The Trivandrum Institute of Palliative Sciences (TIPS), Pallium India, Thiruvananthapuram, and the Institute of Palliative Medicine (IPM), Kozhikode, two major palliative care delivery and training institutions in Kerala signed a Memorandum of Understanding (MoU) on Wednesday, 12th June, 2024 to work on areas of mutual interest.
Pallium India’s flagship demonstration program, the Trivandrum Institute of Palliative Sciences (TIPS) is a WHO Collaborating Centre for Training and Policy on Access to Pain Relief and IPM is WHO Collaborating Centre for Building Country Capacity in Palliative Care and Long-Term Care.
The MoU was signed by Ms Smriti Rana (Head of WHOCC TIPS) and Dr Suresh Kumar (Head of WHOCC IPM).
An excerpt from a joint press release shared by both institutions after signing the MoU reads, “In a historic milestone for palliative care development in the region, the two WHO Collaborating Centres that have worked in parallel for over two decades have joined hands to improve access to pain management and palliative care in India and the Southeast Asia Region”.
The e-hospice India team reached out to Ms Rana and Dr Kumar for a brief interview to gain further insights into this significant collaboration.
What made both organisations choose to collaborate with each other?
Ms Rana: IPM and Pallium India both have unique ways of community engagement. Both organisations encourage community-based palliative care with models that empower the community. Universal Health Coverage aspires to reach people where they are when they need it, and a critical aspect of that is to include people in the design and implementation of healthcare systems in a way that best suits their needs.
We strongly believe that to truly integrate palliative care with the healthcare delivery system – where the need is tremendous but coverage is very low – we have to think beyond tertiary care and involve community members in delivering that care.
Palliative care is not only a medical intervention. Both institutions firmly believe that it is a social intervention that understands the 360-degree approach needed to mitigate what is now termed serious health-related suffering.
IPM has taken the decentralised approach where control truly lies with the community. And not only is the community enthusiastic, but also deeply committed to sustain and scale this model. Pallium India has a more centralised approach, yet involve the community and volunteers in delivering Palliative care services.
It has been particularly inspirational to connect with the student volunteers at IPM – their numbers running into the hundreds – and the infectious joy in their involvement. This goes to not just cultivating and nurturing compassion but also creating leaders who will take this spirit of service into whatever they choose to do in the future.
For us, this collaboration was born from a sense of respect and willingness to learn from each other.
Dr Kumar: Historically, the Institute of Palliative Medicine (IPM) and Pallium India emerged from a shared foundation of compassion, concern, love, and commitment to a hitherto unseen and unheard section of people. Initiated in 1993 as the Pain and Palliative Care Society, the movement gained momentum over the next decade as volunteers became crucial in engaging the community to provide the comprehensive medico-psycho-socioeconomic support needed by individuals with life-limiting illnesses.
Both institutions have been working in a common domain, with emphasis on complementary areas. Other than the delivery of palliative care services in Kozhikode, the focus of IPM has mainly been on establishing decentralized community-based palliative care systems while Pallium India has been focusing mainly on policy, advocacy and efforts in palliative care integration in addition to delivery of patient care.
Creating community-based palliative care systems is crucial, especially in low and middle-income countries, to provide comprehensive care to those in need on a broader and deeper scale. Both organizations are currently in a position to collaborate by sharing knowledge and experiences to achieve this common objective. As WHO Collaborating Centres, with the responsibility to advise the World Health Organization and its member countries on palliative care issues, both organizations have a significant advantage in working together to reach this goal.
The joint press release by IPM and Pallium India says that, “The two WHO collaborative centres that have worked in parallel for over two decades have joined hands to improve access to pain management and palliative care in India and the Southeast Asia Region.” What are the specific areas in which you plan to collaborate?
Ms Rana: Pallium India and IPM have been leaders in the delivery of training in Palliative care for a couple of decades now. Needless to say, education is an area of collaboration. Faculty exchange / clinician / social worker/ community trainer exchange programs are also on the cards.
Beyond the community level, both organisations have been involved in various state, national, and regional level activities related to capacity building, technical support and advocacy. We recognise the value of strengthening and streamlining some of these areas together. The scope of our partnership has broad parameters within which we will support each other’s efforts as and when required.
Dr Kumar: In line with what Ms Rana has suggested, I can identify particular areas for collaboration, including capacity building and facilitating palliative care services in different communities, sharing skilled personnel to create and conduct training programs, and engaging in joint efforts for policy and advocacy both nationally and internationally.
Of the estimated 7 million people needing palliative care in India, it has been reported that only less than 4% of them have access to it. Reports also suggest that there may be up to 15 million people living with moderate to severe pain in the Southeast Asia Region. This multi-faceted problem therefore requires a multipronged approach. The partnership between the two organisations symbolises a growing collaborative network amongst key providers at the country and regional levels to collectively reduce the burden of illness-related suffering.
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