Palliative care, skills training, the provision of equipment and volunteers — United Care Development Services works to plug gaps in the public health system
Syed Nusrat Ali, a 55-year-old suffering from terminal cancer, lies weak and forlorn in his dwelling in Pahadi Shareef village, about 30km from Hyderabad. The silver lining for Mr Ali — once a trucker and a smoker — is the palliative care he has been getting at home over the past year.
Mr Ali and his family are one among many being supported through painful times by the Hyderabad-based United Care Development Services. UC, as it is known, backs the Pain Relief and Palliative Care Society (PRPCS) which organises home visits by skilled doctors, nurses and social workers to help Mr Ali and other cancer sufferers like him cope with the disease.
Launched in 2009, UC is an unusual philanthropic platform that brings together donors, volunteers and NGOs to create social change. Its founder and director, P Gunaranjan, calls it a philanthropy exchange, working to provide a wider ‘giving’ platform.
UC, which is backed by the Tata Trusts, combines four kinds of philanthropy to maximise the impact of its work. The chaar daans (or four donations), as this has been termed, comprises volunteering (shram daan), donations in kind (vastu daan), waste donations (kachra daan) and financial donations (dhan daan).
The palliative care portion — operational in Telangana and Andhra Pradesh in partnership with PRPCS — is one of the more important services that UC provides. This benefits on a daily basis about 1,000 terminally ill patients like Mr Ali.
In the communities that UC works with, the troubles fuelled by cancer go beyond the condition itself. “There is fear and stigma attached to cancer,” says Gayatri Palat, an associate professor at Hyderabad’s MNJ Institute of Oncology. “Patients and their relatives often do not want to discuss the issue and, in some places, cancer is still considered to be contagious.”
The institute handles about 12,000 new cancer cases every year and a large number of patients desperately require palliative care support. The dire shortage of such support, especially in rural areas and smaller towns, was what prompted UC to join hands with PRPCS in 2017. The hospice started by PRPCS was one of the first-of-its-kind in India.
Backing for UC is part of a broader effort undertaken by the Tata Trusts in partnership with the Telangana government to build cancer care infrastructure in the state. The palliative care programme is a crucial component of this effort.
The Trusts’ support for UC-PRPCS has led to eight district-level palliative care centres being opened in Telangana in the past 18 months. These centres provide aid to 80 inpatients and 500 home-care patients at any given time.
Apart from the centres, PRPCS also operates five mobile vans — one with backing from the Trusts — that visit patients across Hyderabad. “We have doctors, nurses and social workers and each of the vans can treat about 20 patients every day,” says PRPCS president Jagan Nath.
As for UC, there is more on its health plate than palliative care. The nonprofit is involved in several health interventions in Telangana and Andhra Pradesh, among them ‘arogya seva - health for all’ (or ASHA), an initiative that exemplifies the endeavour to reach healthcare to underserved communities.
ASHA works to improve emergency and critical care services at the Gandhi Hospital and Niloufer Hospital in Hyderabad and at the Government General Hospital in Vijayawada (Andhra Pradesh). Biomedical equipment, nurses for critical care and volunteers for patient assistance are provided as part of the initiative. About 120 critical care patients and 600 other patients avail of these services every day.
Skilling is another facet of UC’s healthcare package. In 2018 it launched a mobile healthcare skills lab programme to provide training for patient attendants and nursing staff. About 50 patient attendants are trained everyday to provide home care for patients, and some 200 nurses and other healthcare providers have been trained in basic life support and nursing.
UC has also come up with the novel idea of a medical equipment bank. Currently used by eight hospitals and at several health camps, the equipment bank offers access to free biomedical equipment, made available where and when needed. UC has also trained a volunteer team to operate the equipment.
Rural healthcare is yet another area that UC has turned its attention to. It conducts monthly camps in rural reaches to provide free primary and preventive care health services. Currently about 500 patients are served every month through these camps.
UC has also developed Health4All, a Free and Open Source Hospital Information system which has been deployed across 30 major hospitals in Telangana and Andhra Pradesh and is in use in another 15 free health clinics in Odisha, Chhattisgarh, Karnataka and Kerala.
UC’s success lies in its fill-the-gap approach. Such thinking has enabled the organisation to extend the ambit of public healthcare services to underserved communities.