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Agartala Leadership Workshop, Feb2015

Agartala Leadership Workshop

Author : David MacKintosh

In November 2014, for Chris and Wendy, it was to be their third and second support visits respectively, to the Regional Cancer Centre in Agartala, North East India. For Jane and David, it started out as an inaugural Hamrahi experience of spending a teaching weekend in Patna, Bihar, with Odette. By December 2014,  it had turned into a 10 day introductory palliative care workshop for 40 participants organised for the Regional Cancer Centre and Tripura State Government by a combination of faculty from Pallium India and APLI. The participants were to form 10 community teams consisting of a doctor, a nurse, a social worker and a pharmacist destined to eventually provide home care across the state of Tripura, part of the vision of Dr Gautam Majumdar, Medical Director at the Regional Cancer Centre in Agartala.

Palliative care workshop signFeb2015

The programme had been jointly crafted by Dr Chris Drummond (APLI) and Dr Sreedevi Warrier (Pallium India). Dr Sreedevi and  Nurse Jayakrishnan Kalarickal (JK) from Trivandrum, Kerala  were present for the duration of the workshop but were supplemented by Dr Biju Raghavan and Prof Rajagopal who both made excellent guest appearances; actually, calling Dr Raghavan a guest appearance is a little unfair as he spent two full days teaching communication skills which was one of the highlights of the workshop. The remainder of the programme was taught jointly by APLI and Pallium faculty – Chris, David, Jane, JK, Sreedevi and Wendy.

It was a busy 10 days, run consecutively, without a break, and required considerable perseverance from the participants, particularly given the language differences. One benefit of the 10 day format, however, was the opportunity to develop a sense of community, evidenced by increasing ease of conversation and discussion as the workshop progressed. It was difficult to judge how much the participants benefitted from their experience although it was clear that they had acquired a firm understanding of the principles of patient-centred care and the team approach to care; probably two of the difficult concepts of palliative care not readily extracted from a textbook.

Although this workshop was a divergence from the Hamrahi mentorship model, as a collaborative venture it had much to recommend it and while there were certainly lessons to be learned and improvements to be made it could be the basis of further developments in APLI’s relationship with India.

For Chris and Wendy this workshop was an opportunity to catch up with friends and acquaintances and review their relationship with India. For David and Jane this was their first encounter with India, its chaos and its wonderful people.

.teaching faculty, Agartala 2015

 Dr David MacKintosh, Dr Gautam Majumdar, Wendy Salmon, Dr Chris Drummond, Dr Sreedevi Warrier, Jane MacKintosh, Prof M.R. Rajagopal

 Workshop closure Feb2015

Sreedevi, Jane, David and JK receiving gifts at the end of the workshop.

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

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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