How palliative care in India has changed and the importance of e-learning

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Published: 21 Apr 2015
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Dr Mary Ann Muckaden - Tata Memorial Hospital, Mumbai, India

Dr Mary Ann Muckaden of Tata Memorial Hospital in Mumbai, India talks to ecancer at IAPCON 2015 on the developments palliative care has had over the years in India, the importance of palliative care for children and her role as Chairperson of International Children's Palliative Care Network. She also discusses what she hopes to achieve when presidency of Indian Association of Palliative Care is passed onto her and her thoughts on the new e-learning course on palliative care for Indian healthcare professionals created by ecancer and Cardiff University.

I’m currently the Chairperson of the International Children’s Palliative Care Network so that gives me a good opportunity to not only do palliative care work, which is very important in the country, but also to be an advocate for the rights of the child because in the adult palliative care world the children get forgotten.

What are the major changes in palliative care that you have seen over the years?

It’s become more important in the country.

We’ve always needed it but the health system did not recognise the fact that there is a specialty which would look after patients with life-limiting conditions.

Therefore the patients with life-limiting conditions were always mixed up in the general health system and there has always been an emphasis on cure and treatment but the emphasis on palliative care, even now, I would say when I’ve been in the field now nineteen years, it’s just beginning that palliative care is becoming an essential component of the healthcare system in this country.

But, yes, it has helped to have many champions and that is also with the help of Cardiff University because it’s through Cardiff that there are so many people who have been trained and have become palliative care specialists.

The importance of having a specialist is also important because when you have an academic specialty then that’s what makes it a very important branch of medicine.

Can you tell us about the impact university training has had on your career?

I started palliative care in 1996 without having undergone any formal training.

There was no palliative care training in the country at that point of time and that is when some of my colleagues, actually and friends, had recommended that the best course that you could do at that point of time was the Cardiff course.

So I enrolled myself in the Cardiff course, I think it was in 2009. At that time there was just a diploma which I completed in two years and that gave me a lot of understanding into the theoretical background which then applied to the practical background of what we were already doing.

I think it made a huge difference in the way that we looked at patients and how we handled patients.

It also gave me the confidence to then start courses of my own.

Many years later, that was in 2010, I decided that now I need to do something more and that’s when I enrolled myself for the Masters which I very recently completed.

What do you hope to achieve when you become President of the Indian Association of Palliative Care?

I think that because we are the people in the country who have the first postgraduate degree, MD, in palliative medicine has been started by us.

So in all the years that I have been working in the country I have always wanted to associate myself with a higher level of academic learning.

I think it’s a good opportunity for me if I take over as the President is to raise the level of education because we do have a number of short courses, we do not have enough long courses and university recognised courses.

So that’s one thing that I would very much look forward to is to raise the level of the education qualifications which is being offered by the palliative care world.

I also would like to promote children’s palliative care which I have been doing, of course, in the past for the last almost seven or eight years but I would like to take that on as well.

The other thing which really interests me is that we don’t do enough research.

We don’t do enough multi-centric research where many hospitals and units would join together and do research which is pertinent to this country in the field of palliative medicine.

What are your thoughts on the e-learning palliative care course being developed by ecancer?

I think that’s absolutely the most important thing which needs to happen in this country today.

Because palliative care as a specialisation is only in one institution and it can happen maybe at the most in five or six in the next ten years.

So that would bring a very small number of super-specialists in palliative care.

But palliative care has to be offered all around the country in small towns, in villages, and for that type of person who is already employed somewhere else, they already have a job and what they’re actually doing is taking on palliative care as a secondary thing.

They are not going to be able to spare the time to be able to do long-term courses and therefore e-learning is the way to go because you can easily in your own home, on your own computer, do a course, get the knowledge, get the certification, which again is extremely important, and then be considered as someone who is able to offer that basic palliative care.

That’s absolutely what we need in this country today.