Hi Bram- great article you found! Reminds us that it's indeed a difficult task to sustain a program where funding is not guaranteed.
What interests me about what is written in this article is that there are clearly many examples of similar home-based care programmes in India. e.g from the article:Careplus, their aim is to identify at least four hundred donors, well wishers who could donate a thousand Indian rupees. That comes to around 25 US dollars. And with that money they can run this home care program supporting the salary of a doctor, a nurse, fuel for the ambulance, buying dressing materials and the medicines that are needed for home care.

I am going to keep investigating as i think we can learn from organisations such as Careplus.
Carolyn

Hi Carolyn,
We have gone through the message regarding your investigation of care plus. We also think that it is a great and good idea. Thankyou for your efforts. We think that your attempt will be successful and we pray for the success. Have you received any favourable reply from AID?
Thanking you
joseph A M

Hi Joseph, no unfortunately I have no received a reply from AID. This is disappointing. I think we're going to have send a lot of emails before anyone bites back!
I am going to try and put together a document that shows who I have contacted (and anyone else) so that we do not duplicate our efforts. I iwll post it here on nabuur.
Carolyn

Wanted: some local key figure who knits things together (Alzheimer organisation, hospital etc). Could the doctor who is willing to cooperate in the project be the one to do that? His first task then would not be providing care but helping to help embedding and facilitating the project. Also helping to formulate whats needed basically to start. Or there might be someone else?

Hi Bram- yes I agree- we need a local person to help Joseph bring the right group of people together.
I am revisiting some of the key organisations I researched several months ago with the view that now that we a re little bit further down the track we can resume the discussions with them. I feel that face to face meetinsg would be very beneficial- where possible.
There is a group in Kerela who already run a palliative home-based care programme. I have written to the English charity who funds this programm but unfortunately I have not heard back yet ( they are a Chrsitian org).
I would really like to re-visit the peak Alzheimers group too. I think they would be in an excellent position to review a short plan for us- give advice on what would work? Same goes with the India Association of Palliative Care and the Neighbourhood Network in Palliative Care which was mentioned in that excellent article you posted (Barefoot in Kerela) a few months back.
I'm doing this research in the background...it may take some time unfortunately.
Also- Joseph has just mentioned to me via email that his neighbour is a young doctor who has agreed to come on board here at nabuur. So hopefully he will be able to add further to our discussions and planning.
Carolyn

Hi Carolyn,
Thakyou for your investigations and for our project. Now we are doing some help to the patients with the help of doctor Koyakutty of the palliative care service. Young Dr. Nidhish is also very busy. Hope that he has contacted Dr. Bram. We will soon we able to send you the email of the doctor Koyakutty.
once again thankyou for your sincere efforts.
Thanking you
joseph A M

Hi Jospeh that is great news now that you have a second doctor who is assiting with the pilot programme.
How often can Dr Koyakutty help each week? Or each month?
Carolyn

Hi everyone, sorry i have not posted for a few weeks- I've been off sick with the dreaded Flu!
I a now researching and re-investigating some of the organisations which were mentioned in previous posts to see if there are ways in which we can link up with them.

I came across a great government website that had a lot of useful info on it: http://arogyakeralam.gov.in/

In 2008 arogya keralam project was implemented by Institute of Palliative Medicine.

The project aims to
1) Identify patients in need
2) Offer guidance for appropriate treatment
3) Provide care at home for the bed ridden and incurably ill
4) Equip the primary health care system to provide care including medicines to the
socio economically backward patients.

I have attached their report. It shows that there is a lot of work being done in the state around improving palliative care and there are certainly opportunities for training and access to doctors. Next step would be to contact the relevent person and try to find out whether we can connect with their existing program structure.

palliativewriteup300609.pdf

Joseph not sure if you have read this document- it's worth getting familiar with. I will take a good look at it too.
It is the official State of Kerala Palliative Care Policy document.

