Compassionate Growth: A celebration of every step forward

Pain and Palliative Care Society, Thrissur

Palliative activities in Thrissur was pioneered by Dr. E. Divakaran (the present Director of the Institute of Palliative Care). He got support from Dr. A. K. Unnikrishnan, Shri C. R. Parameswaran, Dr. K. Aravindakshan, Prof. Gokuldas, Dr. Pisharody Chandran and Dr. C. N. Parameswaran to make a small beginning in the year 1997 in Trissur, when it started functioning in a small space provided by West Fort Hospital, Trissur.

Pain and Palliative Care Society, Trissur, is continually evolving in its mission of providing palliative care to the most deserving. Ever since then it has been taking longer strides spreading care to thousands of patients in and around Trissur.

Key milestones include:

• 1999: The Palliative Clinic began operating from the Medical College Hospital, with occasional home care services.
• 2006: The society moved to a larger building at the Old District Hospital. The “Institute of Palliative Care” was established to train healthcare professionals and volunteers.
• 2008: An inpatient division was inaugurated. An elevator was installed in the premises easing the patients movements
• 2011. Physiotherapy commenced.
• 2015: CHETANA, a support group for kidney patients, was launched.
• 2016. A significant change was brought about the students participation in Palliative movement when Students Initiative in Palliative Care (SIP) formed.
• 2017: The society began including mentally ill patients through a Mental Health Action Trust (MHAT).
• 2018: A new three-storeyed building was inaugurated, housing Hospice Care and a Day Care center.

In 2022, the society celebrated its 25^th anniversary, marking significant contributions to palliative care in the region. Today, it continues its mission with the support of volunteer doctors and dedicated staff.

Pain Relief and Palliative Care Society

Pain Relief and Palliative Care Society (PRPCS) is a registered charitable organization founded in the year 2007. The society provides a range of palliative care services which include out-patient, in-patient, hospice and home care services in Hyderabad for both adults and children living and suffering with life-limiting or life-threatening illnesses like cancer.

PRPCS is dedicated to providing compassionate and comprehensive care for individuals suffering with life-limiting illnesses.
Activities of the Society –inter alia- include the following:

• 36 bed Hospice (26 adults and 10 Children) by name Kumudini Devi Hospice in Kukatpally.
• Home based palliative care program, Life at your Door step with 12 vans ( 9 adults and 3 children) covering city of Hyderabad and its environs.
• Pediatric Palliative Care Program, a unique children palliative care program for children with cancer and non-cancer conditions embedded in the Government MNJ Cancer hospital and Government Niloufer Children’s Hospital with an extension of home care hospice (Mandara) which is the 1st of its kind, Children’s Hospice in India.

‘All the programs being run by the Society are entirely free of cost’.

The most remarkable journey of PRPCS is that which has shaped the policy of Telangana State in Palliative Care and spread Palliative Care accross the 33 districts of the State extending to one unit in Government General Hospital, Kurnool and one Puttaparthi in a span of 10 years.

Another biggest milestone is making pediatric palliative care in the mainstream in Govt MNJ Cancer Hospital and Govt Niloufer Hospital for children with other life-limiting conditions catering to the special needs of children and caring for them right from the diagnosis and sometimes even before. Another benchmark in catering to non cancer conditions children including Perinatal Palliative care where in pc is provided even before the birth of the child and having a birth care plan for the child and their parents.

Rajagiri Hospital

2017:
• Pain and Palliative Medicine OPD & IP consultation and admission started in October.

2018:
• Free Rajagiri Palliative Home Care (RPHC) a Rajagiri CSR initiative started in March. Providing care to Terminally ill, Chronic Bedridden and those in Pain, 15 kms around Rajagiri Hospital.
• Started as Daily Doctors Home Care (DHC) with a team of Palliative Physician, Palliative Nurse and Social Worker.
• Community Awareness Programs on Palliative Care started.

2019:
• Started Daily Nurses Home Care (NHC) as a second team led by a Palliative Nurse.
• 2 hours Community Training Program in caring for bedridden patients started.

2020:
• RPHC continued Daily Home Visits during COVID Lockdown.

2021:
• Started Daily Community Physiotherapy (CPT) in liaison with Dept of Physical Medicine and Rehabilitation (PMR).
• 5 days Certificate Course in Palliative Care for Volunteers started.
• RPHC, received Excellence Award for COVID Care Services (for community service during COVID pandemic).

2022:
• Pain Clinic Started in October at Rajagiri Hospital.

2024:
• Once a week Community Dermatology Care (CDC), started in liaison with Dept of Dermatology.
• Once a week Community Nutrition Therapy (CNT), started in liaison with Dept of Nutrition.
• Twice monthly Community Occupational Therapy (COT), started inl liaison with Dept of PMR.
• As needed Community Lab Facility started in liaison with Dept of Laboratory Services.
• All the RPHC Community Services are provided totally free for all patients.
• RPHC received Kerala Management Association (KMA) Special Jury Award, Hospital Category.
• Rajagiri Cancer Center received the European Society of Medical Oncology (ESMO) Accreditation as a Designated Center of Integrated Oncology and Palliative Care for the period of 2025 to 2027.

Tata Memorial Hospital and Advanced Centre for Treatment Research and Education in Cancer

Greetings, readers!

