Conference Report: International Update on Pain Management and Palliative Care Advances 2016

Sir,

After a great deal of preparation and organization, the last weekend of June 2016 saw the first state conference in palliative care in Uttarakhand. The conference, “International Update on Pain Management and Palliative Care Advances 2016,” was organized by the Shri Guru Ram Rai Institute of Medical and Health Sciences and the Indian Medical Association (Dehradun). This was deemed a historical event in that:

1. It called for an integration of pain and palliative medicine as a solution to an acute shortage of workforce in both

2. Multipronged in its approach: (a) continuing medical education for the pain and palliative care physicians, (b) sensitization for the allied health-care professionals, and (c) excellent educational opportunity (principles of palliative care) for the undergraduate and postgraduate medical and nursing students

3. Proving that palliative care is increasingly being recognized as an important aspect of health care in the region.

The first opioid workshop in Uttarakhand on day 1 aimed to facilitate the procurement of essential narcotic drugs (ENDs) in Uttarakhand. Dr. Sushma Bhatnagar, Professor and Head, Department of Onco-anaesthesia and Palliative Medicine at AIIMS, New Delhi, gave an encompassing overview of the existing need of the ENDs in India. Dr. M R Rajagopal, Dr. Nandini Vallath, and Dr. Aditi Chaturvedi emphasized on the procurement while avoiding diversion of the ENDs in India and their current availability status in Uttarakhand, respectively. Mr. Satya Narayana Dash, Undersecretary, Department of Revenue, Government of India, highlighted the recent initiatives pertaining to the END availability by the Government of India. Dr. Ajeet Gairola, Director, National Health Mission, was the Guest of Honor at the workshop. To supplement, there was a panel discussion on “ensuring opioid availability to those in need” involving the above eminent faculty as the panelists. There was an over enthusiastic involvement from both the panelists and the delegates. An opioid workshop booklet highlighting the current need and availability of ENDs compiled by me was released and presented to all the delegates and faculty.

More than 250 delegates from different parts of the country who attended the conference were an enriching mixture representing almost all the fields of medicine. The academic feast got a perfect kick start with Dr. Sunil Saini, Director of the Cancer Research Institute, Uttarakhand, emphasizing on the huge need and the evidence-based role of palliative care in the oncology practice. Dr. Sushma Bhatnagar emphasized on the roadblocks responsible for the meager palliative care coverage in India. Dr. M R Rajagopal, Chairman, Pallium India, highlighted how due to the nonallocation of the requisite funds the much-hyped National Program for Palliative Care failed to achieve even a fraction of what it was aimed at. Dana Pierreti, a palliative care nurse from the USA, gave an enlightening personal reflection of the satisfactions which her professional practice provides her.

Dr. Brenda Ward, a palliative care consultant from John Taylor Hospice, England, and a volunteer at Ganga Prem Hospice, Rishikesh, pointed out the differences she noticed in the attitude and provisions of end-of-life care between the two parts of the world. Dr. Abir Doger, associate medical director, John Taylor Hospice, England, elaborated the role of interventional pain procedures in those intolerant or not responding to the WHO analgesic ladder. Other eminent speakers at the conference included Dr. Savita Butola, Dr. Ann Thyle, Dr. Anjum Khan Joad, Dr. Gautam Das, Dr. A K Dewan, Dr. Aditi Chaturvedi, and Dr. Vijay Tyagi.

The conference was inaugurated by Shri Harish Rawat, Honorable Chief Minister of Uttarakhand, who pointed out that the provision of holistic care is of utmost importance to those suffering from chronic life-limiting illnesses. As a token of appreciation, books (An Indian Primer of Palliative Care authored) were presented to the meritorious undergraduate medical students to further their interests in the field of palliative medicine. Dr. Savita Butola who was faculty at the conference pointed out that such a conference should be replicated in other states as well to accelerate the development of palliative care in them.