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Pain relief

The editorial “Offering pain relief” (Oct. 29) is a wake-up call to all the State governments to emulate Kerala in the matter of palliative care of the terminally-ill cancer patients. Improving access to oral morphine and administering it under the supervision of trained volunteers make the twilight hours of the patients less painful. The Union Health Ministry should take note of the Kerala model and spread the message to other States as a benevolent mission. The success of the Kerala model is due not only to the literacy rate but also to the efforts to spread awareness of the facilities.

P. Balakrishnan,

Mangalore

Palliative care goes much beyond making pain relief drugs such as morphine easily available. What needs to be in place for palliative care to be effective is a good support system. It also needs a strong and vibrant primary health system.

One of the major problems medical professionals face in the Indian context is the lack of understanding of the issue. Many a time when a diagnosis with a poor prognosis is made, a lot of resources and energy is spent on running from one doctor to another, or from one system of medicine to another in search of a cure. By the time the truth sinks in, the patient is already much traumatised and in the last moments of his life.

Palliative care warrants strong emotional and financial support from the family, social support from the community towards the family as a whole, and professionally well-qualified counsellors and social workers. Easy availability of morphine in the absence of adequate social networks and support systems would hardly be of any benefit.

Jeevan Kuruvilla,

Vellore

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