A doctor's efforts to improve the condition of terminal patients has become a social movement
Eleven years later, his initiative has grown into a people’s movement—the Neighbourhood Network in Palliative Care (NNPC), which now covers all those who exhaust the scope of conventional medicine. Victims of advanced cancers, incurable neurological disorders, extreme cardiac or respiratory ailments and aids come under the purview of palliative care: treatment of those with incurable illnesses.
The NNPC evolved from first-hand knowledge of the inadequacies of a purely clinic-based approach. The remedy was to involve the community in caring for terminally ill—as stakeholders. The facilitation process starts with an awareness programme in which local people list chronically ill patients in their area. Citizens willing to devote at least two hours a week to the patients are asked to register for volunteer training. Once initiated, they visit the patients in their homes. Unlike traditional methods, the stress is on communication between the volunteer and patient—considered as part of the therapy. In cases where clinical intervention is possible, they are also offered temporary treatment. Among the volunteers are students, head-load workers, autorickshaw drivers—people from all walks and persuasions.
There were also instances where the NNPC went a step further in making patients self-reliant. Take the case of Ali, a 55-year-old cancer patient from Malappuram. They helped him start a tea stall and make a living despite his illness. Soman, 60, also a terminal patient, was given a sewing machine. He today has three machines and an established tailoring business.
His efforts have evoked admiration from the fraternity. Says Dr V.P. Gangadharan, ex-chief oncologist at the Regional Cancer Centre, Thiruvananthapuram: "Dr Kumar and his friends prove that patients in the terminal stage have something to look forward to. Their work adds meaning to the concept that one must add life to days than days to lives of terminal patients".
Today Kumar heads the Institute of Palliative Medicine, a social service venture with a vast army of medics, paramedics and volunteers. This has made it possible to cover 80 per cent of the reported cases in Malappuram, Kozhikode and Wayanad districts. The NNPC has brought about a huge difference in the area. Dr (Sister) Scholastica, 73, a volunteer clinician in the northern district of Wayanad, says: "Our intervention has made fellow allopaths sit up and take note. They provide their facilities to any patient referred by the NNPC. This has brought about quite a qualitative change in the health care delivery".
Eighty per cent of the funds are mobilised locally through small donations from within the community. For instance, nearly 30,000 people in the Muslim-dominated Malappuram district contribute a part of their daily earnings to keep the NNPC afloat. The total expenditure for the NNPC programme in 2003 was approximately Rs 12 million. The state government also chips in. There are around 80 palliative care units in India out of which 50 are in Kerala. Of this, 46 are part of NNPC.
Contact Dr Suresh Kumar: Institute of Palliative Medicine, Medical College, Kozhikode—673008, Kerala. Tel: 0495- 2359157/2354897/2354166 Email: pain@vsnl.com