World Palliative Care Day is celebrated on the second Saturday of October every year. On this day we express our solidarity with those less fortunate whose predicted life span is short and those who suffer from any life limiting illnesses. The emphasis was on cancer earlier but today palliative care principles are applied to any person who needs long-term care (LTC). As India is becoming a ‘greying nation,’ the elderly have definitely to be loved and cared for.A speciality fondly referred to as ‘low tech, but high touch,’ the credit for the ‘message of palliative care in becoming a movement’ across India goes to the Regional Cancer Centre in Thiruvananthapuram, as the country’s first pain clinic was started here in 1986. Today this ‘pain clinic’ has morphed into a comprehensive palliative medicine department, the first of its kind in the country. Slowly, it added several firsts to its credit bringing the speciality from obscurity to quasi-priority with training programmes.The RCC is the only cancer centre in the world to have both oral morphine solution and capsule production plant. Morphine is given free to poor patients suffering from agonising pain. To the RCC also goes the credit of having a weekly dedicated tele clinc for palliative care christened ‘HELP for the Hills’ (HELP = Hear, Ease, Link, Palliate). This is connecting the RCC and a rural hospice at Adimali 300 km away near Munnar.‘The last part of life has an importance out of proportion to its length,’ and ‘The way people die lives in the minds of those who live on’ (Dame Cicely Saunders, Founder of the palliative care movement and the author had the privilege to be trained by her). Because palliative care ‘affirms life and regards dying as normal’ the ‘hope structure’ is ‘deconstructed’ to have an affirmation ‘No matter what happens to you we will not desert you’ and an acceptance ‘You may be dying but you are still important to us.’Today the focus is on ‘good death’ emphasising patient autonomy and the cardinal principles of ethics, beneficence, non-malfeasance and justice.From this year beginning, the palliative medicine department has an ambitious programme ‘Voice in the midst of Noise’ wherein contact numbers of patients are taken and their welfare is enquired into by our social worker through the mobile. This is a model for the rest of the country as hardly any calls are made from any hospital in the country to the patient’s home on a regular basis.For us and the patient and family this is an emotional experience.'Adding life to years complementing years to life’ and ‘Life beyond cancer and care beyond cure’ are our driving forces. Another ambitious programme which the RCC does alongside the NGO ‘Care Plus’ is the ‘Life after life’ project.Bereft of theology, it only means taking care of children and spouses in the event of bereavement, when ‘one life has passed away and there are other lives that await to be taken care of’.Thus we at RCC take care of physical problems like pain and wounds (P), emotional issues (E) psycho-social issues (P), spiritual concerns (S), and interpersonal relationships (I). For us the celebrity is the patient with whom we celebrate ‘Life’ whenever we see PEPSI.
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