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LETTER TO THE EDITOR
Year : 2018  |  Volume : 1  |  Issue : 2  |  Page : 101-102

“So near, yet so far”: Palliative care services remain elusive in India


1 Department of Hospital Administration, School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India
2 Department of Community Medicine, School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India

Date of Web Publication31-Dec-2018

Correspondence Address:
Sudip Bhattacharya
Department of Hospital Administration, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JCO.JCO_7_18

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How to cite this article:
Bhattacharya S, Singh S, Singh A. “So near, yet so far”: Palliative care services remain elusive in India. J Curr Oncol 2018;1:101-2

How to cite this URL:
Bhattacharya S, Singh S, Singh A. “So near, yet so far”: Palliative care services remain elusive in India. J Curr Oncol [serial online] 2018 [cited 2019 Nov 20];1:101-2. Available from: http://www.journalofcurrentoncology.org/text.asp?2018/1/2/101/249061

Sir,

Death is inevitable and a mere thought of it invokes phobia, distress, helplessness, depression, and dejection. Although sudden death of a healthy and young person is a rare event, death usually arrives after sufferings from chronic diseases. The period of suffering may vary from few days to several weeks, months, or years; however, majority of the suffering is preventable, if the patient or the family gets timely access to adequate palliative care (PC) services.[1]

As per the World Health Organization: “Palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.”[2]

Globally, facility-based models of PC may not be possible because of already overburdened health systems. Of the 56 million people who die annually, 44 million are in lower middle-income countries. Approximately 33 million of this group would benefit if PC services are available. The present PC services in most regions of the world are insufficient, and often end up giving a lot to a few.[3]

PC services should enhance the quality of life for patients with terminal illness, who mostly have restricted mobility, and their families. They need to be comprehensive, have holistic approach, and should take care of social, cultural, and economic aspects. PC services need to be implemented as a part of primary health care, which will maintain the continuity of preventive, curative, and palliative services through early detection, appropriate treatment, and palliation to the end. The encouraging aspect of PC is that it is not so expensive, complicated, or technology driven; hence, a primary health-care model should become the cornerstone of community-based PC in low- and middle-income countries with community participation.[1]

Since mid-80s, Kerala (India) has emerged as a model region for smooth functioning of PC services with the help of community participation. As per McDermott et al.,[4] 138 organizations are presently offering hospice and PC services in 16 states or union territories; however, these services are more or less given in the urban areas and regional cancer centers, apart from Kerala, where services reach till the community level. This type of community PC venture and the “Neighbourhood Network in Palliative Care (NNPC)” is the key to achieve significant coverage and care for the people who are terminally ill. These projects reveal the way to “Palliative Care for All.” The state has revealed vast progress in PC and is perhaps the leading community-owned network worldwide. Local volunteers are trained to spot the problems and intervene well in time, whereas a network of highly skilled professionals is always there to help them.[4],[5] This Kerala model of PC services can be implemented countrywide to minimize the sufferings of terminally ill people.

[TAG:2][/TAG:2]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Thakur JS. Public health approaches to non-communicable diseases. 1st ed. New Delhi:Wolters Kluwer; 2015. p. 448.  Back to cited text no. 1
    
2.
Kumar S. Models of delivering palliative and end-of-life care in India. Curr Opin Support Palliat Care 2013;7: 216-22.  Back to cited text no. 2
    
3.
Khosla D, Patel FD, Sharma SC. Palliative care in India: Current progress and future needs. Indian J Palliat Care 2012;18:149-54.  Back to cited text no. 3
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4.
McDermott E, Selman L, Wright M, Clark D. Hospice and palliative care development in India: A multimethod review of services and experiences. J Pain Symptom Manage 2008;35:583-93.  Back to cited text no. 4
    
5.
Lynne J. Handbook for mortals: Guidance for people facing serious illness. New York: Oxford University Press; 2001.  Back to cited text no. 5
    




 

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