This comes at a time when WHO is talking of palliative care at the primary stage. “Kerala is the only place where this has happened. But the quality of service they offer is not uniform,” said technical director of Institute of Palliative Medicine in Kozhikode Dr Suresh Kumar.
A large part of the state palliative care policy is not fully implemented and many tertiary care hospitals, even in the government sector, don’t offer palliative care. “And where it exists, it is not integrated with healthcare but placed in a corner of the hospital,” said chairman of Pallium India Dr MR Rajagopal.
Even as palliative care specialists from Kerala go around the globe training doctors, volunteers and NGOs, they fail to inspire young doctors. “There are only four seats in the country for MD (palliative medicine). These seats are mostly vacant as there are not enough job opportunities and the ones available are with an NGO that is often not well paying. This is a big setback for palliative care movement,” said faculty at RCC’s pain clinic and palliative care department Dr Prasanth CV.
This is happening when many more people are recognizing the need for palliative care for those with other chronic diseases, something Kerala emulated much earlier. “Though most patients we get are cancer patients, this is slowly changing as other departments are also referring patients with serious healthrelated suffering,” said Dr Chitra V, pain and palliative medicine, Amrita Institute of Medical Sciences, Kochi.