Compassionate Growth: A celebration of every step forward

Acharya Harihar Post Graduate Cancer Centre

Our journey…

Acharya Harihar Post Graduate Institute Of Cancer, Cuttack is a Tertiary Cancer Centre, only RCC in Odisha. Palliative care activities at AHPGIC started in early 90’s when WHO supplied free oral morphine to AHPGIC. At present this department of palliative medicine has regular OPD service along with a 12 beded in patients facility which is being managed by a team of doctors, palliative care Doctors, Nurses, Pharmasicts, Physiotherapist, Social worker cum Counselors and Volunteers who are trained in palliative care. It provides a holistic and compassionate care which is patient focused, family-centered. It has got an uninterrupted supply of oral morphine in addition to other analgesics In addition to provide pain relief and other symptom management, we also address psychosocial spiritual issues of the patients and the family members.

The team not only takes care of patient but also educate and empower how to take care at home. AHPGIC conducts regular certificate courses for doctors , Nurses in palliative care under the Banner of IAPC since 2008. Till date we have trained a total number of 285 doctors, 253 nurses, 17 pharmacists and 75 volunteers. It also conduct other training programmes like NPPC and district palliative care programme in colabartion with GOVT of Odisha. It also conducts various sensitization programmes, workshops on psychosocial support, communication skills, and on educating and empowering family caregivers.

Research is also an integral component of our patient care. And also engaged in different community activities, raising awerness through various health camps and media across the state.

Telemedicine center, at AHPGIC (which is the nodal center for Odisha) is of great help for cancer patients of different districts minimizing the long distance travel to the center and in providing continuing of care.

All India Institute of Medical Sciences, Bathinda

AIIMS Bathinda is developing and implementing a comprehensive coordinated community-based palliative care model for cancer patients (C3PaC) in the region. This comprehensive model involves multi-disciplinary to provide holistic palliative care to improve quality of life of patients and their families. The palliative care team has expanded the services to include both Outpatient and Inpatient consultations. Cancer Patients are provided with comprehensive care, including pain management, symptom relief, and psychological support through multidisciplinary approach involving palliative care experts, oncologists, psychologists, nurses and social workers. Along with that, a series of capacity-building training sessions are conducted to empower community health workers in providing palliative care services to patients in rural settings.

Moreover, regular awareness sessions are organized for the local population, cancer patients and their families. These sessions aim at spreading awareness about the availability of palliative care services. Interactive sessions are held with community members to enhance their understanding of end-of-life care, emotional support and coping strategies. A significant milestone is the signing of a Memorandum of Understanding (MoU) between AIIMS Bathinda and Cipla Foundation for strengthening palliative care services . The Cipla Foundation’s support will augment our ability to deliver high-quality palliative care services in the region and ensure sustainability. Another significant milestone that was achieved recently was selection of the C3PaC team, AIIMS Bathinda for the Project “Equip India” project which is aligned to improve the quality of life of cancer patients.

All India Institute of Medical Sciences, Mangalagiri

A year in Review: The Palliative Care Services at AIIMS Mangalagiri have been operational since April 2023, providing comprehensive care to patients and their families.The unit registers patients with palliative needs,with approximately 320 patients currently enrolled.Our Palliative Care Unit not only provides services to patients,but also extends support to caregivers by offering bereavement care to promote comfort,dignity and holistic well-being.Our palliative care team,led by Dr. Samarjit Dey and Dr.Sunit Kumar Gupta and our nursing personnel Mrs.Joshna and Mrs. Pushpa had the privilege of attending the Palliative Care Training Program CTC 6.This program has equipped us with an in-depth understanding of the principles and practices of palliative care.Through a CSR project funded by the CIPLA Foundation, the Palliative Care Unit has commenced providing medications and essential healthcare appliances to patients in need.

Patients suffering from chronic pain, whether due to cancer or other conditions are carefully assessed and provided with Tablet Morphine as needed,free of charge.

Regular follow-up calls are made to address patients’ and families’ needs and concerns,ensuring ongoing support and guidance. Our services extend beyond the patient to also prioritize the well-being of caregivers and family members. As part of our advocacy efforts, we have implemented sensitization programs to educate the public on the significance of palliative care. In addition, we have distributed informational materials and produced awareness videos on palliative care, caregiver support.These resources are continuously available in patient waiting areas. Additionally, we have conducted educational programs for our nurses and doctors to enhance their understanding of palliative care and end-of-life care through CNE and ELNEC programs. In summary, our Palliative Care Services at AIIMS Mangalagiri are dedicated to providing compassionate and comprehensive palliative care services.

All India Institute of Medical Sciences, Jodhpur

AIIMS Jodhpur’s palliative care journey began in 2018 with the Cancer Treatment Centres (CTC) training programs, organized by the Lien Foundation and Asia Pacific Hospice Network (APHN). Dr. Sanjeev Misra and Dr. Sushma Bhatnagar spearheaded this initiative, with later support from Cipla Foundation.

