Restoring wholeness: Celebrating 25 years of Integrated Palliative Care Service in Bangalore

Categories: Care and People & Places.

In 1995, one man dreamt of reaching out to a deprived and forgotten section of society who doctors wrote off as incurable. The Bangalore Baptist Hospital (BBH) on March 13 celebrated 25 years of this tiny seed that has branched out to reach those utterly devoid of hope, with a Silver Jubilee Thanksgiving Programme.

This was preceded by a week of awareness through skits and a poster competition conducted within the premises. Our former Hospital Director, Dr Stanley C. Macaden, set up the Palliative Care Department to respond to the need to care for people with palliative care needs when curative options were considered impossible or inappropriate. Today they reach out to at least one million people in urban and rural Bangalore with life-limiting illness, end-stage medical conditions, the frail elderly and their families and community around.

The need of the hour is an integrated system of palliative care for all life-limiting conditions, that combines the individual, families, community, medical professionals, and Government, believes Dr Macaden.

He quotes C.S. Lewis, saying that the magnitude of suffering in India results in a deafening cry, with palliative care being accessible only for two to five percent of the total population. It is this cry that we hope to answer through love, compassion and holistic care.

A brief history

After its inception in January 1995, a small team was created for this purpose. Facilitated by the Christian Medical Association of India (CMAI), we were fortunate to get the support of late Dr Zach Thomas, an Indian palliative care expert from Saskatchewan, Canada, to help us get more organised.

This was also followed by a visit by Ms Gilly Burn, a nurse consultant with the World Health Organization, to BBH arranged by CMAI. This led to training opportunities for BBH staff at Oxford, UK, under the palliative care pioneer Dr Robert Twycross and Gilly Burn.

Later Dr Macaden had a six-month job at a 25-bed Hospice, ‘Ty-Olwen’, in Swansea, Wales. In May 1996, BBH became an Institutional member of the Indian Association of Palliative Care (IAPC). In 1997 a workshop on Palliative Care was held in Bangalore Baptist Hospital supported by CMAI.

Facilitated by Dr Tim Pennell, Dr Macaden was offered the Elwyn Murray Fellowship for one year at the Wake Forest University Baptist Medical Center (WFUBMC), Winston Salem, N.C, USA. At the end of this year in response to a project proposal for palliative  home care by Dr Macaden and Mr Bob Parker, WFUBMC came forward to support us for a five year Hospice and Home Care project.

Another major door of blessing was the close friendship with Dr Ed Shaw who was chair of Radiation Oncology at WFUBMC. He was convinced and determined to have a Radiotherapy facility at BBH and kept working at it. He visited us several times and worked through Dr Benjamin and Dr Alex and finally this dream was realised in 2010 and BBH became a fully Comprehensive Cancer Centre.

Since 2015 a great opportunity of ongoing support has been through the Kurian Foundation to expand our rural palliative care service. This has been a great blessing and now plans are being made for a Hospice facility in rural Bangalore especially for care of the marginalised.

Our involvement in training programmes, volunteer activities, national policy and research initiatives are summarised as best practices in the attached poster presented at the recent IAPC annual international conference in Feb at Guwahati, Assam.

The aim of the department  

Life-limiting illness always shatters confidence and any semblance of hope and it is this broken spirit and their quality of life that we hope to holistically restore. Our desire is to provide a cost-effective continuum of care to the affected and their kin.

Our chief guest for the programme, Dr J.V. Peter, Director of the Christian Medical College (CMC), Vellore, said, the approach is five dimensional; ABCDE. This includes Alleviation of pain, Being a channel of hope and peace, the intent to Comfort when cure is not possible, Dignity in death and Enhancing the quality of life.

These five important principles are often forgotten by many medical professionals and organisations today, he added. The Bangalore Baptist Palliative Care team has succeeded in being a hospital with such a dedicated programme to care for the helpless.

Home care

Augmented by the initial support by WFUBMC for home care we have continued this, focusing entirely on holistic healing through a multi-disciplinary team of doctors, nurses, and chaplain/counsellor for all strata of society. Two testimonies, by Mr Reddy and Mr Gopinath decorated the sentiment at the program and both rang in praise of the team’s gentle, competent, and compassionate ways of allowing patients a dignified end surrounded by their loved ones.

Outreach

Since its inception, the urban and rural palliative care service has taken care of nearly 10,000 patients. New plans for expansion include taking our services to Chikkaballapur and its population of 1.5 million, including many with pitiable living conditions. Currently our rural team visits over 190 villages in Devanahalli taluk and travel through dust and dilapidated roads to reach whoever they can, wherever they can, in the spirit and mission of Christ.

Integrated Process 

Dr Stanley Macaden emphasises on the need for an integrated and person centred approach and the family is an intrinsic part of every stage of care and treatment. Another special feature is our combined clinics and interface with intensivists and medical specialists to assess and discuss care with the patient and family to ensure a multi-faceted holistic approach and shared care plan.

As our CEO and Director, Dr Naveen Thomas, mentioned during the programme, it was Dr Stanley Macaden who put a stop to saying, ‘nothing more can be done’. “Something can always be done”, is his belief and it is with this affirmation that the team hopes to continue in God’s strength and guidance, adding life to days and trying to restore wholeness for those robbed of proper care, comfort, peace, faith, and hope.