I returned to Pakistan in early March for ten days to work on the Urdu translation of the Missal. But the first outbreak of the COVID-19 virus then occurred and the Government very quickly and firmly responded. All public transport was stopped and airports closed. I managed to return to St Elizabeth Hospital in Hyderabad where I am safely staying for the time being.
Two male nurses on the motorbike ambulance in front of St Elizabeth's Hospital in Hyderabad, Pakistan. Photo: Fr Robert McCulloch SSC
The city is in daily curfew for 18 hours and movement is almost impossible for the rest of the day. Hospitals are permitted to provide care only through emergency departments.
Medical clinics are shut. It is difficult for people to get medical care for non-virus illness. It is almost impossible to get medical care for serious patients who are confined to their beds in their homes. Terminally-ill cancer patients who find it difficult in the best of times to get care in Pakistan are even more in crisis for care.
The Catholic Church in Hyderabad provides hope and light in this grim situation through the Home-based Palliative Care nursing service of St Elizabeth Hospital, a 100-bed hospital with a specialized commitment to providing mother and child care. The hospital is the pioneer in providing home-based palliative care in Pakistan.
Setting up a free Mobile Medical Outreach Programme has been the hospital’s effective response to the plight of very poor agricultural labourers who have no chance of any health care. Beginning the Home-based Palliative Care service is the way that the hospital has responded with compassion and competence since 2008 to the needs and situations of stage three and stage four cancer patients in Hyderabad.
Compassion is the attribute which Muslims always use in invoking God so there is a meeting of minds and hearts when St Elizabeth manifests the compassion of God through its free palliative care service.
On March 27, 2020, during the curfew and lock-down in Hyderabad, two of the palliative team, Dilshad Jehangir and Shamaon Saleem, headed out on the “motorbike ambulance” to care for a patient. People in the area had come to recognize the white-painted “motorbike ambulance” with palliative care logos and flashing siren and the white-helmeted nurses. They called ahead “palliative, palliative” and people move aside to let them through the very narrow streets. Military were enforcing the curfew but when they knew that this was urgent care being brought to a critically ill cancer patient, they lifted the barriers, waved them on and messaged to the next barrier to let them through. It seems that palliative care in Hyderabad is speaking not only about God’s compassion but is touching the reality that cancer has become a part of the life of so many families.
The first palliative care vehicle, bought in 2010, is a small car used to transport female doctors and nurses closer but still a long walk from many patients’ homes. The idea of the “motorbike ambulance” belongs to Eric Siraj who did clinical internships in palliative care nursing in Singapore in 2012-13 and at Cabrini Hospital, Melbourne, in 2015. The motorbike gets the palliative care team quickly through narrow, often very crowded streets and pathways, to the homes of the patients.
St Elizabeth Hospital still struggles with the Pakistan federal government to get permission to use morphine for pain control and relief. This reflects the continuing lack of awareness about palliative care for the terminally ill in the government health departments and throughout the medical profession in general. Farah Anil, the hospital’s Clinical Services Director, is linked to the US-based MJHS Institute for Palliative Care and to Asia Pacific Hospice Palliative Care Network (APHN) in Singapore for clinical webinar sessions about this and other care issues.
St Elizabeth Hospital reaches out through palliative care to Muslim, Christian and Hindu patients and their families. Right now, nine stage three and stage four patients are being cared for intensively. Kind, competent, compassionate care in response to a phone call is bringing patients and their families together. Patients, family members, carers - all speak the common “heart language” of palliative care and come to an open and unashamed trusting in the caring God.
The Home-based Palliative Care Programme of St Elizabeth Hospital, the motorbike ambulance, the training of the palliative care nurses and the ongoing medical care have all been made possible through the support of our generous and loyal donors. St Elizabeth Hospital “cares without cost” in most cases. The hospital staff and patients join with me in expressing our never-ending gratitude for all the generous help and support received.
Listen to "Hope during a crisis"
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- Read more from The Far East, May 2020
