By formulating a palliative care policy in 2008, Kerala had become a model for the rest of the country. But since then, it has done little to infuse the benefits to the deserving patients.
Barring small projects initiated by the National Rural Health Mission (NRHM) in palliative care, the government hospitals do not have exclusive units for the same, a promise unfulfilled by the government.
Though the local bodies submit projects in this regard, inadequate resources and lack of expertise prevents them from realising the full potential. Different dimensions - psychological, physical, social, financial and spiritual - have to be taken care of while giving palliative care.
The role played by family is also important. But the team appointed by the local bodies comprising a health inspector, an Asha worker, trained Auxiliary Nurse Midwife (ANM) and a panchayat member are hardly given any training.
Surprisingly, the doctor in the Primary Health Centre (PHC), who is in charge of the patients is not part of the team. Hence, the element of immediacy is absent in the services offered by the team. The doctors cannot prescribe on the spot treatments or medications, says Dr Jose Babu, Medical Officer, Alpha Pain Clinic.
“These patients will need 24x7 services. Except the ANMs who undergo training for three months, none of them have expertise in dealing with the multiple dimensions of care,” he said.
Dr Jose pointed out that a doctor could offer treatment only when the team returns and is informed about the conditions of the patients. “It will again take two or three days for the patients to get the service,” he said. The home care is being given only once or twice a week. Besides, the medical kit carried by the team have limited provisions. They can only be used to change the catheter or dress wounds, he said.
Dr Suresh Kumar, Nodal Officer, Palliative Care project, NRHM, said has been no substantial advances in the quality of care. “But we could offer basic facilities in this direction. Kerala is the only state which has covered 80 per cent of palliative population in the country,” he said.
If there is any kind of awareness, unfortunately, it is based on misconceptions, says Dr Sunil Kumar M, Head, Training Division, Alpha Pain Clinic, Edamuttam.
“Even the professionals think that the palliative care is only for those patients who awaits death. Even the bed-ridden patients are in dire need of palliative care,” he said.