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  • Kumar used to drive tempos and mini-buses in Bangalore. He was 33 in 2012 when he discovered he had lung cancer. Six months later, he was dying. On a December morning, his family was summoned to meet him. They stand by his bed as his favourite aunt clasps his hand tight.
    Kumar used to drive tempos and mini-buses in Bangalore. He was 33 in 2012 when he discovered he had lung cancer. Six months later, he was dying. On a December morning, his family was summoned to meet him. They stand by his bed as his favourite aunt clasps his hand tight.
  • One person by his bedside that day was not a family member. Somashekara Chari encouraged the family to take Kumar to Karunashraya, the pioneer Bangalore hospice that offers free palliative care for advance-stage cancer patients who are beyond medical cure. That day, Somashekara cajoled Kumar into drinking a few sips of coconut water while cradling his head.
    One person by his bedside that day was not a family member. Somashekara Chari encouraged the family to take Kumar to Karunashraya, the pioneer Bangalore hospice that offers free palliative care for advance-stage cancer patients who are beyond medical cure. That day, Somashekara cajoled Kumar into drinking a few sips of coconut water while cradling his head.
  • An hour after he left and still on the road, Somashekara learnt of Kumar’s death. Most of Karunashraya’s patients live in destitute poverty and close to the border of death.
    An hour after he left and still on the road, Somashekara learnt of Kumar’s death. Most of Karunashraya’s patients live in destitute poverty and close to the border of death.
  • The Karunashraya home care team visits 50 patients per week. Somashekara and the other driver, Thimmaraju drive nurses in their two distinctive blue auto rickshaws.
    The Karunashraya home care team visits 50 patients per week. Somashekara and the other driver, Thimmaraju drive nurses in their two distinctive blue auto rickshaws.
  • The team drives to all corners of the city, no matter how remote or inaccessible, helping the poorest of the poor find peace and dignity before a painful death.
    The team drives to all corners of the city, no matter how remote or inaccessible, helping the poorest of the poor find peace and dignity before a painful death.
  • Karunashraya has offered free home care services for terminal cancer patients since 1995. It established an inpatient service in 1999 at its 50-bed hospice in Whitefield, Bangalore.
    Karunashraya has offered free home care services for terminal cancer patients since 1995. It established an inpatient service in 1999 at its 50-bed hospice in Whitefield, Bangalore.
  • The hospice operates solely on cash and in-kind donations, and sometimes attracts strange items. Donors range from companies like the Tata Group and GlaxoSmithKline to concerned individuals.
    The hospice operates solely on cash and in-kind donations, and sometimes attracts strange items. Donors range from companies like the Tata Group and GlaxoSmithKline to concerned individuals.
  • Patients are referred through a network of institutes and individuals nurtured by Karunashraya; over 70 percent of them live below the poverty line. Many are delighted by the facilities and serene environment of the campus.
    Patients are referred through a network of institutes and individuals nurtured by Karunashraya; over 70 percent of them live below the poverty line. Many are delighted by the facilities and serene environment of the campus.
  • The emphasis here is on providing palliative care, which is a holistic approach that involves medical, psychological and even spiritual support to ensure a peaceful and dignified death for patients.
    The emphasis here is on providing palliative care, which is a holistic approach that involves medical, psychological and even spiritual support to ensure a peaceful and dignified death for patients.
  • Dr Nagesh Simha is Medical Director at Karunashraya and President of the Indian Association for Palliative Care. He is a motivational speaker constantly in motion, offering anecdotes, humour and serious insight to everyone around him. Here, he leads and instructs a team on his daily rounds.
    Dr Nagesh Simha is Medical Director at Karunashraya and President of the Indian Association for Palliative Care. He is a motivational speaker constantly in motion, offering anecdotes, humour and serious insight to everyone around him. Here, he leads and instructs a team on his daily rounds.
  • In a threateningly morbid environment, the dedicated medical team operates with warmth and vibrancy to every patient, no matter how temperamental or angry or depressed.
    In a threateningly morbid environment, the dedicated medical team operates with warmth and vibrancy to every patient, no matter how temperamental or angry or depressed.
  • Pushpalatha, a home care nurse, treats a 27-year-old who was in the last stages of mouth cancer caused by chewing gutka. The nurses check vitals, change dressings and ensure correct medication is provided between visits.
    Pushpalatha, a home care nurse, treats a 27-year-old who was in the last stages of mouth cancer caused by chewing gutka. The nurses check vitals, change dressings and ensure correct medication is provided between visits.
  • "The current state of palliative care in India is not very good and the facilities still have a long way to go," says Dr Simha. "There are some states where palliative care is very active. The best of course is Kerala, which is doing a phenomenal job and involving the government, panchayats, the police, volunteers, medical institutions and students."
