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Jawhar is a municipal council in Palghar district of Maharashtra. This taluka mostly consists of the tribal population and it is a topic of discussion for rampant malnutrition. But amongst the adversities, a team of Patangshah Cottage Hospital Jawhar is running a successful unit of palliative care in the Jawhar taluka. This unit was started in 2011 with the guidance of Tata Memorial Centre Mumbai.

“It is mostly a tribal belt. The word Cancer was unknown to them. We had an extremely challenging situation when we started working,” said Dr Ramdas Marad, Medical Superintendent of Patangshah cottage village Jawhar.

It is a stated  pilot project under NRHM in the state, to improve the quality of life those who are affected with life-limiting diseases such as cancer, HIV, Sickle Cell diseases, Drug-resistant TB, COPD, CCF, heart diseases with functional incapacity, chronic kidney diseases, bedridden patients, children with cerebral palsy etc and other diseases which are not curable.

Nilesh Raval (left) and   Dr Ramdas Marad (right)
Nilesh Raval (left) and
Dr Ramdas Marad (right)

“Initially cancer was given main attention as a life-limiting disease. As we reached out to more people, we felt the necessity to expand the definition of life-limiting disease. Gradually, we kept on improving gradually,” said Nilesh Raval Medical Social Worker for the palliative care service at Jawhar Cottage Hospital.

There are 4 Primary Health Centres in Jawhar taluka which are located in villages like Jamat, Sakur, Sakharshet and Nandgaon. The health workers are the backbones of the health service in Jawhar taluka. There are 220 ASHA’s, 24 active multipurpose workers and 18 NAM in Jawhar.

“Providing Palliative care is teamwork. It takes a lot of efforts and hard work. Our unit won’t run efficiently without the immense contribution of the health workers,” said Dr Marad.

Initially, the team faced some hurdles in reaching out to the tribal population. Now, people contact the workers themselves if they come across someone who is in need of the care. In the year 2015 to 2016, 434 newly identified patients were registered for palliative care. In 2016 to 2017 (till March) 545 newly identified patients were registered. From April 2017 TO August 2017, 45 newly identified patients are registered in Jawhar taluka.

The service not only provides relief to the patients but also empowers the lives of their family members. “This project proved to be of utmost importance. Through its implementation, we could eradicate the loopholes. Once the positive results were visible, the similar project was started in Igatpuri taluka (Nasik district) in 2012,” said Dr Pradnya Bhatawadekar from Tata Memorial Hospital.

In 2014 to 2015, similar projects were started in 8 districts of Maharashtra (Amravati, Bhandara, Chandrapur, Gadchiroli, Wardha, Washim, Satara and Nandurbar). 4123 patients were registered in the year 2014 to 15 in these 8 districts. The number was 5379 and 9039, in 2015 to 16 and 2016 to 17 respectively.

“For the first time, such project was started in Jawhar and then the suite was followed in other districts. We would like to extend this service to as many districts as we can but the human resource is the main hurdle. Palliative care service needs dedicated workers,” said Dr Sadhana Tayade, joint director of the Directorate of Health Services.

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