Issues: Karunashraya ~ a hospice with soul

A BLUE lotus basks in the sunlight at Karunashraya, a decade-old hospice for terminal cancer patients at Whitefield in Bangalore. Its roots are in the mud, its stem surges through still waters, while its scented bloom seeks eternal rays. The blue lotus, in ancient philosophies, symbolized the victory of the soul over the senses.

That blossom, surrounded by wards down stone-walled corridors, sums up the spirit of the hospice. For since May 1999, when Karunashraya admitted its first inpatient, 3,600 souls have passed on amidst shady trees and gentle fountains by the sun-dappled pond. To each, the hospice imparted “peace and dignity,” their birthright in the vision of managing trustee Kishore S. Rao, a votary of palliative care.

                                               A helping hand makes those last steps easier....

Its corridors whisper stories, often unvoiced, of a circle of caring. Of kindness of word and touch, of bonds beyond families, of a gentle passage through time. For who, when faced with forever, would bypass unconditional love?

Chief counselor Gulbano Tan shares the story of Mahesh (name changed), 76, who was steeped in anger when his brother, 80, brought him to Karunashraya from Hasan. Declining conversation, the patient refused a voluntary lawyer to help settle his property issues. He reiterated that he had no family, yet occasionally mentioned his wife and children.

One day, a nurse stumbled upon his telephone book. The staff traced his family in Hasan after many false starts. Mahesh had stormed out of their lives following a dispute years ago. They did not know of his illness. At first, he refused to see them. But once he did, he passed away lighter in spirit.

On another occasion, a pavement dweller, in great pain by the Mysore Road flyover, was brought in. The shopkeeper across the road had called Karunashraya. Unable to fend for herself or her four-year-old daughter, she found peace of mind when her little one was placed in an orphanage. Three weeks later, she met her end tranquilly.

The meditation corner

                                        
At this initiative of the Bangalore Hospice Trust (BHT), no inpatient is charged at the five-acre facility with 55 beds, designed by architect Sanjay Mohe. They are cared for by Sr. Anila and her dedicated team of eight nurses from The Sisters of the Holy Cross at Kottayam, backed by three doctors led by general surgeon Dr. S.N. Simha, supported by 30 young nursing assistants. The latter, selected from socially-deprived families, live on campus. In the photograph-enhanced corridors, all the staff smile, their sensitive eyes and gentle hands bringing solace to patients in acute pain, beyond conventional medical help.

The sunshine in the wards

                                                       

Conservatively estimated, India reports over seven lakh new cancer cases annually, while over 45,000 are detected in Bangalore, according to the Kidwai Memorial Institute of Oncology. Yet, in 1991, the city had merely 500-600 beds for treating the disease, with no facilities for the terminally ill.

The saga of Karunashraya began around 1986, when Rao, then a senior executive at Madura Coats, felt inspired to move into an ambit beyond the everyday. He had heard of Dame Cecily Saunders, who founded London’s St. Christopher’s Hospice in 1967. The British physician wrote, “It appears that many patients feel deserted by their doctors at the end. Ideally the doctor should remain the centre of a team who work together to relieve where they cannot heal, to keep the patient’s own struggle within his compass and to bring hope and consolation to the end."

In 1991, Rao attended an international conference on palliative care by Bombay’s Shanti Avedna Trust, which pioneered Indian hospice care. Gradually, a public charitable trust was set up in Bangalore, with grants from the Sir Ratan Tata Trust, the Rotary Club, among others to spread cancer awareness, to host screening camps.

                                                The tranquil stone building by the pond

Today, the hospice addresses three main services. It nurtures terminal inpatients with understanding. It provides home care to outpatients, counselling for the family, and bereavement support to cope with their loss.

Easing the passage into eternity for patients from two-and-a-half to 92, Karunashraya has so far cared for and counselled over 8,500 families. Over 80 per cent of them have been socially disadvantaged.   

Palliative care distinguishes a hospital from a hospice. At the latter, spiritual, emotional, psychological, emotional and social care layers medical attention.

Facing the future, Dr. Simha chose to train in palliative care from the University of Cardiff. BHT backs a distance-learning programme that connects 14 pan-Indian doctors to Cardiff over the Internet. It has since trained the staff for Indian hospices at Nagpur, Chennai, Vellore, Shimoga, Puttur and Mangalore.

On the Karunashraya campus, humane touches make a vital difference. Such as caregivers who ask patients daily what each would like to eat. Or craft lessons that buffer interludes of pain. Or the leaf-fringed, red-tiled meditation corner, serene enough to inspire journeys within. Or the half-doors opening outwards from each curtained-off bed. These allow fresh air in, besides facilitating the unobtrusive wheeling out of those no more. Or the image-free prayer room, where families gather to grieve around the departed or to observe religious rituals, without intruding on other inpatients. Its outer door leads to both the morgue and the hearse on the driveway.

For the staff, their lives have been enriched beyond recounting. For instance, by a painter named Rashid, who insisted sprucing up the Karunashraya walls before the end. By Gowramma who, when discharged, insisted on giving her nurse Rs. 10. That was all the money she and her husband had, besides Rs. 5 for their bus fare. By Sunita, who was filled with joy at her 19^th and last birthday party, complete with bunting, balloons, and her favourite foods.

Karunashraya eloquently reminds us of the miles to go before we sleep – and of the healing touch. For like the blue lotus, this hospice seeks the sun beyond the darkest clouds.


(More details: www.karunashraya.org)

(Originally published in The Hindu Business Line in May 2009)