IAHPC Traveling Scholarship Reports
Gayatri Palat, MD
Amrita Institute of Medical Sciences
Kchi, Kerala, India
The International Association of Hospice and Palliative Care and MD Anderson Cancer Centre, Houston, Texas sponsored me for a one-month visit to Department of Palliative care and Rehabilitation Medicine, MD Anderson Cancer Centre from 13th June to 11th July 2005. The purpose of my visit was to attend training programs on palliative care as well as undertake discussions and planning sessions on the proposed joint research and educational activities between Amrita Institute of Medical Sciences, Kochi, Kerala, India and the MD Anderson Cancer Center.
It was an opportunity for me to interact with a world renowned faculty working in the department. I was able to observe current palliative and symptom control techniques in advanced cancer. I participated in ward rounds, consults, symptom assessment, family conferencing and multidisciplinary meetings relating to symptom control in cancer patients. I went with the rehabilitation team to observe their rehabilitation work in the areas of occupational therapy, respiratory therapy and lymphoedema management. I also had the opportunity to spend two days with the hospital wound management team learning about recent advances.
It was interesting to observe both the administrative and teaching aspects of the palliative medicine fellowship program being conducted there. It was very instructive to me to learn about the way they evaluate students, teaching faculty and the course as a whole.
The research team of the institution was very keen to discuss various aspects of possible research collaboration between our two institutions and some initial discussion was initiated on specific areas of possible research. A part of my time in the department was used to help Dr. Eduardo Bruera, write two chapters in a book, ’Principles and practice of palliative care and supportive oncology, 3rd Edition’.
It was a very enriching and fruitful trip for me. It permitted me to make friends and contacts for the further development of palliative care and pain management in India. I would like to specifically thank the International Association of Hospice and Palliative Care, the Department of Palliative care, MD Anderson Cancer Centre and Amrita Institute of Medical Sciences for having provided the support to me that made this visit possible.
Dr. Eva Rossino Duarte
Instituto Nacional de Cancerologia (INCAN)
Guatemala City, Guatemala
My visit to Houston was a real blessing, because it was not only rich in information and life experiences, but also a just-in-time opportunity that occurred immediately before we begin our own Palliative Care unit.
Guatemala has only one Cancer Hospital (Instituto Nacional de Cancerologia - INCAN) which is a referral center for the whole country and other countries in Central America. Our doctors, nurses and general workers perform a great and heroic job with cancer patients despite large economic and resource limitations. There is, however, a gap in attention to the total suffering of patients and families as they cope with a diagnosis of cancer, its treatment and the possibility of death.
One change brings on another, just like the stone that is thrown intothe water. The observation of the model at MD Anderson and the warmth of Houston Hospice which I was able to get to know (thanks to my friend, Dr. Sue Krauter) will be a great influence on me during my initial contact with the palliative care patients at INCAN. I was impressed not only by the hospital, its superior high tech systems and the kindness of the people, but by the humanity and brightness of the people inside both institutions who exercise and model the principles of palliative medicine that we read about in books and manuals.
Dr. Eduardo Bruera has set a very high standard of quality for the practice of palliative care. It is based on a humble principle that “hard work and and excellence of care to each and every patient results in the best quality of life possible until their last day.” I’m glad that I can now begin my work here in Guatemala, despite our limitations, to make palliative care a reality for our patients and to develop a supportive culture among our doctors, nurses and other workers at INCAN.
How is all of this going to help me and my country in the development of an effective palliative care program? I observed the highest standards at MD Anderson and the Houston Hospice, but I also saw workings of a life philosophy in every person that I met. They were all models of compassion, esteem and empathy for each patient that goes far beyond any instruction, class, book or diploma one can obtain. This experience has given me what I could not have learned by reading or investigating. The best lesson learned came from the dedication of the people who devote time with patients, who look directly into their eyes, who work hard at keeping patients comfortable by controlling their symptoms, giving family support and keeping their dignity during the process of a chronic and active disease. I think palliative care will be promoted in my country with an attitude of service and humbleness while giving to others from the abundance that we have received.
Thanks again to the IAHPC for helping me have this great experience! I’ll dedicate my time to the development of a palliative care program with the same high standards of quality and attention that I observed in Houston
  
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