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By Siddharth Kundu

the common man aware. Today, pal-liative care is something that we dish out to people when we want to; it is not something that they feel they have a right to claim. Advocacy is the key, and that is not where the palliative care professional’s skill lies. It is a responsibility that we have to accept and a skill that we have to acquire if the burden of disease-induced suffer-ing in the country is to reduce.”

Prof Jan Stjernsward, WHO Emeritus Director, Cancer & Palliative care, from Switzerland applauded the new generation of Palliative care workers coming to IAPCON 2014. He stated that “ The new generation of Indian Palliative care workers com-ing to the IAPCON 2014 conference should become rightly proud by know-ing the history and achievements of their Indian leaders –past and pre-sent, second to more! – something I will exemplify. Having worked in India close to yearly since the early 1980th I am indebted to my Indian colleagues – Much of WHO public health approach, politics and strategies was done and influenced in close collaboration with Indian colleagues, who learnt me a lot, something reflected in the ‘WHO Pain Ladder’, still the global Stand-ard for a method able to cover all, WHO global public health policies and guidelines for its implementation, for national cancer control and evidence based. India has thereafter taken global leadership for a great part of the world for relevant solutions in pal-liative care....”

There were 12 plenary lectures by eminent palliative care experts from abroad. 72 faculties delivered their lectures in 18 different sessions. There were 54 free research presen-tations by palliative care 2enthusi-asts and 30 poster presentations. Three separate workshops were con-ducted for Doctors, Nurses and Vol-unteers ay held at AIIMS, Bhubane-swar and the main conference was held at KIMS.

IAPCON 2014 active in alleviating pain

cesses and failures in the last quarter century of palliative care in India, it seems to me that our biggest failure that the Government of India has, in

Way back in 2002, WHO had notified that the fundamental responsibility of health profession to ease the suffer-ing of patients cannot be fulfilled un-less palliative care has priority status within public health and disease con-trol programme; it is not an optional extra’. Though it took a dozen years since then, on 23 January 2014, the executive board of the WHO passed a resolution for integration of pallia-tive care into health care. This did not just happen; it took years of sustained advocacy by a lot committed people.

“Advances in medical Science, breakthrough in technology and in-creasing consciousness of civil right are some of the factors which have con-tributed to the thought that the people who need palliative care deserve a bet-ter quality of life. As we are aware, the physical, psychological and spiritual aspect of patient care are best looked after by a partnership of different kinds of health professional, commu-nity volunteers and family members,” said Keshab Desiraju, Secretary, De-partment of Health & FW, Ministry of Health & FW, Govt. of India.

According to M.R. Rajagopal, Chairman, Pallium India, Director, WHO Collaborating centre for train-ing and policy on access to pain re-lief, Trivandrum, “Among all our suc-

A total of 80 abstracts in different ar-eas of Palliative Medicine were received and in order to motivate the younger generation, they will be published in In-dian Journal of Palliative Care.

The recent passing of the much awaited, Narcotic Drugs and Psychotropic Substances (NDPS) Act Amendment Bill by the Parliament will ensure that morphine, the essential medicine for pain relief, becomes more accessible to those suffering from chronic pain.

It is certainly a welcome step in the right direction, though it is too little and too late. The simplified regulation will ensure that the barriers that prevented the needy from accessing morphine were being removed.

However, hurdles and barriers continue to be there. Imagine the plight of Indian doctors being ignorant about the usage of morphine tablet for two generation ! They not only lack the experience, most of them may not have even seen the tablet of morphine !! Creating awareness, sensitising the medical fraternity, teaching medical undergraduates about pain and palliative care; and training them to put their knowledge into practice will take the toll of time.

Appreciating the role of the State Government, Prof Jan said, “ The State Government is to be congratu-lated for having committing itself to establish pain and palliative care centres at district headquarters hospitals (DHHs) in Odisha, start-ing in five districts and extended to another five district this year, all in context of the WHO integrated NCD program within the National Health Mission. However Patients in total pain, cannot wait and in a state of 41 million inhabitants, with a death rate of 9/1000 inhabitants, there will be around 450000 deaths (4,5 Lakhs), where at least 60%, would need pal-liative care for “Total Pain” upfront, from the time of diagnosis of an in-curable disease, and not limited to the NCD approach only, but palliative care being incorporated in the State Health program as an essential part. Thus a follow up the conference is urged....”.

CANCER CAPITAL � Approx. 70-80% cancer

pts. are diagnosed late when treatment is less efficient,

� 60% of them don’t have access to quality cancer treatment,

� Out of 300 plus cancer centre in India, 40% are not adequately equipped with advance cancer care equipment,

� This study further suggests India will need 600 additional cancer care centre to meet the req by 2020

Regulations have been simplified but it will not translate into overnight increase in morphine demand. During 2013, about 300 kg of morphine was consumed for pain relief, while the actual annual requirement was around 36,000 kg. Moreover, the amendment will come into force only when the President of India signs the bill.

Morphine to be Accessible

21st International Conference of Palliative Care, held in Bhubaneswar from Feb 13-16, 2014, focused on evidence based palliative medicine. It accommodated all important aspects of palliative medicine in various sessions spread over three days. The conference witnessed the participation of more than 600 delegates which included over hundred representations and guests from 15 countries

the last few years, finally accepted this responsibility of the health care system, at least to some extent. Our biggest failure is that we have not got