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Sunday, July 3, 2011

Palliative Care in India: For Freedom from Pain. (extract)

Sunday, May 8, 2011

For Freedom from Pain , Article published in The Hindu

For freedom from pain
In India, where terminal illnesses like cancer are often detected too late, how many patients get to see a palliative care specialist to help mitigate pain and other socio-psychological trauma? Palliative care doesn't reach people who need them because it continues to be a neglected speciality, says DR. PRIYADARSHINI KULKARNI

Taking a holistic view of treatment...

"Naina Patil (name changed) may not be aware that another World Cancer Day has come and gone. It has been a decade since she was diagnosed with chronic myeloid leukemia (CML). At 20, she is a bright and cheerful girl, doing her second year in BA and looking forward to becoming a fashion designer.

Such an aspiration was probably the last thing on her mind when she was admitted to my Centre about three years ago. She was confined to a wheelchair, contorted with pain and scared about life. Over the next few days, the transformation was dramatic. The girl who could not walk was merrily riding a bicycle.

There has been no miracle. Sad as it is, the cancer within her is getting worse. Just a few days ago, she chose to celebrate her birthday at Cipla Centre, her “second home”. Her entire family was around. Everyone present, including other patients and their relatives, fed her a piece of cake and then wiped a tear out of her sight. We do not know about her next birthday. What we do know is that thanks to palliative care, she has regained her zest for life and her smile".

"The challenges

The WHO defines palliative care as “an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.” It has recognised palliative care as an integral and essential part of comprehensive care for cancer, HIV and other health conditions. It has urged countries to take action in three areas — policy making, education and drug availability. In India, we face major challenges in all three areas.

It is difficult to put an exact date to this but we believe that palliative care was introduced in India about 20 years ago. According to official estimates, at any given time, 25 lakh people have cancer in India. Almost two lakh new cases are diagnosed every year. Of these, 80 per cent cases are detected too late for any curative treatment to have an impact. About 1.6 million Indians endure cancer pain each year but only a tiny fraction, 0.4 per cent gets relief through palliative care.
Ironically, 80 per cent of the funds under the government's Cancer Control Programme continue to be spent on treatment facilities. The remaining 20 per cent goes towards cancer awareness programmes and cancer detection facilities. Palliative care does not figure here at all, just as it does not figure in our medical curriculum".


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Palliative Care India: For Freedom from Pain , Article published in The H...:

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