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Plea for public participation in palliative care

By Kabita Duarah
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GUWAHATI, Jan 6 � Many die a thousand deaths before the actual end comes because they have no access to programmes that can alleviate pain.

Alleviating pain in those suffering from cancer and other chronic illnesses has been a mission for a handful of medical practitioners and volunteers in this region that has recorded low participation on motivational issues unlike other parts of the country.

For the Guwahati Pain and Palliative Care Society (GPPCS), a community-based service founded in 1999, apart from lessening pain it has been also a challenge to make the family and the society in general aware about their responsibility towards those in pain.

According to GPPCS honorary secretary Dr Dinesh Chandra Goswami, the society needs to work heavily on motivational issues, particularly when working with patient, families and the public. �Unlike in other parts of India, motivation for voluntary work is desperately low in this part of India. For the same reason our activity in Digboi and Jorhat as link centres has not been able to gain much impetus. The need of the hour is public motivation and their participation to promote the cause of palliative care,� said Dr Goswami, adding that much can be achieved by the participation of the common man.

Palliative care believes in the relief of pain through oral morphine which is also considered to be the golden standard drug for pain relief by the WHO. But earlier it was an item scarce in the North East, and the GPPCS has been instrumental in making it available for the people of this region.

�Since the inception of the society, morphine has been made continuously available and is being supplied to patients in need, free of cost by the society. However, constraints are still there in making the drug freely accessible to all. Unless it is made accessible to the rural Indians, pain relief programme cannot be successful,� observed Dr Goswami. The society has adopted various advocacy measures for popularising use of morphine and on its availability.

The society has been running a clinic that caters to about 900-1,000 cancer patients every year. The cases are referred from cancer centres or medical colleges.

�We try to attend the patients in a holistic manner. The aim is to address the problems of the patient as well as the family, as in palliative care they are considered to be the unit of care. Plenty of time is spent on listening to the stories of the patient and their families. Accordingly, a care plan is formulated by imparting information, explanation and physical examination and so on,� he elaborated.

Earlier, in 2001, the society started a home care programme in the city area to support people afflicted with advanced diseases and who are unable to attend the clinic. �As a matter of fact, for people suffering from terminal illness, home is the ideal place for care instead of the medical institutions where principle of approach is still governed by ensuring life under any cost. We take care to explain to patients and families about the reality of the situation, and offer measures for reducing/balancing the worst experience of cancer in a holistic way so that they die healed,� said Dr Goswami.

The GPPCS team comprises doctors and non-doctor volunteers numbering 38. While all the services of the society are free of cost, the society wants all citizens to come forward and be a part of its mission.

As of now, the society runs on public donations only and despite the financial challenges, the team is optimistic to take palliative care to every nook and corner of the State.

It needs to be mentioned here that in 2011, the Leadership Development Initiative, USA, selected the Dr Goswami for a 3-year diploma course in Palliative Care. He was selected among 23 global leaders.

The GPPCS feels that it has been able to make a difference in the lives of the people and families afflicted with chronic incurable diseases, but much more needs to be done.

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Plea for public participation in palliative care

GUWAHATI, Jan 6 � Many die a thousand deaths before the actual end comes because they have no access to programmes that can alleviate pain.

Alleviating pain in those suffering from cancer and other chronic illnesses has been a mission for a handful of medical practitioners and volunteers in this region that has recorded low participation on motivational issues unlike other parts of the country.

For the Guwahati Pain and Palliative Care Society (GPPCS), a community-based service founded in 1999, apart from lessening pain it has been also a challenge to make the family and the society in general aware about their responsibility towards those in pain.

According to GPPCS honorary secretary Dr Dinesh Chandra Goswami, the society needs to work heavily on motivational issues, particularly when working with patient, families and the public. �Unlike in other parts of India, motivation for voluntary work is desperately low in this part of India. For the same reason our activity in Digboi and Jorhat as link centres has not been able to gain much impetus. The need of the hour is public motivation and their participation to promote the cause of palliative care,� said Dr Goswami, adding that much can be achieved by the participation of the common man.

Palliative care believes in the relief of pain through oral morphine which is also considered to be the golden standard drug for pain relief by the WHO. But earlier it was an item scarce in the North East, and the GPPCS has been instrumental in making it available for the people of this region.

�Since the inception of the society, morphine has been made continuously available and is being supplied to patients in need, free of cost by the society. However, constraints are still there in making the drug freely accessible to all. Unless it is made accessible to the rural Indians, pain relief programme cannot be successful,� observed Dr Goswami. The society has adopted various advocacy measures for popularising use of morphine and on its availability.

The society has been running a clinic that caters to about 900-1,000 cancer patients every year. The cases are referred from cancer centres or medical colleges.

�We try to attend the patients in a holistic manner. The aim is to address the problems of the patient as well as the family, as in palliative care they are considered to be the unit of care. Plenty of time is spent on listening to the stories of the patient and their families. Accordingly, a care plan is formulated by imparting information, explanation and physical examination and so on,� he elaborated.

Earlier, in 2001, the society started a home care programme in the city area to support people afflicted with advanced diseases and who are unable to attend the clinic. �As a matter of fact, for people suffering from terminal illness, home is the ideal place for care instead of the medical institutions where principle of approach is still governed by ensuring life under any cost. We take care to explain to patients and families about the reality of the situation, and offer measures for reducing/balancing the worst experience of cancer in a holistic way so that they die healed,� said Dr Goswami.

The GPPCS team comprises doctors and non-doctor volunteers numbering 38. While all the services of the society are free of cost, the society wants all citizens to come forward and be a part of its mission.

As of now, the society runs on public donations only and despite the financial challenges, the team is optimistic to take palliative care to every nook and corner of the State.

It needs to be mentioned here that in 2011, the Leadership Development Initiative, USA, selected the Dr Goswami for a 3-year diploma course in Palliative Care. He was selected among 23 global leaders.

The GPPCS feels that it has been able to make a difference in the lives of the people and families afflicted with chronic incurable diseases, but much more needs to be done.