Establishment of Palliative Care OPD – In August 2018, AIIMS Jodhpur launched its Pain and Palliative Care Outpatient Department (OPD) service twice a week. Due to high demand, the service expanded to all working days. Since its inception, AIIMS Jodhpur has dispensed free Tablet Morphine to patients, and its electronic data record system has been widely appreciated. Dr. Manoj Kamal and his team have played a key role in the development of palliative care services at AIIMS Jodhpur, which also collaborates with the Rajasthan Government and ICMR to train healthcare workers.

Services at AIIMS Jodhpur’s Palliative Care Unit

• Dispensing free Morphine for pain relief.
• Addressing emotional, psychological, and spiritual needs.
• Specialized care for chronic wounds.
• Launched in 2019 and supported by Cipla Foundation since 2022, offering home based palliative care. Over 400 patients have benefited from this program.

Education and Training – AIIMS Jodhpur became a nodal centre for the Indian Association of Palliative Care’s (IAPC) Certificate Course in Essentials of Palliative Care (CCEPC). Over 300 participants have completed Part 1, and more than 60 have completed Part 2. AIIMS also trains ASHA / ANMs under ICMR funding to provide basic palliative care at the community level.

Outreach and Collaboration – AIIMS Jodhpur conducts workshops at various centres and collaborates with Navchetana Home Care Society to enhance patient support. It is also involved in raising palliative care awareness through events like World Hospice and Palliative Care Day celebrations.

Future Directions – AIIMS Jodhpur aims to expand its palliative care services across Rajasthan.

Amrit Dhara Palliative Care Trust

Amrit Dhara Palliative Care Trust has embarked on a remarkable journey dedicated to providing holistic and patient-centred care to individuals battling cancer. Since its inception, the organization has shown tremendous growth in its commitment to improving the quality of life for both patients and their families. With a range of services including home-based care, outpatient consultations, counselling, and training programs for healthcare professionals and volunteers, Amrit Dhara’s impact continues to expand.

From 2020 to 2024, the organization made significant strides in patient care, particularly through home-based services. As of August 31, 2024, Amrit Dhara has cared for nearly 700 patients and completed 214 home visits.

In addition to in-person care, the organization has successfully incorporated telemedicine into its services. In 2023, 50 patients were supported through tele-consultations and video calls, a number that nearly doubled by August 2024. These services have been especially valuable for patients in remote areas or those with mobility limitations. Last year it opened an satellite center at Sundergarh in association with another local non -government organisation.

A major milestone was the establishment of a new center in Kalinga Nagar, expanding Amrit Dhara’s reach and enhancing its ability to provide specialized palliative care to more communities. This center serves as a hub for outpatient consultations, day care, and home visits, reflecting the trust’s commitment to serving marginalized populations.

Training has been a core component of Amrit Dhara’s strategy, with 17 programs since 2023 training over 705 professionals, including nurses, doctors, community health officers (CHOs), ASHA workers and volunteers. These efforts are vital in building a sustainable palliative care ecosystem across Odisha.

Amrit Dhara’s work extends beyond direct care through research and advocacy aimed at integrating palliative care into cancer treatment in Odisha.

Bangalore Baptist Hospital

It is rewarding to look at the journey of the Palliative Care department in Bangalore Baptist Hospital (BBH), born with the vision of Dr Stanley C Macaden. The department was started in BBH in 1995, as a response to the need to care for patients with life-limiting illnesses. This was augmented with the “Hospice and Home Care” program in 1998 in partnership with Wake Forest University, USA.

In mid-2000 BBH realised that Palliative Care (PC) services were practically non-existent in the rural areas as existing services were mostly urban-centric and hospital based. Hence BBH started a Rural PC program in 2013 which has now expanded to serve four rural districts, currently serving a 3.5 million population. The newest development of the department is the  launch  of a 50 bed Hospice in Devanahalli to serve patients living in 6 districts – Bangalore Rural, Chikkabalappur, Kolar, Tumkur, Ramnagara and Bangalore city.

From its humble beginnings, BBH has now blossomed into an institution with all facets of PC services under one roof with its rural and urban home care services, interdisciplinary  PC services embedded into a quaternary healthcare institution and a hospice. The department has mutually benefiting liaisons with oncology, geriatrics, critical care, neurology, family medicine and other departments.  This provides good end of life care in line with the Best Care for the Dying Person care plan by the International Collaborative.

True to the definition of PC, families are empowered to care for their loved ones and “family driver” is one of the key innovations. Bereavement care is provided through visits and an annual memorial service.

Apart from that, BBH partners with national palliative networks and works closely with the government for national policy initiatives.

With the ever increasing need for PC, the BBH team hopes to serve more people in the future!

(Image: Newly launched BBH Hospice, September 2024)

Bangalore Hospice Trust – Karunashraya

It’s not often that a dream becomes reality, but when it does, it’s truly a cause for celebration. It all began from a noble vision of Mr. Kishore Rao in 1992 to care for terminally ill cancer patients. In 1994 with modest funds and a small 10×10 office in Bangalore offered by a friend, the dream became a reality and the team begun homecare services. Faced with countless setbacks, social rejections, tight pocket, but fuelled by conviction and perseverance, Karunashraya evolved into a Public Charitable Trust five years later.

