Varanasi, also called KASHI, is famous as the MOKSHA DHAM according to the ancient Hindu belief. People come here to attain salvation and realization. It is a common belief that one who dies in Kashi, attains moksha or salvation from their sufferings and liberation from the cycle of birth and rebirth. It is in this traditional and cultural capital of India, that the Cancer Treatment Center (CTC) has helped tremendously in starting palliative care.
Varanasi is also famous as the seat of learning. Dhanwantri, the God of medicine taught and delivered the knowledge of Ayurveda on this holy land. The Buddha also delivered his first sermon after enlightenment here in Sarnath. In the present times, Varanasi’s Banaras Hindu University is considered the capital of knowledge, a conglomeration of old and new wisdom, which harbors six institutes and the Institute of Medical Sciences stands as the pride of the University. The Institutes’ hospitals cater to a population of more than 1 lakh patients per year. Almost one-third of these patients suffer from cancer. Lack of awareness and poverty brings patients to our center at the terminal stages of their diseases. Due to the busy OPDs, the overburdened doctors are unable to deliver personalised care that a patient and family require especially after the diagnosis of a life-limiting disease. Moreover, the lack of awareness and lack of training of the healthcare workers was another roadblock for efficient care delivery to patients. The patients are poor, uneducated and unaware of what they can do to help themselves.
In 2019, our institute was given the offer of participating in the CTC program; a joint initiative of All India Institute of Medical Sciences, New Delhi (AIIMS, New Delhi) and the Asia Pacific Hospice Palliative Care Network (APHN) to train doctors and nurses in palliative care. We attended the orientation course in January 2020. But soon after, a nationwide lockdown was implemented due to the Covid-19 pandemic. The limitations imposed provided new opportunities for interaction and our learning continued through weekly online classes, case presentations and discussions. We could learn and interact with the most experienced mentors throughout the lockdown. It was a true learning and it also kept us motivated through such difficult times.
As things started getting back to normal, we were invited for a clinical attachment to AIIMS, New Delhi arranged by the CTC programme. This experience gave us new insights into managing our own clinical practice and patient care. We could see how the palliative care OPD works and about IPD patient care. The spectrum of care would have been incomplete if we were not exposed to home care visits. It was heartening to see the patients in their houses and was a humbling experience.
With this knowledge and skill, we revamped our palliative care services in our hospital this year. We could conduct an End of Life Nursing Education Consortium (ELNEC) course to train many nurses from different specialties to deliver good patient care. With the CTC programme we gained the confidence of starting palliative care in our hospital from our pain clinic. Presently we have six pain and palliative care beds and we are successfully running the pain and palliative care clinic three days a week -taking care of our patients with compassion. All thanks to the CTC programme.
I really appreciate the CTC programme initiative which has helped me and my institution to improve the care of our patients.
Article written by: Dr Nimisha Verma
Edited by: Ms Trudy Giam
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CTC (Cancer Treatment Centre) Programme is a novel initiative to develop capacity to provide palliative care in cancer institutes in India that can be sustained beyond completion of the programme. This programme is a collaboration between the All India Institute of Medical Science (AIIMS) and the Asia Pacific Hospice Palliative Care Network (APHN) and sponsored by the Lien Foundation of Singapore. For more information, please visit https://www.liencollab.org/