Regards Carolyn

palliativecare.pdf

hello everyone.A very important paper it would be a great succes when our project is connected to the existing government supported program!!!

hi
carolyn
i read it carefully ,as a whole it is great ,but in actual scenario, it is not been properly implemented ,not available every where ,also those people not won confidence of people so that realtives of patients can reach out when in trouble;may be in coming future;dream may come true;i also suspect about how they uses the fund ,well i worked 5-6 phc i was not informed of them ,or never asked to visit ,or never heard of something like that .....
i shall check through in the proper way,i still believe things are not being goin as such told in documents,i fear those objects remain as just words in those papers
thanking you
nidhish

Dear Carolyn,
We have great pleasure to make you know about the seminar. It was for one day. Palliative care doctors and nurses were present in the seminar. Mr. Praveen, secretary of the kerala chapter of the Indian Association of palliative care and Dr. Koyakutty gave lecters on palliative care. Later on there was group discussion. In this seminar, the importance of palliative care was discussed. Old age is the part of our life and so it should be treated with all its importance and care. Old parents should not be a burden to the family and so they should be given proper treatment and care in order to make their lives pleasant and hopeful. These were the most important facts they have pointed out. For achieving the above object the family as well as the society should have to provide the necessities for the old people.
In your message you have attached the document about Arogyakeralam. Thank you for your great efforts.It is a project having the same ideas and aims of our project “Home care service”. Palliative care service mentioned in Arogyakeralam has started by the government very recently. It is even now unknown to the ordinary people. It has not yet been implimented in the panchayaths. As the PH centers do not have sufficient staff it is very difficult to start the work. This project of Arogyakeralam is not a profitable undertaking and so nobody will be interested in carrying out this quickly. There are many practical difficulties for the government agencies to execute this project successfully. In this circumstance the NGOs are the best ones. They have close contact with the villagers who require palliative care. But they have no resourse at all. This is the main problem here. Any how we are trying to get the help and guidance of the government agencies as per your guidance. We do not know whether it will be successful or not.
Best regards
Joseph A M

Dear Dr Brahm
I have gone through your message and read madam Carolyns document about Arogyakeralam. It is also having the same ideas and aims of our project “Home care service.” We are also trying to get the help and guidance of the government agencies of Arogyakeralam. We do not know whether it will be success or not.
Thanking you
Joseph A M

Hi Nidhish, Hi Joseph,

Firstly- welcome to Nabuur Nidhish. It's great to see you here and thanks for posting.
I understand that just because the Government releases policy doesn't mean that it always gets implemented properly. Trust me- we also have that problem in Australia! But at the same time the ploicyt remains in important document as it make government accountable for what it has identified as a priority for Kerala.
Nidhish it is important to hear from you that even though you worked in many phc you haven't heard about the policy or it's implementation. I wonder if you are able to check "through the proper way" about this program as it might open some opportunities or connections. It also lets the govt know that there are local people who are interested and want to do something about palliative care. I also still firmly believe that if we can connect with a group such as this one then we are not inventing a program from scratch. the advantage is that they have already done a lot of the planning work which for us is taking a very long time right now.

At this stage I agree that an NGO would be the best way to progress the home based medical care program but i just haven't made any useful connections on how we can get this off the ground in a practical way.

Carolyn

Hi Joseph,
thanks for your update about the seminar you attended. I was also wondering what type of people came to this seminar. Where there others like yourself who are trying to build a community program? Or if not- why were they there?

About your comment - "This project of Arogyakeralam is not a profitable undertaking and so nobody will be interested in carrying out this quickly"...I am puzzled. This kind of project is not intended as a profit making venture. It is about providing the community which a much needed service. No one would make money out of that. Not even an NGO can expect to make money from providing Alzheimer's or Palliative care. Yes- pay the required salaries- but not a profit.

I agree with you that the NGO is closest to the community. I also agree that we need to get help to kick start such a program. are you able to share any more info about how the Saturday sessions are going ( with the visiting doctors?). I feel a bit stuck with this because without a program plan we cannot ask anyone for assistance (even if I we found groups to contact!)
If other Neighbours have any ideas or can help progress the research into funding agencies or volunteer groups- that would be GREATLY appreciated!
Carolyn