What started as a 50-bed hospice has now grown, three decades later, into a 73-bed facility, widely respected hospice in the field of palliative care. Our caregiving team, which began with just a handful, has blossomed into a dedicated group of 250 strong! Over the years, Karunashraya touched the lives of over 30,000 cancer patients in advanced stages, providing them compassionate palliative care. Our serene campus, an architectural marvel, offers a meditative atmosphere with tranquil views— a space for compassionate care alongside our home care services.

Karunashraya offers a comforting environment for patients in their final days, where their dignity and comfort are prioritised. Families, too, find solace here, as they witness their loved ones cared for with respect and compassion. This growth and impact would not have been possible without the unwavering support of our well-wishers.

Our natural progression in the following years, led to the establishment of KIPCER (Education & Research division), offering evidence-based clinical practice, training, and internships for healthcare professionals and volunteers.

Bagchi Karunashraya, a 110-bed facility, is our latest venture, extending palliative care across Bhubaneswar city, and its surrounding areas in Orissa.

A single line to encapsulate Karunashraya’s work in the last 3 decades would be: “Adding life to the days of our patients’, rather than just days to their lives”.

Cancer Research Institute

CRI (Journey: 2006 – Present)

Cancer Research Institute (CRI) founded on April 2006, is a constituent unit of SRHU and an Associate hospital of HIMS. Under the leadership of Director CRI, Prof. Sunil K. Saini, it serves the largest referral centre for comprehensive cancer care in Uttarakhand.

A dedicated program of Supportive and Palliative Cancer Care Services (SPCCS) takes initiative and manages all supportive and palliative needs for cancer patients from first day of diagnosis till last time. 20 beds are designated for supportive and palliative care across various wards at our 262 bedded cancer center. CRI has been associated with Ganga Prem Hospice Rishikesh since 2007 facilitating care for terminally ill cancer patients. CRI with its various social program & community camps focuses on awareness, early detection and treatment of cancer patients.

SPCCS runs three Supportive and Palliative Cancer Care OPDs focusing on physical, emotional & psychological needs of patients. A team of dedicated cancer/adjunct specialist provide this care under one roof for patient’s convenience. SPCCS team members includes Surgical Oncologist, Radiation Oncologist, Medical Oncologist, Dental Oncologist, Anesthesiologist, Psychologist, Physiotherapist, Nurses, Yoga & Ayurveda Consultants, Social Worker and symptom specific specialist works in close collaboration with Indian Association of Palliative Care (IAPC), Pallium India and various other NGOs providing training to Doctors and Nurses in supportive and palliative cancer care.

CRI is an recognised training center for IAPC palliative care courses. CRI is also part of ten nodal center for strengthening of palliative care services in northern India under ICMR project under AIIMS Delhi. CRI mandates a multidisciplinary working and socially oriented care focused on affordable, cost effective and integrated care.

Caritas Hospital

Sharing the remarkable milestones of Caritas Palliative care.

i. In 2004, Dr. Mary Kalapurakal started Palliative care OPD at Caritas cancer Institute.

Further major progress is given below:

• November 13, 2006 – started Home care-serving 1000+ free visits every year
• November 22, 2006 – conducted 1sttraining programs for staff and volunteers
• March 2008 onwards – conducting multiple cancer awareness classes and camps
• October 20, 2009 – 1^st SDM cheque distribution for poor cancer patients-continues yearly once
• July 4, 2010 – 1^st patient meet at Koodalloor church parish hall
• September 2013 – Dr. Manu John Joined the team as Consultant Palliative Oncologist
• Year 2014 – 18 new volunteers joined the team for providing hospital based care to cancer patients
• June 2015 – 1^st cancer awareness classes in the schools of Kottayam
• Year 2015 – presented a paper on palliative care in a national conference of Legal authorities
• Year 2016 onwards – associated with IPM Calicut and Pallium India for teaching programs
• January 21, 2017 onwards Conducting CME and training programs for doctors
• September 24, 2017 – Pontifical Academy team from Italy visited our centre
• Year 2019 – associated with Mudiyoorkara Parish for conducting a certification course on Bioethics
• August 2020 – initiated Caritas paid Home Care services (on demand service)
• May 2021 – procured 40 Oxygen concentrators from NCG and Tata Hospital for poor patient use
• July 2023 – Dr. Sharon Eliza (Community Medicine and Palliative care Physician) Joined the team to carryout community programs and Palliative Home care services
• September 2023 – Initiated the Caritas Hospice services at our satellite CFH Hospital
• May 2024 – Launched the Community volunteer empowerment program “Santhwana Sparsham Enniloode” to initiate palliative care activities in Kottayam and Idukki District Arch Diocese parishes

ii. Best Palliative care unit in Kottayam District Award from Chief minister 2013.

iii. KCBC appreciation award 2014.

iv. Conducted ELNEC training program.

v. Recognised as NFPM training centre.

vi. Financial aid to poor cancer patients.