Saif Mohammed, Institute of Palliative Medicine
Over a 1000 trained volunteers have geared up to launch the first-ever community-based palliative care programme in east India, in Nadia district of West Bengal. Named Sanjeevani (“life-giving” in Sanskrit), the programme is set to commence in Krishnanagar, the district headquarters of Nadia and the neighbouring villages of Badkulla, Bagulla, Dignagar, Dogachi, Bahadurpur and Chapra.
Sanjeevani has been envisioned by Dr P B Salim, District Magistrate, Nadia and Dr Suresh Kumar, Director, World Health Organisation Collaborating Centre, Institute of Palliative Medicine, Kerala.
The district administration set the ball rolling by gathering doctors including members from the local branch of the Indian Medical Association (IMA), students, teachers and representatives of different non-governmental organisations for a kick off meeting on May 10, 2014. The core team put together at this meeting drew up a blueprint to make the ambitious plan a success.
Dr Salim said, “Knowing the limitations of administration as an insider, the realisation that palliative services can be best rendered with community participation led me to this. Sanjeevani will have the support of both government and non-government organisations. The government is committed to providing affordable health care and relief to the needy and I believe this palliative care service initiative will supplement our efforts optimally.”
Dr Suresh Kumar added, “This project draws on the lessons we learned in Kerala over the last two decades. One strategic difference from the Kerala model is in the use of the district administration as the platform to gather the community around the theme of volunteering for palliative care. We have found that the active involvement of the district administration helps in effectively cutting short the preparatory phase to a couple of months from six to nine months in other cases. The response has been overwhelming and has put to rest all apprehensions. We hope to cover the whole district and start a similar project in the neighbouring district of Murshidabad within one year.”
The IMA Bhavan, Krishnanagar hosted a workshop for 14 doctors on the basics of palliative care, on June 14 and 15. More than 150 volunteers participated in an elaborate train-the-trainer programme on July 26, 27 and 28. These trainers then spread out to the villages and conducted satellite training programmes, yielding a total workforce of 1000 volunteers across the selected locations.
Volunteers conducted a survey to identify the beneficiaries of the project. Every volunteer will be responsible for two patients, primary and secondary. This ensures that every patient will always have the support of at least one volunteer.
Dr Sanghamitra Bora from Kolkata, well qualified and experienced in palliative care, has joined Sanjeevani as the Medical Officer in Charge. She will guide the work of a panel of doctors, each of whom has promised to devote at least two hours every week for Sanjeevani. Dr Bora will lead the doctors’ home care programme every week.
Dr Bora anticipates the number of patients needing help to grow fast, “given the large of volunteers who have been given the task of identifying the beneficiaries. Availability of opioids can be a problem in the initial stages. So will be the absence of a local, specialised palliative care centre for referral. We expect the local hospitals to offer beds for palliative care. “
Dr Mukti Prosad De, one of the local doctors trained for the project was doubtful, initially. “As medical students we knew about palliation, but the idea of delivering palliative care to the community at this scale was a new idea. We were astonished by the great enthusiasm among the volunteers. We are grateful to our Honourable District Magistrate (DM) Dr P B Salim for giving us this opportunity.”
Volunteer Subash Mukharjee described the project as an “auspicious voyage”. He appreciates the great confidence shown by the DM in the all the volunteers from different walks of life. “In the first workshop I was quite surprised to note that even medical persons from my locality did not know about palliative care. That speaks for the dire need for such a programme,” Mukharjee observed.
The entire project is being studied by Devi Vijay, Assistant Professor at Indian Institute of Management, Kolkata. She said, “I shall document the emergence and evolution of the Sanjeevani palliative programme in Nadia district. I will be deeply immersed in the fieldwork, will continue to be an observer at all events and will be talking to various people involved in the project. It helps that I am familiar with birth and growth of the palliative care programme in Kerala.”
This longitudinal research project will help the replication of the programme in other parts of the country.
The official launch of Sanjeevani is set for September 21, 2014. The funds for Sanjeevani have been mobilised locally.