P. T. Jyothi Datta
Recently at Warje
At a two-and-a-half hour drive from Central Mumbai, cloaked in silence and greenery, is Cipla's 50-bed palliative care and training centre at Warje, off the Mumbai–Bangalore Bypass Road.
But the over 12-year-old centre still finds only half its beds occupied, though its facilities are free for people requiring palliative care.
Lack of awareness about palliative care services and a mind-set against approaching an institution for pain management are the prime reasons for the centre not seeing more patients, say administrators at the centre and doctors specialising in this approach of providing “total care”.
Palliative care seeks to improve the quality of life for not just the patient, but also the family, through pain management, along with psychological, emotional and spiritual support. It comes into the picture from the time an illness, say, cancer, is diagnosed till after death, when the family is helped to cope with the loss, said Dr Priyadarshini Kulkarni, Medical Director with Cipla's palliative care centre.
At any point in time, there are 2.5 million cancer cases in India, and 70 per cent are in an advanced stage, she said. And yet, only 0.4 per cent has access to palliative care in the country, she added.
Patients lack awareness on this approach of care that is, however, popular in developed countries, she said. The medical fraternity too needs to be sensitised on palliative care, she added.
The other problem in palliative care becoming more common is the access to pain medicine such as morphine. There are strict laws relating to transportation, etc., making access difficult, she said.
PIL for policy
In fact, there is a public interest litigation (PIL) at the Supreme Court, filed by the Indian Association of Palliative Care, against the Union Health Ministry and the Centre's Department of Revenue, said Mr M. R. Rajagopal, Chairman of Pallium India, a charitable trust.
The PIL highlights the need for a palliative care policy both at the Centre and in the States; a scheme for implementation and steps to bring it into the medical education system, he said. The litigation also sought easier access to pain medicine morphine, without the dilution of checks against misuse, he added
The Cipla centre has seen more than 6,400 patients, said Cipla's Head of Human Resource, Mr S. V. Iyer. But only one-third of the five- acre plot at Warje has been developed, he said, indicating there is room for expansion if the number of patients increased.
While the centre runs on a unique model involving the patient's family as well, in the last one year, the centre has extended itself to providing home-care to patients in a 40-km radius of the centre, he said.