The Lara Nara Project
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The Lara Nara project is an e-learning program through the MNJ Radiation Oncology Residency Program. This is the product of a collaboration between local medical experts led by Dr. Sanjeeva Kumari, professor of Radiation Oncology at MNJ Institute of Oncology, Hyderabad, and Dr. Francois Bachand (Radiation Oncologist, BC Cancer, University of British Columbia and Two Worlds Cancer), Dr. Eva Brun and Dr. Maria Grebe-Medhin (Radiation Oncologists, University of Lund, Sweden) and Dr. Nadia Octave (Medical Physicist, Universite Laval, Canada) has been in place now for three years. The e-learning modules cover a wide range of fundamental concepts in Medical Physics, Radiobiology and clinical basics of Radiation Oncology, informing decision making and determining treatment planning. The program has grown since its start, with the addition of modules that are specific to the needs of the program in Hyderabad, sensitive to the local academic environment and clinical demands. Our team continues to adapt to novel communication methods, using new platform like Whatsapp and Facebook groups, in order to bring the experts and students closer although the distance and time change remains a challenge. The local champions are progressively incorporating their views and knowledge in the modules.

Almost one year of interactive Zoom-enabled regular meetings between the Canadian and Indian teams (MNJIO, Pain Relief & Palliative Care Society, Panineeya Institute for Dental Sciences and the Government Dental College) preceded the initial pre-feasibility (February 2nd) and feasibility (IRB –approved protocol –directed) study on March 4th.

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Workshops in North India on poplation-based palliative care

  • An INCTR-Canada/Two Worlds Cancer and MNJIO-hosted workshop for northern Indian states expressing interest in developing population-based palliative care programs was held in New Delhi, February 21st.2018.
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  • Delegates from Rajasthan, Punjab, Uttar Pradesh and Uttarakand attended, along with participants representing the government of India, the Indian Association of Palliative Care, national NGOs (CanSurmount, CanKids, JivDaya and the Indo-American Cancer Association), cancer institutions and palliative care leaders and practitioners.
  • The government of India presented its enthusiasm, support and models for the development of community palliative care, including funding. This information has been largely under-appreciated, but has been a key component of the community development program in Telangana. NGO support is strong, capable and willing to engage productively.
  • Workshop discussions identified that political support and funding is not necessarily a limiting condition, but rather an absence of leadership, organization, dedicated commitment, and “readiness and preparedness” underlie the slow progress to date towards population-based palliative care across India.

NEPAL Programs

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A visit to Nepal was carried out by Two Worlds Cancer in February 2018.

  • The ongoing relationship with Nepal Association of Palliative Care (NAPCare) was cemented with plans for ongoing advocacy for the National Strategy for Palliative Care in

Nepal implementation, increased effort as regards nursing education, and other activities.

  • A follow-up meeting on February 27th, hosted by NAPCare and Two Worlds Cancer, focussed on the state of palliative care and implementation of The National Strategy for

Palliative Care in Nepal. Two Worlds Cancer associates Drs Max Watson (University of Belfast) and Dan Munday (University of Warwick, UK) led the discussions and break-out
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  • Two Worlds Cancer team members, affiliated with the Partners in Compassion hospice twinning project, collaborated with Nepali colleagues at the Bhaktapur Cancer Hospital.
  • Two Worlds Cancer volunteers met with Nepali affiliates to explore expansion plans for a new Hospice Nepal facility in the Kathmandu Valley.

SRI LANKA Programs

In response to a request to help establish and implement a palliative care program in the Northern Province of Sri Lanka, a week-long mission was carried out in November 2017 by Two Worlds Cancer and MNJ program leads. Extensive consultations were made, and a final planning meeting drafted a plan based on WHO guidelines. The plan calls for an integrated palliative program to be developed over a number of years with the help of the Hyderabad Centre for Palliative Care.

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