Continuing our contributions from afar

By Helaina Jackson, Specialist Oncology Dietitian, Cambridge University Hospital Trusts

Nearly two years ago to this day, I flew with my colleagues to Rishikesh, India, on what now feels like a once in a lifetime opportunity. The aim of our trip was to work closely with the staff of the Ganga Prem Hospice (GPH), a spiritually orientated, non-profit hospice for terminally ill cancer patients from vulnerable communities. The aim of the trip was to exchange knowledge and understanding of nutrition in palliative care and ultimately, improve the quality of patient lives.

Sadly, for many patients, our arrival was too late to implement any prophylactic measures. I recall seeing many cases of trismus in head and neck cancer patients, and it was frustrating not being able to help more, particularly in the knowledge that it can be prevented. We quickly spotted the need to provide pre-radiation patient education such as simple jaw stretching exercises, a quick, easy and importantly free approach which can prevent heavy disease burden. In addition, from a nutrition perspective, we observed many extremely malnourished patients. At this stage, it was felt that perhaps many were deteriorating more rapidly as a consequence of their poor nutritional state than the disease itself. Our experiences on the trip taught us that early intervention by educating patients and colleagues on the most therapeutic diets to consume throughout their treatment is key. We realised our input is more valuable at the point of diagnosis because then our skills and education could be most beneficial to the patients. Hospital-based education will be a key focus for future trips

The arrival of Covid-19 halted our return trip to Rishikesh, where we planned to provide one week of training sessions at the local hospitals to empower care providers, including Doctors in nutritional care. Like many healthcare professionals globally, we have adapted to new ways of working and were delighted to have the opportunity to deliver a webinar for colleagues at the Himalayan Institute Hospital Trust (HIHT) and Ganga Prem Hospice (GPH). The mission of HIHT is to develop integrated and cost-effective approaches to health care and development for the country as a whole, and for underserved populations worldwide. The webinar focused on general nutritional assessment, the dietetic and swallow management of head and neck cancer patients and an ICU COVID patient. Together with SLT Anne, we were able to deliver a taster session on the key aspects of the care we provide on a day to day basis. We were thrilled to see such a positive response with 100 delegates in attendance.

Reconnecting through this webinar gave us all a renewed sense of energy and determination. It also served as a poignant reminder on how we can all continue to make a difference, regardless of our circumstances and our location. We look forward to continuing this valuable partnership in the future and having a positive impact on patient lives at the right moment.