Transforming palliative care for all: using education to change attitudes and approaches

Anu’s story

Anu’s experience of nurses and hospitals started young. From the age of six she accompanied her father into the local mission hospital and was struck by the ‘compassionate behaviour and devout nature of the nurses’ she encountered. But it was the example set by her mother that really showed her the duties and responsibilities of a nurse.

“Assessment, feeding, cleaning, safety, advocacy, teaching, leading and managing along with various other traits, our mothers have done in the best possible ways for us.”

After some time as a volunteer caring for people at the end of life, Anu became a nurse and chose to specialise in palliative care. In 2013, she became the lead for nursing services for a hospice in Chennai, Tamil nadu. In one year, she has upgraded the centre to a training centre with the help of Institute of Palliative Medicine. She was also successful in making a club for hospice volunteers.

She moved to Pondicherry in 2014 to set up palliative home care services for IPM under the mentorship of Dr Suresh Kumar. Her team was not only successful in setting up home care services, but also in gaining public acceptance, and  creating awareness about palliative care in various public platforms. The homecare team also led disaster relief activities during the 2015 flood, started food support programs for patients suffering from extreme poverty.

Two years later in 2016, she was appointed to the Mahatma Gandhi Medical College and Research Institute to set up the first palliative care multidisciplinary team and together opened inpatient facilities and a pain clinic.

Additionally, Anu started the first certified training programmes in palliative care in the state, in association with the Indian Association of Palliative Care. The university has since  drafted modules to integrate palliative care into the medical, dental and nursing curriculum, which is celebrated as a significant step in the recognition of how palliative care can be integrated into all disciplines.

What drives you to make a difference?

Anu is driven to improve the lives of as many people as possible. “I want to create awareness so that people can be hopeful about living in comfort and dying with dignity.

“Several things inspire me to keep going: The smile when patients and family see you, the blessings they shower, the respect you receive, the curiosity of students, the spark in our volunteers’ eyes, the sight of a comfortable sleep after many painful sleepless nights, clean skin which was previously eaten by maggots, the warmth of a shaking hand and many more.”

How do you inspire others to care with a palliative care approach?

Working in a country where the concept of palliative care is still in its infancy means there is much to do but also huge potential for Anu and her colleagues to deliver truly significant change. She adheres wholeheartedly to the concept of total inclusivity and leaving no-one behind. This is probably best illustrated in the work she has done working with Sahodaran Community Oriented Health Development, a Puducherry based NGO for LGBTQI, and Pallium India, on a two day workshop to explore the concerns of the marginalised LGBTQI community and their coping behaviour.

Anu has demonstrated the power nurses have both to facilitate change and enable colleagues through upskilling to deliver palliative care. As well as providing her fellow nurses with the clinical knowledge to help people to live and die with dignity, Anu also believes wholeheartedly in the positive change her mantra, ‘do small things with great love’ can enable

How have you increased awareness of palliative care in your community?

Anu has inspired and recruited a team of volunteers to help conduct ‘mass awareness programmes’ as she calls them – spreading palliative care services to many new places. She has encouraged excellence in care through her ability to convene seminars, symposiums, workshops, debates and competitions for students and whole faculties. 

And as well as striving hard to inspire and enable change on the frontline, Anu has also enlisted the support of the state governor and minister of state. Not content with facilitating wide scale change and improvement to palliative care in her own region, Anu now has her eyes set on a wider goal. She says: “I would like to spread the knowledge we gained during the last few years, which might be helpful in developing palliative services in developing and underdeveloped countries.”

Anu Savio
Mahatma Gandhi Medical College & Research Institute
Pondicherry India