Volume 23, Number 5: May 2022
CanSupport Pioneers a Mobile Palliative Care Clinic in New Delhi
By Harmala Gupta, IAHPC Board Member and
Founder-President, CanSupport
“Our Mobile Palliative Care Clinic is an attempt to reach the unreached.”
—Dr. Ravinder Mohan, CanSupport physician
The mobile clinic, “all dressed up” for its inauguration. Photo used with permission.
Recently, two public hospitals in New Delhi—Safdarjung Hospital and LNJP Hospital—reached out to CanSupport to start pain treatment and palliative care services for their cancer patients. Since these hospitals could not spare space within their premises, and renting a location would be expensive, we decided to launch a Mobile Palliative Care Clinic (MPCC).
For the past 12 months, the MPCC van has been parked outside one or the other of these hospitals, Monday to Friday, from 9:30 a.m. to 3 p.m. On board is a multidisciplinary team: a doctor, nurse, social worker, and outreach officer. Like all our services, treatment is free of charge as it caters to people who are underserved.
Nuts & bolts
The cost of the customized van (INR 2,100,000/$28,000 US) was met by Punjab National Bank Housing Finance Ltd. The corporation was happy to contribute to a project that would visibly showcase its brand. After purchase, it took eight weeks to make the van fit for our purpose.
Outfitting the van for its new purpose took eight weeks. Photo used with permission.
The annual operating costs are estimated to be about INR 2,600,000/$34,500 US. This includes salaries, vehicle costs, medicines, nursing supplies, nutritional supplements, phone bills, printed information, etc. We rely on donors committed to CanSupport to defray these costs.
Coinciding with clinics
The MPCC operates on days that coincide with each hospital’s chemotherapy and radiotherapy clinic days. Consequently, patients receive the benefit of the services of both facilities on the day they come for treatment.
After hospital outpatient department hours are over, the driver takes the team to nearby low-income areas, slums, and villages to disseminate information about palliative care and CanSupport’s services.
In its first month, the mobile clinic had 34 patient visits; recently, the MPCC racked up 111 patient visits in just one week. If patients and families need advice or support outside regular hours, they can access all team members by phone.
A multipurpose effect
The mobile clinic provides much more than immediate, on-site care.
A nurse dresses a wound inside the mobile clinic. Photo used with permission.
- It seeks to demystify cancer.
- It aids informed decision making.
- It prepares patients for treatments and procedures, and motivates them to complete them.
- It coordinates care with treating oncologists (not always easy!).
- It helps deal with side effects of treatments.
- It responds to pain and other distressing symptoms promptly and adequately (including prescribing oral morphine for moderate to severe pain).
- It manages co-existing illnesses, both physical and mental.
- It facilitates third-party referrals for second opinions.
- It mobilizes financial and other resources for ongoing treatment.
- It provides comprehensive nursing care.
- It gives dietary advice and nutritional support.
- It offers guidance and support with personal care to ensure active living.
- It supports and counselsand suggests ways to cope.
- It enables family caregivers to prepare for and handle what lies ahead.
- It demonstrates and teaches simple skills for more effective caregiving.
- It helps patients and families cope with the COVID-19 pandemic by providing pertinent information, referrals, counselling, and resources.
Easy, dependable, caring
Patients and caregivers who have used the MPCC find it useful for a variety of reasons. They talk about how easy it is to access, its dependability, and the fact that consultations are never rushed. In the words of one patient, “The nurse very patiently tells me the timings of all medications that I am supposed to take.”
A patient speaks with the mobile clinic’s social worker. Photo used with permission.
The mobile clinic can dispense oral morphine, which patients regard as “a blessing,” as is the dressing of wounds which saves them time, money, and effort. They are also reassured that, should their condition deteriorate further, the team offers continuity of care by visiting them at home. Patients say that the mobile clinic helps them to be better prepared, less afraid, and more accepting of what lies ahead, and caregivers, who are often far from home, feel supported. “I feel I am not alone,” said one caregiver, “and that we have friends in a strange city.”
Changing minds
The MPCC marks another milestone in CanSupport’s continuing endeavor to bring care ever closer to where it is most needed. By working in tandem with oncology departments in two major public hospitals in Delhi, it has the added benefit of improving the quality of life of cancer patients undergoing treatment. I believe that it will also help break the unfortunate association of palliative care as something that is only provided at the end of life.
To learn more about CanSupport visit the IAHPC Global Directory of Palliative Care Institutions and Organizations.
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