Soban Singh Jeena Government Institute of Medical Sciences and Research, Almora, Uttarakhand, has made significant progress in establishing pain and palliative care services after capacity-building initiatives under the ongoing ICMR-funded project led by Dr. Sushma Bhatnagar at Max Super Speciality Hospital, Saket and Dr. Brajesh Kumar Ratre at AIIMS, New Delhi.
The pain and palliative care services at the institute were initiated by the Department of Anaesthesiology under the leadership of Dr. Urmila Palaria, Professor and Head, along with Dr. Aditya Kumar Chauhan, Associate Professor and their team. With support from trained nursing officers, the department has successfully established and expanded palliative care services within the hospital.
The institute has started a dedicated daily Pain and Palliative Care OPD along with a six-bedded pain and palliative care ward. In an important step towards community-based care, the team has also initiated home care services for patients requiring palliative care support. They have also initiated research activities in pain and palliative care. They have established systematic documentation with NDPS Act compliant opioid management practices, including dedicated registers for inventory management and implementation of standardized pain assessment and follow-up documentation for OPD and IPD patients.
The institute has actively undertaken several awareness and educational activities to improve understanding of palliative care services. Awareness camps are regularly organized within the hospital as well as in remote community areas. Educational talks on palliative care are also being delivered monthly through All India Radio (Akashvani) Almora. The hospital has incorporated palliative care sessions into its monthly CMEs and has initiated palliative care teaching sessions for undergraduate and postgraduate students, including integration into the foundation course curriculum.
Prior to the establishment of these services at Almora, patients from nearby regions often had to travel nearly 90 km to Haldwani, more than 300 km to Rishikesh and even farther to Delhi for pain and palliative care treatment. Following the training and implementation activities, the hospital has successfully started dedicated pain and palliative care services locally, reducing the need for patients to travel outside the region. Patients are now seeking care at Almora not only from nearby areas but also from Pithoragarh and bordering regions of Garhwal.
To further promote awareness, palliative care-themed paintings and educational displays have been placed across the wards, OPD and other hospital areas. These continuous academic and awareness initiatives have contributed to increased referrals from various departments within the hospital.
The visit highlighted the encouraging progress made by the institute in integrating pain and palliative care services into routine clinical practice and demonstrated how focused training, mentorship and the dedicated efforts of the trained doctors and nursing staff can successfully establish new palliative care services in remote and resource-limited settings. These initiatives are helping ensure that patients and their families can access pain and palliative care services closer to home, reducing the need to travel long distances for treatment.
The progress at the institute reflects how capacity-building initiatives and committed local teams can strengthen pain and palliative care services in government hospitals and improve access to care for patients in remote regions. Such initiatives may also serve as a useful model for strengthening palliative care services in other hilly and geographically challenging regions of India.
Dr. Varun Shekhar
Consultant (Non-Medical)
Department of Onco-Anaesthesia & Palliative Medicine
Dr. B.R.A. IRCH
All India Institute of Medical Sciences (AIIMS), Delhi
Email ID: varunshekhar18@gmail.com
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