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Project January 12, 2016

The Best Place to Die in India


Image by Atish Patel. India, 2015.
Image by Atish Patel. India, 2015.

In India, as in much of the world, the death of a terminally-ill or elderly person is often approached as a medical failure, not a normal and inevitable course of life. And global health systems continue to promote costly treatments for often just a few extra days of low-quality life.

But medical professionals and citizens in Kerala, the southernmost tip of India, decided to put quality—not quantity—of life at the center of their health policy. For the past 20 years they have built this philosophy into an extensive palliative care program that ensures chronically ill and dying patients a more peaceful and painless end.

Through state policy reform, and a deeper understanding of pain management and counseling throughout the health system, Kerala is now home to the overwhelming majority of India's palliative care centers, has expanded access to painkillers, and trained an army of volunteers to support thousands of patients at their homes.

The community-based model has been praised widely and is slowly spreading across India, where access to palliative care remains abysmally low at under 2 percent nationally.

In this project, Ankita Rao and Atish Patel look at how the Kerala program is being implemented on the ground and whether it can be used as a global example of how to successfully implement palliative care, an often forgotten but critical part of primary health.


navy halftone illustration of a female doctor with her arms crossed


Health Inequities

Health Inequities