The Hindu : Kerala / Thiruvananthapuram News : Offering succour to the terminally ill

Online edition of India's National Newspaper
Sunday, Oct 09, 2005

Kerala

Kerala - Thiruvananthapuram

Offering succour to the terminally ill

On October 8, World Palliative Care Day, we celebrate the lives of those millions of terminally ill people and pledge the community's help to alleviate their pain through physical and emotional support.

NOBLE GESTURE: Dash of sweetness to help them forget pain. Child patients at RCC with a giant chocolate bar that had been gifted to them (file photo). - Photo: S.Mahinsha

Thousands of cancer patients spend every living moments going through excruciating pain and suffering.

Their lives do not touch us till some day when we are forced to encounter the pain of our own loved ones.

The day also focuses on raising awareness about the need for more palliative care and hospice centres to help those suffering from terminal illnesses live through their last days pain-free and with dignity.

Palliative care is required not just for cancer patients, but for all those who suffer from terminal illnesses, including HIV.

It is based on the ethos of care and not cure; that there may be a limit to cure, but not care, says Cheriyan Koshi, who head the Palliative Care division at the Regional Cancer Centre here.

The day was observed at the RCC with many doctors, social workers and volunteers joining hands to bring smiles on the faces of those terminally ill patients undergoing palliative care. Several family members also joined the occasion to cheer up their loved ones.

Palliative care is based on the concept of `total pain'.

It concentrates on alleviating not just the physical pain of the disease, but the emotional distress of patients and their families and offering them psycho-social and emotional support all through the illness and bereavement.

A team - including doctors, nurses, social workers, volunteers and cancer survivors - works together to address the needs of patients and their families and to create a support system for them.

Providing relief from the physical pain and distress of the disease is a crucial part of palliative care.

With almost 80 per cent of the cancer patients coming in for treatment at later stages of the disease, relieving the pain of the disease through drugs like morphine, helps patients focus on more positive aspects of life.

Though India supplies morphine to the world, because of stringent drug laws, less than 20 per cent of the people who need drugs have access to them.

WHO recommends the three-step ladder of drug regimen for cancer pain, by starting with non-opioid drugs in the initial stages of the diseases to mild opioids to stronger drugs like morphine in the end stages.

This has been found to be a relatively inexpensive yet effective way of dealing with the pain of illnesses like cancer.

Palliative care has evolved as a people's movement in Kozhikode, where the community has joined hands to form the Neighbourhood Network, to offer succour to terminally ill patients and their families.

Doctors and social workers are worried that the increasing prices of painkillers and non-availability of cheaper morphine is making palliative care inaccessible to a lot of patients.

The problem is also posing several ethical dilemmas for doctors, as to whether they should be prescribing expensive pain-killer drugs for patients who would have been financially drained by the treatment costs.

Palliative care starts right from the time of diagnosis of the disease and the treating doctor should be able to instil courage and confidence in the patients all through the treatment period.

Training for doctors in communication and interpersonal skills is also emerging as an important aspect for delivering palliative care.

C. Maya

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