HAMRAHI VISIT TO THANAL CHARITABLE SOCIETY, KAVARATTY, LAKSHADWEEP
Dates of visit: 14th November, 2016 to 19th November, 2016
Participants
- Dr. Sophia Lam
- Ms. Sarah Begeley
- Dr. Abu Laize C.B.
Islands Visited
- Kavaratti
- Amini
Report written by Dr Abu Laize C.B.
25/11/2016
Back ground of Palliative care in Lakshadweep and Project Hamrahi
Lakshadweep islands are a group of islands in the Arabian Sea is in fact a paradise. Islands are surrounded by a lagoon and coral reef. These are actually coral islands. Inhabitants live on fishing and coconut farming. For a tourist it is a paradise and a place of untouched natural beauty. But the moment you go deeper into the hearts of people, you can hear the weeping sound which is never heard outside
Many of them are suffering from chronic diseases which needs palliative care. Access to medical care is limited and in case of medical emergencies the only option is to take the patient to main land which takes 4-5 hours in chopper. CVA cases are increasing day by day. Cancer has become a common disease, Inthis context Hamrahi visit has many meanings.
Palliative care movement was started in Lakshadweep by Thanal Charitable Society founded by Abdul Hameed Moulana with the help of Pallium India and they have wonderfully developed a community model of palliative care. This is a closed community which is isolated from the main lands. All islanders belong to Islam and they consider it as their religious obligation to help others. This became the root cause of volunteering. But we could see that these trends are changing as the culture is changing slowly.
It is the third time Hamrahi team is visiting Thanal, Kavaratti, Lakshadweep. Dr. Sophia and Sarah from Australia and Dr. Abu Laize from India formed a team and started visiting Thanal Charitable Society, Kavaratty from 2013 onwards. The aim of the project was to visit a budding a palliative care center 3 times in consecutive years to handhold, train, mentor, help in patient care and exchange of ideas.
Visits were made to these islands
- Kavaratti – 2013
- Kavaratti and Agatti – 2014
- Kavaratti and Amini – 2016
As the same team was visiting Thanal, the progress made by them was evident. In 2013, it was just a budding center limited to one island- Kavaratti. When we made our last visit in 2016 – they have expanded and now they have their presence in 6 islands.
Visit report 2016
14th November, 2016
Dr. Sophie and Sarah flew from Australia to Cochin in India and Dr. Abu joined the team from Cochin.
From Cochin it is a 1.15 hour flight to Agatti. Agatti is a very small and beautiful island which itself is in the shape of a run way. There is only one flight to Agatti and Air India runs it as part of their commitment to society even though it is a less profitable route. Previously chopper service was available from Agatti to Kavaratti, but now it is being limited to patients only. This chopper is an Air Ambulance which is used to carry sick and very ill patients or emergency patients to hospitals in Cochin.
We took a catamaran to Kavaratti which took about 3 hours to reach. As usual we received a warm welcome from Thanal. It was 4 pm and we moved to Thanal office and the Chairman Abdul Hameed Moulana, gave us a briefing on our activities for the coming days. A public function was planned for that evening.
After the briefing we visited a patient, evaluated the care given and we found that the volunteers are giving the best care they could.
Public Function at Kavaratti
During every visit, there is a public function and Thanal has chosen the time of our visit to present awards for the best nurse, center and to thank all those who have helped and is helping them.
This year’s function was a special one. In addition to the above said awards, Thanal decided to honor one more person – Amina Hajjummawho was a mid-wifefor the last 60 years. She was the only mid wife available when hospital facilities were not much developed in this island and is a very dedicated person. She is 90 + and is still ready to go if she gets a call. Many eminent people in island shared their experience about her.
“Amina Hajjumma is such a wonderful lady, I remember, even at midnight if somebody is in labor pain and she gets a call, she used to visit the patient and stay with the patient till she gets delivered, do all the necessary care, give advice to pregnant women. She is a gift of GOD to us islanders.”
Another one shared – “Myself like many others are born into the hands of Amina Hajjumma. There is not a single house is Kavaratti which has not utilized her service. She was doing this as her duty and never asked for money.”
Nursing excellence award was given to Abdul Hakkim, of KadmatIsland and the award for best center based on last year’s performance was presented to Kiltan Island unit of Thanal.
The function came to an end by 10.00 pm.
15th November, 2016
As planned, we started our travel to the next island, Amini at 8.00 am. It was a small catamaran with a seating capacity of 20 and the journey was not like yesterdays. On entering into the deep sea, the catamaran started dancing in the waves and few of us got sea sick. We reached Amini at 11.30 am and went to Amini unit Office. A small session was planned with all the members of Amini unit. After the introductions and discussions, it was decided to go for home care visits. The main aim of this was to train the volunteers – On the Job training.
By 5.00 pm we finished 8 home cares on different cases and training was given on wound care, bed sore, catheter, constipation and general patient care.
Here also a public function was planned at 7.00 pm. The talks were mostly on palliative care, activities of Thanal and what we are doing here. We met many officials in this function and requested their support for the cause.
