Project Hamrahi – Patna, Bihar July, 2010

July, 2010
IGIMS, Patna
Dr. Vinod Verma. Palliative Care Consultant IGIMS
Australasian Palliative Care International
Dr Odette Spruyt. Palliative Care Consultant PMCC.
Pallium India
Professor Rajagopal, Chairman

This visit was a follow-up to a project led by Pallium India, National Cancer Institute, USA and the WHO Collaborating Centre at Madison-Wisconsin, to initiate palliative care facilities in Regional Cancer Centres across India. At the invitation of the Director, IGIMS, I was fortunate to visit Patna and my thanks go to Dr Vinod Verma for hosting this visit and to all those who showed an interest in palliative care development at IGIMS. The level of support was encouraging and the need for palliative care very evident. The visit extended over one week which allowed time to meet with key figures involved at the Institute, to provide three talks to nursing, medical and wider audience including media and NGOs. It allowed time to develop friendships and experience the warm hospitality of the medical staff in anaesthesiology and medical oncology. Dr Vinod and I were able to spend some hours reviewing the current service and barriers to development. From this basis, ongoing support will be provided through email and phone contact, to assist Dr Vinod to develop a program for service development over the next 6 months. My impression was that it will be very important for Pallium India/APLI through Project Hamrahi, to maintain close contact with Dr Vinod as he expressed his doubts about his ability to achieve the sustained establishment of the Pain and Palliative Care Service.

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