End-of-Life & Palliative Care in Delhi
The World Health Organization defines palliative care as an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering through assessment and treatment of pain and physical, psychosocial and spiritual needs. (WHO)
The field of palliative care is growing rapidly. A recent article from NPR Health News highlights the current state of palliative care in America and the growing need for licensed palliative care practitioners within the US to adhere to patient needs and meet the best practice standards. India has some of the highest rates of oral and oesophageal cancers, yet only a tiny faction of those coping with life-threatening or life-limiting illness have access to effective pain relief. There is a lack of facilities, personnel trained in palliative care, and cultural awareness of the importance of palliative and end of life care.
CFHI’s local partner in New Delhi is a non-profit organisation founded in 1996 with a mission to work towards a caring and supportive society where people with cancer and their families live with dignity, hope and comfort. It is our mission to enable these people to make informed choices while receiving appropriate physical, emotional, social and spiritual support. The organisation was established as a 3 month pilot project in collaboration with the cancer hospital in the All India Institute of Medical Sciences (AIIMS), New Delhi, to bring palliative care to the homes of six patients with terminal cancer along with Ruth Wooldridge, a nurse from the UK. Today, the home-based palliative care programme is the largest in India. At any one time more than 2000 cancer patients and their families are being visited and cared for by our palliative care teams. It is well regarded both at home and abroad for the high quality of its services which continue to be provided free of charge to underprivileged cancer patients and their families resident in Delhi and the National Capital Region.
Travel to Delhi, India, the second most populous city on the planet. Join small healthcare teams on homecare visits within the city of Delhi. Throughout rotations, learn from physicians, nurses and social workers providing primarily free services to low income families. Gain access to the very personal patient-provider relationship unique to this field, while learning how to implement a pragmatic palliative care model in the developing world. Understand how culture impacts communication and decision-making amongst patients, families and physicians.
Become immersed in Indian culture while living in a private apartment in a residential neighborhood in south Delhi. Visit Delhi’s numerous museums, restaurants, and shops or visit World Heritage sites like the Red Fort or Humayun's Tomb. CFHI participants may also choose to organize day trips over the weekend to the spectacular Taj Mahal and Agra Fort.
CFHI's partner organizations in Delhi offer participants the opportunity to participate in rotations and activities in some or all of the following settings:
Home Care - 28 Home Care teams – each consisting of a doctor, nurse and counsellor –enable patients and families to do this. The frequency of home visits and the goals of care are tailored to the needs of patients and their families.
Teams focus on providing:
- factual information to patients and families, communicating the pros and cons of different options to help them make informed decisions for themselves in the context of their own priorities
- pain relief and management of any distressing symptoms to maximize comfort and keep the patient functional
- comprehensive nursing care and provision of necessary medical equipment to help with daily activities of living
- family caregivers and even patients with simple nursing skills to regain control over their care
- patients and families an opportunity to talk and understand what to expect during the future course of their illness and know how to manage predictable symptom crises at home efficiently and not panic
- counselling and emotional support to help reconcile psychosocial and spiritual pains or help find ways of coping
- assistance to work through feelings of loss or grief
- practical support for financial, legal and other resource needs
Clinics - located near Delhi’s major cancer hospitals and offer the following facilities:
- Guidance to patients and their caregivers through the maze of cancer care from diagnosis to end of life, including information, education, consultation and navigation related to the type of cancer
- Prepare patients for curative therapies for better coping and compliance
- Pain and symptom management, especially managing side effects of curative therapies and keeping the patient comfortable and motivated during the therapy
- Outpatient nursing care, especially wound management
- Psychosocial support for patients and families
- Financial aid through government schemes for cost of treatment and investigations
- Referrals to home care and hospice care facilities
Day Care for children
Children undergoing cancer treatment as well as their parents and siblings can visit our Day Care centre every Monday. Volunteers pick them up from nearby Hospitals, and they spend a day filled with positive, life affirming activities such as art, craft, dance, storytelling and music. Meanwhile, their parents/caregivers get a chance to meet counsellors and fellow caregivers in the supportive environment of the Day Care centre.
A Nutritional support program offers children a daily breakfast and nutritional supplements. Children and adults alike enjoy a delicious lunch before they return to the hospital for their appointments. Festivals and special occasions are also celebrated throughout the year in the Day Care with great verve and gusto. A library and a non-formal education program keeps children in touch with studies while they are away from their homes.
Day Care for adults
Fridays are reserved for the Adult Day Care. Volunteers pick up patients and their caregivers from the dharamshalas outside partner hospitals and bring them to the Day Care for an enjoyable interlude in between treatments.
Patients are offered alternative healing practices such as yoga, meditation, visualization and music therapy. Volunteers are always ready to lend a supportive ear to hear their stories, share their pain and joy, talk and laugh with them. After a nutritious home cooked meal they go back feeling relaxed and cared for, having spent a pleasant day out at the Day Care.
Day Care for Teenagers
To cater specifically to the needs of teenager cancer patients, a separate Day Care has started on Wednesdays. The needs of young and adolescent cancer patients are unique and age appropriate care is needed to address them.
