2009; Volume 10, No 10, Octuber

 
IAHPC
 

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IAHPC Traveling Scholars’ Reports

From Chennai, India
by Subathra Muthukumaran, MD

I work at the Lakshmi Pain and Palliative Care Clinic, a charitable Trust at Chennai, India. I am an honorary palliative care physician since 2005 and without the support of the International Association for Hospice and Palliative Care I would have not been able to make the trip to Singapore for the classroom intensives which are part of the Certificate Course in Health (Palliative Care) of Flinders University, Australia.

Our clinic has been interacting regularly with the Ministry of Health, Government of Tamilnadu state, to promote palliative care - starting clinics, simplifying the license for oral morphine, and including palliative care in the medical and nursing curriculums. Tamilnadu state was among the first few states in the country (India) to simplify the licensing of storage and dispensing of oral morphine; but training in palliative care is necessary to get the license and there are very few trained professionals in this state. Hence our clinic is committed to training professionals and to teach them about end-of-life care and the use of oral morphine to relieve the pain and suffering of cancer patients. With this view, our clinic organized the Certificate Course in Palliative Care for doctors and nurses at Chennai (approved by the Indian Association of Palliative Care) and I am one of the faculty members. We are also planning to train volunteers to form a network in the community to better reach all those who need palliative care. I decided to obtain the Graduate Certificate in Health (Palliative Care in order to equip myself provide better care for my patients and to be a better teacher of health care workers.

The classroom sessions in Singapore were very interactive and it was a good opportunity to learn from experts in the field. There were professionals from 15 different countries which helped me learn about many different palliative care models and also about the differences in end-of-life care in various cultures. Portfolio writing and video critique teaching tools were used. These helped me to identify areas where I felt a need to improve and learn more; they also helped hone my knowledge and communication skills.

The completion of this course has provided me with a tremendous feeling of confidence. I wish to thank IAHPC for sponsoring and making this trip possible.

Traveling Scholar’s Report after attending the International Network of Cancer Treatment and Research (INCTR)
by Mr. David Wata, Kenya

The International Association of Hospice and Palliative Care (IAHPC) sponsored me, through their traveling scholarship program, to attend the 8th INCTR meeting on countries with limited resources that was held in Antalya, Turkey during March of 2009.

I learned a great deal by attending the meeting; the following are some of the highlights:

  • Making a difference and leading by example – building capacity to manufacture oral morphine preparations. A poster presentation demonstrated how a government cancer centre in India was able to set up a facility to manufacture morphine solution and capsules. The institution I work for, Kenyatta National Hospital, in Nairobi, Kenya has a small manufacturing unit. We do prepare a morphine solution, but do not manufacture the capsules. From this paper, I have learned that it is possible for us, with institutional and professional support, to produce morphine solutions in large batches and also, hopefully, to manufacture morphine capsules. This will enable us to reduce the cost of morphine to the patient.
  • Use of wheat grass in the supportive care of terminally ill cancer patients. A study was presented that examined if there is an effect of wheat grass juice on the quality of life of terminally ill cancer patients. Terminally ill cancer patients drank wheat grass juice for a six month period. At the end of the study, they measured hematological indices and performance status and found that those taking the wheat grass had improvements between 50 – 70% in the parameters measured. Their conclusion was that wheat grass juice should be used in these patients. Wheat grass is widely available in my country but it is hardly, or never, used by medical practitioners in palliative care for terminally ill cancer patients. In fact, the use of most herbal and complementary medicines is frowned upon. I intend to conduct a study using wheat grass and other complementary medicines that are currently in use by alternative health practitioners in order to determine their clinical effectiveness.
  • The INCTR PAX program presented the work they do. INCTR established the PAX program to address the challenges related to the delivery of palliative care in developing countries in which such care can be hindered by limited access to opioids and other symptom-relieving medications, rural dislocation of a population, competing health priorities, war or political instability, and limited access to health care services. The goal of the PAX Program is to assist developing countries to initiate and sustain effective palliative care programs suitable for their countries in order to provide an improved quality of life for all patients with cancer, especially for those when cure is not possible.

All this has been done in developing countries including Kenya. The next step for us is to access the same INCTR structures and support to be able to further develop palliative care services. This should be possible since we already have a few INCTR projects running in my country.

We received a free copy of a palliative care handbook from INCTR – a reference guide.

This experience was very valuable for me. I learned a lot and I am a better person for it. The patients that come to my institution will be able to access better and more innovative services than they would have had I not attended this conference.

I am very grateful to the IAHPC for providing the financial support that enabled me to attend this meeting. Once again, thank you very much for awarding me the scholarship.

Mr. DAVID WATA
Oncology Pharmacist
KENYATTA NATIONALHOSPITAL
Nairobi, Kenya

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