“I have seen my childhood icon, my grandmother, suffering from cancer. Since then, I just wanted to learn more about cancer and understand the pain of it. This was one reason that pushed me forward to opt for this course,” says Amita Wawdekar, a patient navigator from Tata Memorial Hospital (TMH).
Patient navigation has become a growing profession in the healthcare sector. And for the first time in the country, in partnership with Tata Institute of Social Sciences (TISS) and with support from Tata Trusts, Tata Memorial Centre (TMC) has come up with a one-year advanced diploma course in patient navigation, named Kevat.
“It is a vast and effective course; cancer is not a disease that can be dealt with easily as it is extremely painful and takes a heavy toll on patients. It destroys the mental stability of the person. It is not only difficult for the patient, but for the caretakers and the family members too,” Wawdekar pointed out.
It is for the first time that Kevat has come to India. The concept has been obtained from Dr. Harold Freeman’s study on patient navigation which was done in 1995. In a disease like cancer, it is very important to understand each and every need of the patient. The patient navigator has to be well aware of the current healthcare structure.
India might have about 1.7 million cases of cancer by 2035
Kevat comes from the epic Ramayana wherein Lord Ram was helped by Kevat, a boatman, to cross the Ganga river. It stands as an analogy that even God needs proper navigation in times of troubles just like the cancer patients across India or worldwide. According to a research study conducted by TMH, India might have about 1.7 million cases of cancer by 2035.
“Each day almost two thousand cancer patients come in to our hospital for medical treatment and this is the normal OPD rate,” said Nishu Singh Goel, head of the patient navigation programme at TMC.
According to Goel, the term Kevat was coined by TMC director Dr RA Badwe, who came up with the idea of patient navigation programme in India, which began in April 2018. However, there is not much awareness across the country about these programmes.
The programme was launched keeping in mind the importance of easy access for the patients to better treatment and also to make sure that any patient who visits TMH has a hand to hold on to from the beginning to the end of the treatment. The treatment is free of cost irrespective of the financial status and all are treated equally.
“Almost 60 percent of the patients who visit the hospital are from places outside Maharashtra and some also come from abroad,” Goel added.
Urgent need of trained patient navigators
Patient navigation programme offers patients an in-depth information about the disease. All aspects of cancer care are covered under it. A six-month didactic training programme is provided with a six-month of internship at TMH for the people who opt for the diploma course. Both academic and practical knowledge is required for the learners to understand the needs of a cancer patient, be it financial, psychological or physical. Kevat helps treat the cancer patients in a structured manner. Doctors under patient navigation programme act as the entry and exit points for the patients who come to TMH for medical assistance.
A patient navigator’s job is to interact with the patients and deliver care and concern to reduce the burden they deal with. At times, they have to act as counselors too. There is an urgent need of trained patient navigators in the field of oncology. On top of that, the scope of development and growth for the navigators comes with high potential in public and private sectors of the medical field.
As the level of awareness remains extremely low, TMH and TISS have set up hubs around the country. That is also the reason why by default patients are made aware about the programme right when they reach the hospital for treatment.
Says Apoorva Tiloda, another patient navigator from TMH: “Coming from a paramedical background, I have seen the spectrum of healthcare in India as well as abroad. I have seen people suffering for medication in community pharmacies. I have seen people struggle to get proper access to healthcare. Having that background and knowledge, when I got to know about this course, I found it as an opportunity to gain an insight into cancer care. The meticulous knowledge I gained through the course will help me better the level of care I can offer to patients.”It’s hard to deal with patients suffering from cancer, mainly because of common myths and misconceptions about it. “For instance, I remember bringing my own mother to the hospital for check-up when we got to know she is suffering from oral cancer. The first question she asked the doctor was ‘will I pass on the disease to my daughter?” said Goel.