Counseling is offered as an ‘Interaction Therapy’. It allows patients and families to talk about any fears, worries or conflicting emotions they may be experiencing, in a safe and confidential environment.
The counselors encourage patients or family members to talk about what’s bothering them in order to uncover any root causes and identify their specific ways of thinking. They assist them with relationship issues and help resolve problems. They teach strategies to handle anxiety and may share meditation or relaxation exercise to help ease physical and emotional pain. They also help reconcile issues or find ways of coping. Each session is generally tailored to the individual.
India is the seventh-largest country in the world and the second-most populous with over 1.2 billion people. There are over 20 languages spoken across India’s twenty-nine states. The country is also the birthplace of four of the world’s major religions—Hinduism, Buddhism, Jainism and Sikhism. India offers a rich history, vibrant culture, and diverse landscape unlike anywhere in the world, as well as breathtaking architectural wonders like the Taj Mahal and Golden Temple.
New Delhi, the bustling capital of India, is sprawled over the west bank of the river Yamuna and is one of the fastest growing cities in India, one of the largest cities in the world. Delhi’s historic monuments intersperse with modern infrastructure and government buildings to create a unique city fabric. A true urban experience, the movement, colors, sights, and sounds of Delhi.
Things to Do
CFHI participants have free time during most evenings and weekends and may choose to organize weekend trips to nearby destinations and take part in cultural activities offered within Delhi itself.
Visit Delhi’s numerous museums, restaurants, and shops or visit World Heritage sites like the Red Fort or Humayun's Tomb. CFHI participants may also choose to organize trips to the spectacular Taj Mahal and Agra Fort.
Accommodations & Homestays
Participants stay in apartments in a residential area of Delhi in the same building as CFHI’s India Director. CFHI accomodations provide a unique opportunity to learn about local culture and live amongst locals in a residential area.
The apartments have have either two or three bedrooms, a bathroom with Indian style toilets and shower, and a common living room area. Acommodations are comfortable and include two meals a day. A local caretaker will provide the meals and cleaning of the apartment. At the welcome orientation, participants will be instructed on recommended transportation from housing to program visits and getting around the city.
Eligibility: Who Can Apply?
This CFHI program is ideal for students and non-students of all levels and health disciplines with an interest in palliative care and a passion for global health and medicine. The primary focus of the program is to build a working knowledge of palliative medicine and to gain exposure to how holistic care is provided at the community level for patients with life-limiting and life-threatening illness. For more information, please read CFHI's general eligibility requirements.
Language Spoken: English
India is a multicultural and diverse country with over 30 different languages spoken by more than a billion native speakers. English and Hindi are considered the language of government and business and are widely spoken by most professionals and used daily in many business and academic settings.
Hindi is used widely in the northern Indian region where Delhi is located. Professionals at the various NGOs and CFHI staff you will interact with speak fluent English. You may find that daily communication amongst locals and community members will be in Hindi. However, the Local Coordinator will often accompany participants during rotations and can provide interpretation if needed.
Participants should arrive in Delhi, India on the program start date and will be picked up from the airport by a CFHI representative and taken to their housing. A welcome orientation will take place the Sunday or Monday after arrival.
US citizens and others should apply for an Indian tourist visa in advance. More information and specific instructions on visa applications will be provided by CFHI after acceptance into the program.
CFHI Program fees include the majority of your on the ground costs.
- Guidance from CFHI staff in San Francisco before departure
- Program-specific materials with information on making travel arrangements, visa requirements, recommended immunizations, etc.
- Airport pick-up upon arrival and transportation to housing in Delhi, India with local CFHI representative
- Welcome orientation with other participants covering safety, transportation, and other logistics
- CFHI Local Team: providing instruction, logistical support, and 24/7 emergency response
- Weekly meetings and lectures on local healthcare system and socio-economic determinants of health
- Placement and coordination of public health activities and NGO's
- Accommodation, two meals a day
- Local cell phone
- International emergency medical and evacuation insurance
- Access to CFHI alumni-only LinkedIn group featuring news and career opportunities related to Global Health
- CFHI alumni newsletter highlighting events, resources, and ways to stay involved
Uniquely CFHI, 50% or more of student program fees go directly to the communities they will be visiting, benefiting the local economy at large and specifically underserved health systems. Read more.
Hema Pandey- CFHI India Director: The role of the India Director is to coordinate and manage activities for all CFHI programs in India. Hema has been instrumental in establishing CFHI's growing presence in India, developing new program sites and researching CFHI's growth potential in-country. She has worked for CFHI since 2005. She holds a Bachelor’s Degree in Business & Commerce from Kurukshetra University and a PG diploma Fashion Design from International Institute of Fashion Technology. Her professional interests include rural and urban healthcare, water and sanitation, gender, social development. She likes helping CFHI students achieve academic and personal goals and develop leadership skills during their time on program. In her free time she enjoys photography, travelling with family, volunteering, basketball, and cycling.