  • "The concept of palliative care is not understood by many people and one of the biggest impediments is the medical profession itself," says Dr Simha."Things are changing, but India is such a vast, complex country. I’m confident that in the next 5-10 years, we’ll see [many more] palliative care centres, not only for cancer but also for end-stage kidney and cardiac diseases."
  • Uniquely, Karunashraya also provides patients with images of gods of all religions (but only if they ask for them).
    Uniquely, Karunashraya also provides patients with images of gods of all religions (but only if they ask for them).
  • Around 9 million people die every year in India. The WHO estimates that 4 million of them would benefit from palliative care; less than 1 percent get it.
    Around 9 million people die every year in India. The WHO estimates that 4 million of them would benefit from palliative care; less than 1 percent get it.
  • Patients have access to experienced counsellors like Renuka, who strive to put bewildered and fearful minds at ease. There are group and individual counselling sessions with family members and caregivers, many of whom are illiterate and harbour common misconceptions like cancer being contagious.
    Patients have access to experienced counsellors like Renuka, who strive to put bewildered and fearful minds at ease. There are group and individual counselling sessions with family members and caregivers, many of whom are illiterate and harbour common misconceptions like cancer being contagious.
  • The kitchen staff maintains a diary of the patients’ dietary requests and takes these very seriously, since they never know if a certain meal is a patient’s last one. Having cooked thousands of last meals, from puris to fish curry, no request is too big or trivial to conjure up in this kitchen.
    The kitchen staff maintains a diary of the patients’ dietary requests and takes these very seriously, since they never know if a certain meal is a patient’s last one. Having cooked thousands of last meals, from puris to fish curry, no request is too big or trivial to conjure up in this kitchen.
  • The kitchen is headed by Kurshid, who has served here for over a decade.
    The kitchen is headed by Kurshid, who has served here for over a decade.
  • The kitchen staff wheels out meals for the patients three to four times a day.
    The kitchen staff wheels out meals for the patients three to four times a day.
  • Laundry might seem minor in the larger scheme of things, but Rosemary in the housekeeping team has tackled the vast quantities for 11 years now.
    Laundry might seem minor in the larger scheme of things, but Rosemary in the housekeeping team has tackled the vast quantities for 11 years now.
  • Providing clean bedding and clothing is an essential part of palliative care.
    Providing clean bedding and clothing is an essential part of palliative care.
  • Home care nurse Susheelamma, in her early 20s, leaves after a routine check at a patient’s home, but can’t hide the sombre shadow across her face.
    Home care nurse Susheelamma, in her early 20s, leaves after a routine check at a patient’s home, but can’t hide the sombre shadow across her face.
  • Somashekara has physically lifted people who could not move, cracked jokes for gloomy patients and their families, scolded those who were giving up on life, given practical advice, and cleaned up after people who vomited or soiled themselves. He has personally helped over 2,000 people in their most desperate hours.
    Somashekara has physically lifted people who could not move, cracked jokes for gloomy patients and their families, scolded those who were giving up on life, given practical advice, and cleaned up after people who vomited or soiled themselves. He has personally helped over 2,000 people in their most desperate hours.
  • Almost every time, he leaves patients with a laugh and good cheer.
    Almost every time, he leaves patients with a laugh and good cheer.
  • Accessing morphine for pain relief is one of the biggest challenges for institutes offering palliative care in India. Here, a home care nurse labels a bottle of oral morphine solution to prevent accidental use.
    Accessing morphine for pain relief is one of the biggest challenges for institutes offering palliative care in India. Here, a home care nurse labels a bottle of oral morphine solution to prevent accidental use.
  • Faced with death, the terminally ill go through a range of feelings and thoughts: they savour the good memories, express regrets, bemoan the slippage of time, show consideration for children and other loved ones, get angry and frustrated, discover pride and satisfaction, and constantly ponder the meaning of life, death and the afterlife.
    Faced with death, the terminally ill go through a range of feelings and thoughts: they savour the good memories, express regrets, bemoan the slippage of time, show consideration for children and other loved ones, get angry and frustrated, discover pride and satisfaction, and constantly ponder the meaning of life, death and the afterlife.
  • When you look at death in the face, you realize the luxury of a peaceful end. Palliative care as offered by organisations like Karunashraya serves a seminal purpose: the right to die with dignity.
    When you look at death in the face, you realize the luxury of a peaceful end. Palliative care as offered by organisations like Karunashraya serves a seminal purpose: the right to die with dignity. "Our aim at Karunashraya," says Somashekara, "is to take patients from darkness to light."

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