Kerala has broken new ground with a palliative care policy that aims at covering every bedridden citizen in the State – rich or poor, down to the last rung. The Arogya Keralam Palliative Care project is being touted as India's first, and the only government initiative of its kind in entire Asia.
Community participation
Flagged off Statewide in 2008, the project got off to a good start in Kozhikode and Malappuram districts in North Kerala. Three years down the line, North Kerala still scores over the rest of the State because of the active involvement of the community there, points out Dr. Anju Miriam John, Medical Officer of the programme in the Kottayam district hospital. “An initiative of this nature can succeed only with people's participation,” she stresses.
The Arogya Keralam Palliative Care project is aided partly by the National Rural Health Mission (NRHM). Every district has a core team of a programme co-ordinator, medical officer, nurses and helpers. Smaller teams fan out at the panchayat levels.
The helpers first identify the beneficiaries of the programme through a door-to-door survey. “Once the patients enrol with us, we take them under our wings,” elaborates Dr. Anju John. A team comprising two nurses and helpers makes house visits periodically to check on the patients. The doctors step in when there is a crisis. The team also supports the care-givers through the ordeal.
All district hospitals in the State have a palliative care department where the doctors see the patients or their care-givers for follow-up action. Services under the State's palliative care programme are free, even wheel chairs, water beds and walkers for patients. For the very poor, the medicines also come free.
“We want to ensure that all, even the poorest of the poor, with a chronic ailment or an old age infirmity can die with dignity,” says Ms. Annamma T.C., sister-in-charge of palliative care services, Kottayam district hospital.
