By Alison Ramsey
IAHPC Newsletter Editor
An associate professor of pain and palliative medicine at the MNJ Institute of Oncology and Regional Cancer Center in Hyderabad, India, Dr. Gayatri Palat was instrumental in establishing the Department of Palliative Care within the institute by developing clinical services—including outpatient, inpatient, and home-based care—as well as training programs.
A fuller list of her major accomplishments (in the colored text box) is testament to her persistence, a quality of which the International Association of Hospice and Palliative Care is well aware, as she has also been one of our most loyal members. Dr. Palat joined IAHPC in December 2008: only one other person has been a continuous dues-paying member for longer.
Dr. Gayatri Palat was instrumental in the development of the Department of Palliative Care at MNJ Institute of Oncology and Regional Cancer Center, Hyderabad, as well as the Department of Palliative Medicine and the Diploma in Palliative Medicine—the first of its kind in the country—at Amrita Institute of Medical Sciences, Kochi. She also helped develop a pediatric palliative care fellowship program at the MNJ Institute.
She has played a key role in the amendment of opioid regulations in the state of Andhra Pradesh, working with the government and other stakeholders.
She is a founding member and currently executive secretary of the not-for-profit Pain Relief and Palliative Care Society in Hyderabad, which provides home-based palliative care (“Life at your doorstep”), offering rural outreach, advocacy, and training in palliative care.
Dr. Palat contributed to curriculum development of the Indian Association for Palliative Care’s (IAPC) course on palliative care, and leads the association’s Special Interest Group—Pediatric Palliative Care.
She has been involved in opioid availability activities though the IAPC and the Pain and Palliative Care Society, Calicut (a WHO Demonstration Project).
She has also participated in the development of the EPEC-India curriculum to facilitate implementation of palliative care in institutions throughout the country.
Through her involvement with the International Atomic Energy Agency, Dr. Palat participated in initial planning of palliative care within the National Cancer Control Program for Sri Lanka, Indonesia, and the Philippines.
As a director of the palliative care initiative in South East Asia for Two Worlds Cancer Collaboration, she works with health care professionals in resource-challenged countries to reduce the burden of cancer in South East Asian and African countries.
“When I joined,” she recalls, “there was no palliative care in the state. To date, we are one of the few states in India with a palliative care program. Now, we have extensive home-based and hospice programs for both adults and children in every district.”
Despite her achievements, Dr. Palat is clearly not complacent.
In a recent conversation with IAHPC Executive Director Liliana De Lima and Senior Advocacy and Partnerships Director Katherine Pettus, she was asked the key ingredient in building the relationships that have led to establishing and extending palliative care in India and beyond—and what her next steps will be.
“There were years of work, consistently not giving up, and a few other things that really helped us,” said Dr. Palat. “My work with an NGO organization, the International Network for Cancer Treatment and Research, showcased both what was needed and what was possible. Showcasing a good program was an important aspect: we could say. ‘Wow, it works! Let’s try it elsewhere.’
“The second thing was working within the system, and a critical step was understanding that social scientists have a role to play. The program had to be sustainable within the public health system. However much you work with an NGO, they cannot accomplish that step. You have to reach out.
“The third thing was the importance of partnerships. We received a small seed grant, but collaboration and partnerships made it have a large-scale effect.”
“Now, we need to do an evaluation of programs within the public health system. For example, I feel great about the children’s program, but what is the impact? What is the need? Is it worth putting so much money into it? Not many programs are exclusive to children in India.
“The pediatric palliative care we see is not standard: we see patients who are much beyond the textbook description. They are not at the traditional ‘end-of-life,’ but these are children who are suffering.”
Dr. Palat sees many opportunities for future advocacy, both near and far. “I am particularly interested in activities related to improving access to opioid medications,” she says, “and standardization of training programs in developing countries.”
To learn more about MNJ Institute of Oncology & Regional Cancer Centre, Amrita Institute of Medical Sciences, Pain Relief Palliative Care Society, Indian Association for Palliative Care’s (IAPC), or Pain and Palliative Care Society visit the IAHPC Global Directory of Palliative Care Institutions and Organizations.
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