Authors: Dr. Veena Anand, Dr. P. G. Hariprasad
SAT, Government Medical College, Thiruvananthapuram, Kerala, India
On a warm Sunday, 22nd March 2026, a group of pediatric healthcare professionals gathered at Ananthapuri Hospital and Research Institute, Thiruvananthapuram not just for another continuing medical education program, but for an experience that would challenge their assumptions and reshape their approach to care.
The Pediatric Palliative Care (PPC) Workshop, conducted as part of the “RAINBOW program”—Presidential Action Plan 2026 of IAP Kerala, jointly organized by the Indian Academy of Pediatrics (IAP) Kerala, IAP Thiruvananthapuram, and Pallium India, marked the beginning of a series of PPC training program being planned across Kerala state. This is a 3 day comprehensive programme that includes a one-day onsite workshop, followed by home visit training, and then an online discussion being planned in different districts of Kerala. This was the first day of the training program planned in South Kerala. Forty-five participants attended the first session of this program, each bringing with them clinical expertise and leaving with deeper understanding of compassion in child care.
Beyond Cure: Reframing Pediatric Care
For many participants, palliative care had long been associated with terminal cancer care. The workshop dismantled this narrow understanding early on.
It was emphasized that only a small proportion of children needing palliative care have cancer, while the majority live with chronic, often lifelong conditions—prematurity related, congenital malformations, neurological diseases, genetic disorders, organ failures and complex comorbidities. In India alone, around 1.6 million children require such care but remain largely invisible within mainstream pediatric / subspecialty practice. This realization was unsettling and transformative.
One question asked during the session remained in everyone’s mind.
“How many of us have actively provided palliative care to such children?”
Silence followed.
From Knowledge to Practice: A Structured Learning Experience
The workshop was carefully designed to move beyond theory into practical clinical relevance. The sessions, as outlined in the structured academic program, covered a comprehensive range of topics:
- Introduction to pediatric palliative care
- Pain assessment and management
- Protocols for procedural pain
- Neurological, respiratory, and gastrointestinal symptom control
- Feeding and nutritional challenges
- Communication strategies in pediatric palliative care
- General nursing care
- End-of-life care in children
The sessions were led by Dr. P. G. Hari Prasad, Dr. M. M. Sunilkumar, Dr. Manjusha Nair, Dr. Veena Anand, Dr. Sangeetha Suresh and Smt. Sheeba R. S. These were not delivered as abstract talks. Faculty members, each with deep practical experience, explained real-life scenarios, shared decision-making processes and the emotional complexities of caring for children and their families.
The session on communication explained the most challenging one, breaking bad news, in quite an interactive way and was very impactful. Participants reflected on the difficulty of balancing honesty with hope and clarity with compassion. Communication in PPC is not a one time disclosure but a process of accompaniment; walking alongside families as they come to terms with evolving realities. The goal is not to take away hope, but to redefine it.
Sessions around pain & symptom management, nutrition, nursing care, and comfort focused care were discussed with sensitivity and clarity. Participants learned about alternative approaches, such as subcutaneous fluid administration, that prioritize comfort without compromising dignity.
The session on end-of-life care left a profound emotional impact. It made participants reflect deeply on some of the most difficult decisions in practice—decisions that are rarely discussed in traditional training.
What emerged was a shared realization: Palliative care is not about giving up—it is about caring with dignity.
Leadership and Vision: Rolling Out the Pain-Free Hospital Initiative
A significant highlight of the workshop was the formal rollout of the Pain-Free Hospital Initiative by Dr. Gopika Sekhar, president of IAP Thiruvananthapuram.
This initiative represents a commitment to ensuring that no child should suffer untreated pain within healthcare settings and to prevent and treat procedural pain using standard operating procedures. By integrating pain assessment protocols, training healthcare professionals, and standardizing care pathways, the initiative aims to transform institutional practices.
The rollout during the workshop was not symbolic; it was strategic. It anchored the learning into a system level change, reinforcing that PPC must move beyond individual practice into institutional culture.
A Collective Effort
The success of the workshop was the result of collaborative leadership and dedicated planning. Faculty members, organizers, and participants all contributed to create an environment of openness and learning.
Feedback from participants reflected this impact:
“It was an eye-opening experience.”
“This should reach every pediatrician.”
“We realized how much we have been missing in our care.”
The sentiment was clear—this was not just a workshop, but the beginning of a shift.
Looking Ahead: From Participants to Torchbearers
As the first workshop in a planned series, the program sets the stage for a broader transformation in PPC across Kerala.
The hope is that the 45 participants will not remain passive recipients of knowledge but become advocates and implementers of PPC in their respective settings.
The closing message by Dr. P. G. Hariprasad expressed this vision:
“Together we can.
Together we should.
Together we will.”
A Necessary Change
The Pediatric Palliative Care Workshop at Thiruvananthapuram did more than impart knowledge. It challenged a deeply ingrained, cure-centric model of care.
It reminded pediatric health care professionals that while not every disease can be cured, every child can be cared for.
And in that shift—from curing to caring—lies the true essence of medicine.
“Our motto is that no child who needs palliative care should suffer without it—Every child, Everywhere, Every time.”
Let’s hope this program will lead the way to achieve this motto.
This PPC Program is jointly led by IAP Kerala, under the leadership of Dr. Nandakumar M K (President, IAP Kerala) and Dr. Gopi Mohan R (Secretary, IAP Kerala), along with Dr. Gopika Sekhar (President, IAP Thiruvananthapuram) and Dr. Sreejith Kumar K C (Secretary, IAP Thiruvananthapuram) and Pallium India.
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