On World Hospice and Palliative Care Day 2024, I want to share my 28-year journey since my inception at Tata Memorial Hospital (TMH) in Mumbai in 1996. The hospital’s visionary administration entrusted me to Dr. M. A. Muckaden, initially housing me in a single room. My mission was to assist patients with advanced cancer from across India. Dr. Muckaden championed my cause, expanding Adult Palliative Care and Home Care with a team of only a handful of doctors, nurses, mental health professionals, and volunteers. In 2000, she established the country’s first Paediatric Palliative Care (PPC) clinic, setting a precedent for others.

In 2011, my status was elevated further when the hospital launched India’s first full-time MD program in Palliative Medicine, a milestone for the field. Since then, 20 MD Palliative Medicine physicians have been trained here, thriving in both academia and corporate sectors nationwide. Currently, 12 more doctors are pursuing their MDs, with five seats approved for this year’s intake.

We pioneered several initiatives: a Respite Palliative Care center in 2015, an independent track in the hospital’s annual Evidence-Based Medicine conference in 2020, a dedicated PPC home care team in 2021, a 2-year Fellowship Program in PPC and, a yearly Continuing Educational Programme in Palliative Care (CEPaC) from 2022 and a fully equipped Point of Care Ultrasound in Palliative Medicine in 2024. In 2022, we also established a new facility at our ACTREC center in Kharghar to extend specialist palliative care to patients undergoing treatment there. We conduct research in a wide range of topics like early integration of PC, prevalence of symptoms,needs assessment, to name a few.

Currently, I serve around 15,000 patients annually, offering outpatient clinic, in-patient unit, consultation-liaison, emergency department referrals, home, and respite palliative care services.

Thank you for listening!

Department of Palliative Medicine at TMH & ACTREC

The Jimmy S. Bilimoria Foundation

PALCARE from The Jimmy S. Bilimoria Foundation was founded in December 2015 to provide a much-needed home based palliative care service for cancer patients, in Mumbai, at a time when, apart from Tata Memorial Hospital (TMH), who catered only to their own patients, palliative care was not available in a home setting.

From a team of 10, PALCARE has expanded to 38 staff in 2024, distributed over 7 zonal teams, including doctors, nurses, counsellors, and support staff, spread over the Mumbai Metropolitan Region, with an area of 6,328 square kilometres and a population of over 26 million. Since inception, PALCARE has enrolled over 3,450 patients and manages over 250 concurrently. Its annual caseload exceeds 750.

PALCARE emphasizes that a high-quality service requires rigorous training, weekly knowledge sharing, and guest lectures, as also external conferences, and training programs to constantly enhance staff skills.

PALCARE’s advisory board of experts has developed 39 evidence-based clinical guidelines for adult palliative care, available online since 2019, along with a published article in the Indian Journal of Palliative Care.

Collaborating with TISS, PALCARE researched caregiver challenges, publishing the findings in 2018 in the same journal.

PALCARE is one of the few of services in India that has integrated technology into its services. Patient data is captured digitally, which enables PALCARE to respond to patient’s needs promptly and efficiently, to coordinate care between team members, and track patient progress.

PALCARE receives referrals from diverse healthcare providers and furthermore offers consultations at Lokmanya Tilak Hospital at Sion.

With over 80% of patients dying at home, PALCARE supports & empowers caregivers, thereby reducing end-of-life hospitalizations.

As we reflect on our journey, from enrolling our first patient to caring for nearly 3,500, it’s remarkable to witness how far we’ve come.

Vardhman Mahavir Medical College & Safdarjung Hospital

This journey of Palliative Care in VMMC & Safdarjung started in the year 2007 when Dr. Saveena Gulati Raheja went for a WHO Fellowship in PALLIATIVE CARE under the aegis of the Institute of Palliative Medicine (IPM) in Calicut/Kozhikode. “First time in a tertiary care central government hospital,” an OPD of Pain & Palliative Care was started.

Amidst great struggle and perseverance, a once-a-week OPD was started in 2007 between 10 am to 1 pm. This OPD was held in the Chemotherapy room of the Radiotherapy department. In 2012, the cancer care division of the Ministry of Health suggested that a dedicated Palliative Care Clinic be started. To gain further knowledge and hone better skills, Dr. Saveena G. Raheja and Dr. Madhu Dayal, along with a team of two sisters, were sent to CTC (cancer training center) under the LIEN foundation, Singapore, in collaboration with IAPC & AIIMS. Thus, Safdarjung Hospital became CTC-certified. In 2016, the cancer training center team visited the Pain & Palliative Clinic OPD and did their first AUDIT. The team was headed by Dr. Cynthia Goh (LIEN foundation, Singapore) in collaboration with Dr. Sushma Bhatnagar (AIIMS, New Delhi).

In 2017, our team got another boost by joining of Dr. Dimple, Dr. Deepa, and four nursing officers (including two senior officers), improving patient care. Dr. Deepa was awarded MSc in Palliative Medicine at Cardiff University in 2018. We started with two days/week, which increased to 4 days/week. With an exponential increase in patients, in October 2016, a full-fledged dedicated Palliative Care Clinic was started with separate OPD services. “Day Care” services started in 2021. We started an operation theatre dedicated to diagnostic & interventional procedures like RFA & POCUS. We have a dedicated new wing, Room no 207-210, 2^nd Floor, old OPD building inaugurated in 2024.