.

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To address such issues, a public interest litigation (PIL) was filed in the Supreme Court by the Indian Association of Palliative Care, against the Union Health Ministry and the Centre's Department of Revenue — to bring palliative care into mainstream medical practice.

Filed two years ago, the PIL highlights the need for a palliative care policy both at the Centre and in the States; a scheme for implementation and steps to bring it into the medical education system, he said. The litigation also sought easier access to pain medicine morphine, without the dilution of checks against misuse, he added.

And while the PIL takes its course, Dr Rajagopal further points out, it has been two decades since the National Cancer Control Programme outlined palliative care as a necessary component of pain relief. And yet, it remains a “paper tiger”, he says. Seriously ill people are not an organised group and not a vote-bank, he laments, responding to why palliative care gets little political support to make it a mandatory part of healthcare delivery. Also, the medical profession has changed from “healthcare service” to an “industry” and there is little in palliative care to attract industry, he adds.

Across the country there are about 200 palliative care centres, of which about 140 are in Kerala. But there is still much ground to cover in the country, as other developing countries too are doing better than India, he says.

Also, the scope of palliative care extends into geriatric care, as the ageing population increases as also mental and respiratory illnesses, observe doctors. So, as more corporates get into healthcare and hospitals mushroom across the country, a hospital without a pain relief facility is inhuman, says Dr Rajagopal.

About living!

Palliative care is not about dying but living to the fullest, says Iyer, trying to break the mind-set. A sentiment the D'sa family seemed to endorse, recollecting their father's memories at the Centre.

And that the connect with the centre continues beyond the life of the inmate, is seen with Tomal's mother. She visits the centre every year on the day she lost her 22-year-old son, and spends the entire day there. Another young man, who lost his wife to cancer recently, still talks to staff at the centre. The young man had begun to draw at the centre, as an outlet to his grief, and his wife painted-in the colours, recount the staff.

Tomal's painting and those of the young couple too are up on the walls of the centre, standing silent testimony to their love, pain and a talent that evolved at the palliative centre.

(Names of all patients and family members have been changed to protect their identity)