Is the Future of Medicine in the Past? was the title of a presentation on Palliative Care in India delivered by 2018 Nobel Peace Prize nominee, Dr MR Rajagopal, at the UKZN Nelson R Mandela School of Medicine.

Rajagopal, who is considered the father of palliative care in India, is the Director of the World Health Organization’s Collaborating Centre at Trivandrum for Policy and Training on Access to Pain Relief, and the founder-Chairman of Pallium India. In 2018, he received the prestigious Padma Shri award from the government of India for his work in helping cancer patients with pain and end-of-life care.

His initiatives to remove regulatory barriers to the availability of oral morphine for pain relief have contributed significantly to the recent Amendment of the NDPS Act of India. In 2014, Human Rights Watch honoured him with the Alison Des Forges award for “extraordinary activism in promoting the notion that denial of pain relief is a violation of human rights”. A documentary film: Hippocratic: 18 Experiments in Gently Shaking the World – based on his contributions to Palliative Care – was released by the Moonshine Agency in Australia. The film echoes the teachings of Mahatma Gandhi, from whom Rajagopal has drawn much of his inspiration, and follows his (Rajagopal’s) journey in establishing palliative care in India from an individual to a population level.

Palliative care is an approach that improves the quality of life of patients and their families who face problems associated with life-threatening illness. Despite advances in diagnostic and therapeutic medicine, many individuals around the world continue to face life-limiting conditions. Receiving the diagnosis of a life limiting disease is often met with denial, fear and isolation; with some patients silently succumbing to unrelenting disease, never experiencing the solace of compassionate care.

In his presentation, Rajagopal said Palliative Care prevented and relieved suffering through the early identification, correct assessment and treatment of pain and other problems. ‘Palliative care prevents and relieves suffering of any kind- physical, psychological, social, or spiritual – experienced by adults and children living with life-limiting health problems,’ he said.

UKZN’s Dr Saloshni Naidoo invited Rajagopal to share his experiences in light of the recent launch of the National Policy Framework and Strategy on Palliative Care by KZN Health MEC, Dr Sibongiseni Dhlomo. Speaking about potential challenges in implementing the policy, Rajagopal warned that although coverage may initially improve, quality could be expected to decline. He added that significant public discourses and advocacy would be needed to generate the necessary pressure for delivery of high quality, integrated palliative care services.

After his presentation, Dr Rajagopal visited the Mahatma Gandhi Settlement in Phoenix where he was given a guided tour of the area. Home to Mahatma Gandhi for 21 years, the Settlement is devoted to Gandhi’s principles of Satyagraha (passive resistance). Rajagopal’s work similarly strives to give voice to the silent suffering of millions and renew the commitment to compassionate care.

Words: Nombuso Dlamini