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A Prayer For The Dying

I read obituaries. Sometimes it’s all I read in a newspaper on a given day. I wonder what kind of human being the deceased was? Did they live well? Did they suffer much? How did they die?

The quality of life you lead, sadly, won’t determine the quality of death you’re awarded. I wish it were that simple. Be a kind person, live a virtuous life and when the time comes, death will take you peacefully in your sleep. The idea of death, the fear of it, haunts the living. You can’t bargain with death, the most that you can ask for is a little dignity in your final days. Sadly, too many people in our country are denied that dignity.

As a practicing anaesthesiologist, Dr. Sursh Kumar witnessed first hand as terminally ill patients were sent home with unprepared family members. When all curative options had been exhausted, patients with incurable cancers, AIDS, spinal injuries or myriad complications from old age were being discharged without a thought to their suffering in their remaining days.

In 1993, Dr Kumar started The Pain and Palliative Care Society in Calicut, Kerala. The society strives to help individuals and families coping with life-threatening illnesses and need efficient access to services that enhance their quality of life.

“Only 10% of people die unexpectedly from say a stoke or due to an accident. 90% of people will need some form of palliative care in their lives. For people with life limiting conditions- enduring pain, anxiety, depression and social isolation, there is limited assistance from conventional medical care”, he explains.

According to a 2010 report by the Economist Intelligence Unit on end-of-life care across 40 countries, India ranked at the bottom with the lowest over all score. The report factored availability, cost, quality and environment in end-of-life care.

The state of affairs in Kerala is a big departure from that grim picture. With only 3% of the country’s population, the state provides two thirds of India’s palliative care services. It is also the only state in India with a formal palliative care policy in place. The state government funds community based care programs and Kerala was among the first states to change it’s narcotics regulations to permit the use of morphine by palliative care providers. There are more than 250 self-funded palliative clinics and a massive volunteer base that crosses 20,000 trained volunteers in the state.

Dr. Kumar advocates a three pronged approach to dramatically improve end of life care in India. First- India needs a national palliative care policy or program. Even successful initiatives like national cancer control and AIDS control programs, have inadequate funds and attention given to palliative care. Second- mainstreaming of palliative care and pain management by including them in the formal curriculum in medical studies. Third- state governments must ensure the availability of necessary drugs for treatment. It is a cumbersome process to get a licence to purchase and stock morphine, resulting in many hospitals and pharmacies preferring to not stock the drug all together.

The unprecedented community participation and holistic approach to end-of-life care in Kerala is a success story that urgently needs to be replicated across India. In 1996, World Health Organisation conferred the title of ‘Demonstration Project’ on The Pain and Palliative Care Society and promoted it as a model for the developing world. Healthcare activists like Dr Suresh Kumar are working to ensure that millions of Indians may spend their last days living well, and not merely dying.

Dr. Kumar is eager to share the credit with the dedicated volunteers. Sharing the story of 72 year old retired civil servant Mr Gopalakrishnan from Kozhikode, who solicits donations for palliative clinics from joggers, church goers and any passers-by who care to inquire why a well dressed man is collecting alms in a cloth bag. He has collected and donated lakhs towards the cause.

It is this social capital that offers more hope for the dying than any drug known to mankind. If it take a village to raise a child, it takes the same to lay one to rest.

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17 Responses to “A Prayer For The Dying”

  1. Nandini Lakhiya says:

    saw you at unbox, had read some of ur articles and just found ur blog, great talk, wish you had more time.

  2. Niya from bhopal says:

    surprised why ur stories are not read more, look for more partners to spread the message. i read ur site with my son, he’s 12. best of luck

  3. just a fan says:

    bahut accha kaam kar rahi ho- all the best

  4. DK Dhillion says:

    if u have been to a government hospital, even the ones in delhi, bombay etc- it will tell you more about the ‘quality of death’ in india than any report. it’s a great sorrow to see people dying slowly and painfully with no concern by the establishment.

  5. Devyani Desai Parikh says:

    gr8 story. I have seen both my parents pass away and have felt helpless in easing their pain in their final days. god bless Dr Kumar

  6. J Mathews says:

    maybe we should all go to kerala to retire (and die?) they don’t call it god’s own country for nothing.

    proud mallu…

  7. Siromani Gowda says:

    not for the fain hearted, the work you are doing. well done to Dr sahab and to you for highlighting his work

  8. Nirupama Jogesh says:

    ‘you can’t bargain with death’ true… and i read obituaries too. reminds me to really ‘live’ everyday.

  9. Hashim Bashir says:

    found your blog through our common family friends. very proud to see your effort

  10. krishna pai says:

    good

  11. janak kumar says:

    i volunteer with ngo caring for people with spinal injuries. i am 3rd yr bsc student, here many studnets are working and raising funds for palliative care for elderly and injured

  12. bishnu panigrahi says:

    no story from north east of country o far. no heroes here you think?

  13. Aavid reader of ur blog says:

    this is my dream. i want to travel the world and volunteer in diff places. i am a banker and maybe i can be of some help to small organistions. i need motivation to start. pls help

  14. Take 2 says:

    can we use your story for our newsletter? mailed u details

  15. Lock Stock says:

    I have promises to keep and miles to before i sleep…

  16. ishan daruwalla says:

    palliative care is catching on, though too slowly for comfort considering our massive population and the millions unable to afford private hospice care or home nurses

  17. Karnik Rungta says:

    morbid topic, we all might be afraid of death, no one likes to talk (or read) about it~ imho!!!!

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