Featured Story

Volume 23, Number 11: November 2022
Amrit Dhara Palliative Care’s cyclothon helped raise awareness in the state of Odisha, India. Photo used with permission.

Amrit Dhara: An inspiring example of World Day’s potential

By Alison Ramsey
IAHPC Newsletter Editor

Roundtable participants (left to right) Subodh Nayak, state drug controller; Dr. Niranjana Mishra, director of public health; Dr. Antarjhami Mishra, district urban primary health officer; Prof. Bidhu K. Mohanti, director, Kalinga Institute of Medical Sciences; Shri Jagadananda, cofounder, Centre for Youth and Social Development; and Dr. Mami Parija, president of Amrit Dhara. Photo used with permission.

Outpatient and day care provider Amrit Dhara Palliative Care is a perfect example of why World Hospice & Palliative Care Day exists.

This IAHPC member is a newcomer established just two years ago in an eastern district of India. The government funds one doctor and a nurse in each district who provide palliative care, but it remains widely unknown to the public and poorly understood by the majority of local medical practitioners. Amrit Dhara’s mission is treating cancer patients, but it also shares the World Day focus on community awareness and education.

For their World Day, this small group of dedicated palliative care providers in Bhubaneswar enacted an ambitious program:

And it all came together in one month.

Amrit Dhara Palliative Care

Located in Bhubaneswar, the state capital, population 850,000; the metropolitan area comprises 1.3 million people.

Staffed by 1 doctor, 2 nurses, 1 office assistant, 1 pharmacist, 1 person who does housekeeping. Three physicians (including Mami Parija) volunteer on a rotating basis. A radiation oncologist provides mentorship.

Funded entirely by friends & family, and run in a donated space, Amrit Dhara’s services include 3 day care beds for treating severe pain, intractable vomiting, breathing difficulties, dressing cancer wounds & other procedures. It has a pharmacy and license to dispense morphine. Nurses do follow-up calls, and “if patients can’t come to us, we try to go to them.”

Its hours of operation are 10 a.m. to 6 p.m., six days a week.

“When we learned that the theme was ‘Healing Hearts and Communities,’ we decided to do it,” says Dr. Mami Parija, president of Amrit Dhara Palliative Care Trust. “It was not difficult for us. I’ve been working here (as a consultant anesthesiologist) for more than 20 years.” In short, she knows a lot of people! For example, “We contacted a member of Parliament who is a doctor who agreed immediately” to speak about the importance of palliative care. The cyclothon instantly gelled when a friend linked to a cycling club took the initiative.

“We know that people are suffering, but are not being addressed in a proper way. We have to connect with other organizations: that’s why we tried to involve everyone. They will help us to move forward.”

Close to 100 people attended Amrit Dhara’s World Day. “I’m very pleased with the attendance,” says Parija. “How to move forward next is in our mind.”

A rangoli made for World Day celebrations at Amrit Dhara. Photo used with permission.

Palliative care, she adds, is gaining momentum among health care professionals, but cancer physicians have yet not been keen to refer to palliative care until a patient suffers severe pain and is told “nothing can be done.” Because it is associated with imminent end of life, “people are scared” when referred to palliative care. But the care they receive—making them comfortable at home—is a welcome surprise.

“When the demand comes from patients,” she adds, “things have to change.”

Plans for the immediate future

Amrit Dhara’s urgent to-do list includes: sensitization of grassroots health workers, advocacy, and community outreach. Volunteers at Amrit Dhara receive three hours’ training, but in January the institution will institute a 16-hour training program approved by the World Health Organization and Indian Association of Palliative Care.

Parija has elicited a promise from the head of a successful telemedicine operation to help set up their own telemedicine service in a year’s time.

“These are our first steps,” she says. “Our baby steps.”

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