Sarah and Sophie from their speech in public Function – “We went for home care today. Even though they are in pain and is suffering, we could see a lot of smiling patients. We are sure it is because of your activities and care only”
Dr. Abu Laize –“This is just a wonderful model here. We boast of community model of palliative care in Kerala. Take the age of volunteers. In Kerala most of them are retired persons, who has fulfilled their needs in life and is the top of needs pyramid – searching for social satisfaction and self-actualization. But look at you guys. You are so young and vibrant, but has decided to spend your time for the suffering humanity. We have a lot to learn from you.”
16th November, 2016
This day was fully dedicated for home care and training. In the afternoon, we conducted a training session for the doctors, nurses, volunteers and the care givers of the patients at the Community Health Center Hall.
Topics were based on the cases seen in home care and as per the request from the unit members.
Topics covered are
- What is palliative care
- Role of each member in palliative care team
- Patients’ care taker – a part of palliative care team
- Bed sore prevention and its management with role play
- Constipation
- Communication skills and Counselling
- Self-Care
A dinner was planned with the volunteers that night and was a nice function with island’s own cuisines.
We got time to interact with volunteers and many questions were asked from both sides and were answered.
To a Volunteer
What difference do you feel from the beginning of your service and now?
“When we started the services, one year back, it was impossible to enter a patient’s room because of the foul smell of urine, feces, decaying wounds and wastes inside the room. Now you can also see the difference. We are welcomed, rooms are clean, patient is cared well, the care taker also have an idea of what to do and what not to do. They are less panicked.”
To the Amini unit Chairman
What do you feel is your immediate need?
“We do not have proper training. We would like to get trained in this field more. We started the services a year back, now we have 3 doctors (one Allopathic, one Homeopathic and one Ayurvedic) and few nurses – all volunteer their time with us after their duty hours. In certain cases we really get confused and we have to call doctors and nurses at Kavaratty. Training is a big need. We could not find funds to send them for training.”
We also realize that, this is one of the prime needs in all islands.
17th November, 2016
This day was planned to see the island and to know its culture and to meet people. On the go we consulted patients also. We went to see the coconut products manufacturing unit and related cottage industries. The manager of Coconut manufacturing unit is a volunteer and Secretary of Thanal Amini Unit.
At 2.15 pm we started or journey back to Kavaratty and reached at 5.50 pm. This was a big Catamaran going to many islands and the sail was very smooth.
18th November, 2016
This day was fully dedicated for official visits and to help Thanal in their administrative matters.
The entire Thanal team was surprised by an invitation from the Administrative head of Lakshadweep islands – Mr. Farooq Khan for a discussion and breakfast with him. The discussions were very productive and he offered his support to Thanal. He was concerned about the increasing number of cancer cases in Androth and Minicoy which are far off island from Kavaratty in the India Ocean. From Kavaratty, it takes one day and a night to reach these islands in ships. The difficulties in travel, financial constraints to reach far off islands were discussed and the administrator promised his support and asked Thanal Chairman-Moulana to start the steps towards beginning a palliative care unit in these islands.
We also shared a long cherished dream of Moulana – to start a hospice facility / In-patient unit in Kavaratti to take care of sick patients which could be used as a training center also. Administrator asked us to put forward a proposal for the same, which he shall try to forward to concerned authorities for action. Developing a person as a trainer was also discussed, in which we suggested Ahmed Khaafi, the senior most and very experienced nurse who is now the Nursing Super intendent of Thanal.
Another request from Thanal was to post one nurse for each islands for palliative care by Lakshadweep Administrative Authority so that financial burden on Thanal could be lessened which was also welcomed
We summarized the administrator about APLI, Hamrahi Project, the aims and objectives of our visit and the progress made by Thanal in 4 years. His wife was very much attracted about this cause and promised her whole hearted support for the same. She shared her personal experiences and said this is the need of the time and both were saddened to hear this is our last visit. Both enquired about the possibility to extend our services in the future and has requested APLI to consider sending the team again in next year.
3 hour long discussion was very productive and we hope this makes Thanal to serve more needy people.
The same day we met Health Secretary and other officials and requested their support for Thanal. We shared our concerns in the increasing cases of CVA in the islands and requested the health secretary to have a research study on this.
This was the last eve at Kavaratti and a dinner was planned in the beach near to Thanal Office. It was such a grand function where all the officials were invited. Administrator and his wife, Police Super intendent, Cost Guard Commander, Managing of Lakshadweep Development Corporation were some of the invited guests.
The specialty of dinner was the community participation. Each volunteers bought a dish from their home, the best one they could make.
19th November, 2016
It was time for the team to say good bye to Thanal. It was a sad moment for all of us after a week’s togetherness. Morning 7.30 am we started our journey back to Cochin and reached Cochin at 1.15 pm.
Conclusion
Hamrahi visit to Lakshadweep was a fulfilling experience for everybody in the team.
Funds and source of funds
Last year Thanal received some funds from the Lakshadweep health services and from some CSR initiatives. Their activities are restricted due to fund constraints and being isolated islands from mainland - people are unaware of the sufferings of people in these islands. In the beginning volunteers were contributing for the activities which is not a sustainable model. A sustainable funding source is very much necessary for organizations like Thanal to sustain and grow. We would like to request international community to have a look into this matter.
Future plans
Future plans include extending services to far off islands and to start an in-patient facility at Kavaratty. Development of existing centers, training of volunteers are the immediate plans and are getting delayed due to lack of funds.