Project Hamrahi – Jamshedpur, Jharkhand November 2010

November 29 to December 4 2010

PalCare India Project

Meherbai Tata Memorial Hospital
Dr Master, Medical Director
Dr Urmila Patel, Senior Medical Officer  **
Ms Sunita Ekka, Staff Nurse, Meherbai Tata Memorial Hospital

Tata Main Hospital
Dr Madhusudanan, General Manager, Tata Main Hospital
Dr Koshy Varghese , Anaesthetist, Critical Care Unit **
Ms Jeseentha George, Staff Nurse, Tata Main Hospital **

(**Attended training in Trivandrum Institute of Palliative Sciences, Trivandrum, Kerala in 2009)

Australian Palliative Link International

Dr Anil Tandon, Palliative Care Physician, Perth
Wendy Scott, Clinical Nurse Consultant,  Perth

Pallium India  

Dr. M.R. Rajagopal, Chairman,
Mr Anosh Varghese, Project Officer, CanKids Kolkata


A first visit, as directed by Professor Rajagopal, to support and mentor 4 local health care providers from two neighbouring hospitals, the Meherbai Tata Memorial Hospital (MTMH) and Tata Main  Hospital (TMH), who had been supported by Pallium India in 2009 to complete a 6 week palliative care training course and who had then initiated some limited formalised palliative care service provision at their individual hospitals.


It was a privilege to visit Jamshephur. Our thanks to Tata Steel for hosting this visit and to all those who showed an interest in palliative care. Dr Koshy had organised a very busy, concise, well planned and promoted program.  Hence, despite the short time available we were able to achieve all the objectives to some degree. We identified some challenges in service provision but there was obvious enthusiasm for training and for the development of local palliative care services. It was extremely encouraging to see how much has been achieved with the existing small services but the visit also highlighted the need to continue the support to enhance sustainability and future growth.

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