WHO South-east Asia Region addresses on palliative care best practices for low- resource settings
The timely decision made by the World Health Assembly to exhort the government to deliver palliative care services alongside safe testing and treatment for COVID-19 will help in reducing the burden on the healthcare system
The WHO South-East Asian Regional Office organised a webinar on Palliative Care of COVID-19 patients: Best Practices for Low- Resource Settings, the first event of its kind to empower healthcare providers with skills necessary to relieve the suffering of patients and their families who are infected and affected with COVID-19.
The timely decision made by the World Health Assembly (WHA) to exhort the government to deliver palliative care services alongside safe testing and treatment for COVID-19 is appropriate and will help in reducing the burden on the healthcare system.
Addressing the participants, Dr MR Rajagopal, Director - Trivandrum Institute of Palliative Sciences, (WHO Collaborating Centre for Training and Policy on Access to Pain Relief) said, “Like in most low or middle-income countries, the need for palliative care is greater in India than in the West because disease-specific treatment does not reach patients adequately or early enough. The COVID-19 pandemic has brought the relevance of Palliative Care to the forefront. Beyond physical suffering like breathlessness and agitation, fear of death and enforced separation from loved ones causes loneliness, anxiety, and depression.”
Dr Rajagopal in his presentation highlighted that the key areas for palliative care interventions in COVID-19 management are communication and goals of care, symptom control especially in those not receiving ventilator support, psychosocial and spiritual care, end of life care and staff support.
Dr Rajani Surendar Bhat-Physician, Interventional Pulmonologist, Intensivist and Member, Governing Council, Indian Association of Bronchology shared a clinician’s perspective on ground zero. The pandemic has had an impact on access to health care encompassing all aspects of delivery: Acute Care, Chronic Care, Preventive Care, Public Health Measures. Sharing her experiences and ground reality she emphasised that not all patients with severe COVID-19 infection will benefit from treatment escalation, ICU care and the importance of training healthcare workers in the process of shared decision making in triage.
Dr Chitra Venkateswaran, Professor and Head, Department of Psychiatry and Palliative Care, BC MCH, Tiruvalla, Kerala; Clinical Director, Mehac Foundation; Member, Board of Directors, International Association of Hospice and Palliative Care shared her views on Psychosocial aspects of COVID 19 and the need to identify and manage distress. She expanded on the emotional distress and emphasised the need to focus on establishing a strong relationship even with limitations of distancing and precautions of mask and the importance of communication.
Dr Mhoira Leng, FRCP, Makerere University, Kampala Global Health Academy, University of Edinburgh and Medical Director Cairdeas International Palliative Care Trust presented on the Development and Delivery of the Palliative Care in COVID-19 Resource Toolkit for Low- and Middle-Income Countries. The Palliative Care in COVID-19 Resource Toolkit for low- and middle-income settings has been developed by a group of palliative care experts accessing the available evidence-based approach and utilising experience over many decades and different settings including humanitarian emergencies. The resource toolkit covers the overall impact of the COVID-19 pandemic in the context of serious health related suffering and palliative care. They include issues of communication, goal setting and decision making and the use of algorithms for symptom control.
Smriti Rana, Director – Programs, Pallium India spoke about the Impact, Implementation and the Way Forward. The 75 mins week long training program is open to all healthcare providers free of cost and is delivered via Zoom. It is accredited to the Trivandrum Institute of Palliative Sciences, the WHO Collaborating Centre for Training and policy on Access to Pain Relief. As on date 253 participants have been trained and the majority is from India.