This article talks about hospices in India, and are they really necessary.
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The hospice, a home away from home for terminally ill patients, is said to have originated in France several years ago and is a popular concept in the Western world. In England alone, a country smaller in area and population to many of our Indian states, there are around 200 hospices. Of late, however, they are steering away from hospice and moving towards home care. This is quite understandable, as these countries have developed an excellent health care system. With a manageable population, better socio-economic standards and higher literary background, a patient can very well be managed at home, if health care is delivered at his doorstep as it is done in these countries. This is as it should be, for there can be no place like home.
In India, on the contrary as in most third world countries, the panorama is entirely different and in no way comparable to the West. The hospice movement, or for that matter palliative care itself, is still in its infancy in India. The first hospice ‘Shanti Avedna’ was started in Mumbai in 1988. ‘Jeevodaya’, the second hospice in India and the first such in south India was registered in Chennai in 1990 and started inpatient care in 1995.
It is true that the family structure in India is such that the responsibility of looking after a patient rests with the family, but, to generalise and to assume that every patient has a loving family, caring for him or for that matter to assume that every patient has a family at all is to deceive ourselves.
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Mrs. Sakunthala (name changed) was picked up by the police from the platform and admitted in a government hospital, where we found her on the floor, near the toilet with not a yard of clothing on her. She had a massive fungating tumor of her breast, crawling with maggots – no one wanted to go anywhere near her. We had her transferred to the hospice where she was cleaned, clothed and made to look like what she was meant to be – a human being. She died peacefully in the hospice after a couple of days, surrounded by people who cared for her. The last rites were done by the hospice.
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