Lakshadweep Hamrahi visit November 2014

Lakshadweep Blog, November 2014

Sarah Begley &  Sophia Lam

It has been a pleasure visiting our friends of the Lakshadweep Institute of Palliative Care on the Island of Kavaratti a year after our first visit in 2013. Their service has gone from strength to strength and among many successes, have been able to care for 27 patients at the end of life at home and have maintained a continuous supply of morphine over the last year. The service continues to grow and we travelled with the team as they assessed potential patients on a neighbour island of Agatti where they plan to expand the service.

sophia and patient 2014

Undoubtedly one of the services biggest successes was that, a year on, the same staff and volunteers remained, a testament to the support and leadership provided by their leader Moulana. Again we were welcomed with open arms into each of the volunteers homes and continued to build strong links and friendships with those in the service. We visited homes of patients together and again lobbied hospital directors of government figures to provide greater support to the service.

From a nursing perspective the nursing education of families had improved significantly with each family we visited with a very good idea of how to care for their loved one at home. One nurse Sister Crezentia had received an award for nursing excellence and it was an honour to be present to witness her receiving this award.

Dr Sophia and I conducted formal and informal sessions about reflective practise, communication, teamwork and self care. During an informal reflective practice session I listened with great joy as a newly graduated nurse from the island, now being trained in palliative care, spoke about his experience in caring for a woman at the end of life. He told of how he had been touched by the suffering of this patient and how satisfying he found caring for her and allowing her to die with dignity.

We look forward to visit again in 2015 and are very proud to share the palliative care journey with the men and women of the Lakshadweep Institute of Palliative Care.

home visits with Brother Khafi and Monseuir new trainee 2014


Project Focus

As some of you may be aware, in early 2016 the Asia Pacific Hospice Palliative Care Network (APHN) held four ‘APHN Dialogs’, in which clinicians across the Asia Pacific region could link in through Skype to attend a webinar. The following webinars took place:

- A discussion of palliative care service development in the Asia Pacific region, presented by Odette Spruyt
- Pain control in palliative care by Yoshiyuki Kizawa from Kobe, Japan
- Management of the cancer wound by Edward Poon from Singapore
- Bereavement care by Jun-Hua Lee from Taiwan

These sessions were well received and provided a valuable opportunity for clinicians in different countries to learn from an expert in that field and also to share their own professional experiences. Unfortunately, not all countries in the region have reliable internet coverage or sufficient bandwidth so some attendees were unable to join the meetings. In response to this, in recent months APLI has been looking at a new educational initiative in partnership with APHN.

Project Focus aims to set up online discussion groups between palliative care clinicians in specific countries in the Asia Pacific region and APLI mentors. Some nascent palliative care centres struggle with isolation, limited practitioner experience and variable institutional support. In effect, Project Focus would work towards similar objectives to Project Hamrahi: to improve the capacity for best practice patient care in the local setting and to reduce the isolation of palliative care providers in emergent services.

APLI is therefore calling for expressions of interest for mentors to volunteer their services to help support our regional partners. Project Focus would particularly suit clinicians who might otherwise find it difficult to travel overseas for mentoring work, as the contact will be online using a small group discussion format on the ‘Slack’ communication platform. APHN has already identified local clinicians in two separate services in remote and regional Indonesia who would like to be partnered with APLI mentors. In addition to this, there has also been some interest from doctors in Vietnam, Brunei and Nepal whose learning needs were unable to be supported by the APHN Dialogs.

Although the exact process will be flexible, it is proposed that education would begin with case presentations from the local APHN clinicians. These would then serve as a springboard for the APLI mentors to explain current evidence based practice recommendations. The subsequent discussion would then take into account local factors such as medication availability, local resources, staffing and other factors such that a viable and culturally appropriate management plan can be formulated.

I hope that you will share our excitement for this initiative. Project Hamrahi has demonstrated the value of teams of mentors made up of both doctors and nurses working together with local Indian clinicians over a sustained period of time. Project Focus has the potential to broaden the scope of such partnerships to other countries and so I invite you to contact me via chairman@apli.net.au with a short biography and reflection on why you would wish to work as a mentor.

- Anil Tandon


Your donations to APLI help in the following ways:

assist with training of doctors and nurses in palliative care practice in developing nations

support nurses to travel and teach as part of Project Hamrahi

help with purchase of critical site resources such as essential equipment and supplies,  medicines and educational materials