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  Medical Social Work  
     
   
     
  Introduction:  
     
 

In 1978, at the insistence of Dr. Mrs. Banoo Coyaji, the Department of Medical Social Work was started at the KEM Hospital, Pune, to look into problems faced by patients during their treatment.During the last two decades and more, this department has endeavored to help the ill, bewildered, worried, frightened patient who comes to the KEM Hospital. The Medical Social Worker (MSW) was, and is, the link between the patient, the Hospital's Medical team, its administration and the community at large.

 
     
 

Over the years, the Department of Medical Social Work has grown in terms of personnel and activities, and in terms of acceptance of the role of the Medical Social Worker by the medical and para medical staff of the Hospital. Most of all, it has grown in terms of the help extended to the poor and needy patients of the Hospital. The doctors, nurses and other staff of the KEM Hospital refer many of the cases handled by the MSWs.

 
     
 

The Department now has … qualified Medical Social Workers, a full time Voluntary Worker and a Consultant/Head who is also a professionally qualified Medical Social Worker.

 
     
  Ward Rounds  
     
 

This is the most interesting and important activity of the Department. Bed to bed rounds bring the MSW closer to the patients, the relatives and the hospital staff. They enable the MSWs to anticipate the problems related to their illness or disease that patients may have to face. Ward rounds enable the MSWs to understand and make allowances for the emotions of the patients and the relatives and to gauge their socio-economic condition. Often, bedside counseling smoothens away many of the patient's / relatives' worries and fears before they assume overwhelming proportions. She helps them verbalize their fears and work them out.

 
     
Counseling  
     
 

Some of the patients or their relatives need in depth counseling and emotional support to help them overcome, or, if not, to accept their problem. Cases picked up during ward rounds or referred by doctors, nurses, other patients or the administration are patients with -

 
     
 

Chronic or long-term illness / disease with the resulting depression and upheaval in the patient's / relatives' state of mind, family life and economic condition - e.g Renal failure, Tuberculosis, Cancer and Cardiac problems.

  Attempted suicides, accident cases and burns cases.
  Pre and post-operative problems.
  Parents of premature babies or children with disabilities.
  Attempted, incomplete abortions with resultant complications.

Marital discord / family problems / occupations problems arising out of the patient's illness.

Problems of acceptance of limitations in the patient's physical capabilities due to a sudden illness or accident.

Cases where it is advisable that treatment be discontinued because the final result will not justify the expense in terms of money, time, pain and discomfort to the patient and disruption in the family life. She helps the patient and relatives face up to the fact that the illness is terminal or life-long.

The MSW attached to the Terres Des Hommes Rehabilitation Center for the Handicapped, of the KEM Hospital, establishes a rapport with the parents of physically and mentally challenged children and helps them come to terms with their child's limitations. She motivates them to continue the necessary long-term therapies, and provides emotional support to them. Sometimes it takes parents a long time to accept that their child is different and it is the MSWs unenviable job to help them along the path of realization and acceptance. She discusses with the disabled child's parents the prognosis and the treatment plan in detail.

 
     
  HIV Counseling  
     
 

This important, distressing dimension has been added to the counseling work done by the MSWs since the last few years. HIV infected patients and, where permitted by the patient, the spouse and other family members have to be counseled. Many problems inherent in the situation have to be worked out : the acceptance of the diagnosis, ventilation, helping the patient handle his/her despair and face the future with courage. It is important that the MSW is non-judgmental, supportive and maintains confidentiality.

 
     
  Workshops  
     
 

The Department has conducted a series of workshops on HIV Awareness, Attitudes and Bio-safety precautions, for the KEM Hospital staff to :

 
     
 
Sensitize them to the HIV infected patient.
To raise levels of awareness about HIV among them.
To motivate them to practice universal bio-safety precautions.
 
     
  Special Units  
     
 

Each of the MSWs and the Voluntary Worker works with one Special Unit viz., Intensive Care, Renal, Pediatrics, Oncology, Neonatology and Tuberculosis. Working in the Special Units helps the MSW to focus on specific problems related to the illness. She provides clear and simple information, clarifies misconceptions and assists in decision making for future treatment. In chronic, long term and terminal illnesses there is a great need for supportive and crises counseling, mobilizing a support network and providing the patients with proper, appropriate referrals for medical as well as material help.

 
     
  Support group  
     
 

The Department of Medical Social Work has been instrumental in setting up a support group called "Prerana" (Motivation) for families of cancer-afflicted children. The MSW organizes group meetings, 7-8 times a year to discuss problems faced by them, to provide information about the illness and its treatment and to arrange recreational outings for the children and their family members. The Oncologist is a very important part of this support group, "Prerana" gives its members a sense of belonging. It reassures them that they are not alone in their fight.

 
     
  Follow-up, Visits and Referrals  
     
  Follow-up  
     
 

The Medical Social Worker endeavors to ensure that patients in need of long-term treatment do not drop out due to social or economic problems or as a result ot the depression and lethargy that inevitably creeps in. Follow-up is of immense importance in cases of renal failure, T.B., Cancer etc. The MSW is an important team member of the Chest and Renal Clinics.

 
     
  Visits  
     
 

Visits are made to the patient's home, school or place of work when necessary for the patient's treatment and rehabilitation.

 
     
Referrals  
     
 

Referrals to outside agencies are made when the patients need help not available at KEM Hospital; e.g., special schools, shelter homes, orphanages, employment centers, agencies for educational support, marital counseling, other hospitals etc. Special efforts have to be made to raise funds for major requirements like cardiac surgery or renal transplants or chemotherapy.

 
     
Financial Assistance  
     
 

About 50% of the patients who come to KEM Hospital are from the poor or middle class sections of society. For them, medical treatment, especially hospitalization, is a backbreaking financial burden. The hospital tries to help in some cases by giving concessions in the charges and occasionally, by waiving them altogether. But the patients still have to buy medicines and provide their own food. Some of them cannot even afford this. The Department of Medical Social Work steps in here too and tries to help with the medicines and extra, or even basic, nutrition. For this purpose, the Department arranges fund raising programs and has set up a Poor Patient's Fund. (provide a link here) A few regular donors and some charitable organizations help it in its endeavors.

 
     
  Other Activities  
     
  The Department of Medical Social Work has some other important activities, viz.,  
     
 
Participation in the education of Social Work students
 

These students are placed in the Department for their field work training. The MSWs supervise their working and provide necessary guidance. Occasional participation in classroom teaching at the Schools of Social Work and in the examinations of the students enables them to contribute to their own profession.

   
Programs for professional growth
 

Every member of the Department of Medical Social Work attends workshops and seminars on subjects related to their field. The Department has, with the help of the late Dr. J.H. Balwani, started building up a library of professional books and journals.

   

Exchange programs for social workers and social work students from abroad

 

The Department organizes orientations, visits and work experience for professional social workers and social work students from countries like Sweden, Germany, Finland, Austria, Turkey, Nepal etc. this provides an opportunity for both, the visitors and for the MSWs here, to learn about social work practices in each other's countries.

   
Motivation workshops for hospital staff
 

This is another area that the Department of Medical Social Work has ventured into, the purpose of these workshops is to open up channels of communication, build up rapport, involve different levels of staff in the problem solving process and, above all, to motivate the staff to improve patient care.

   
Promoting community relations
 

The Department establishes and maintains contact with social organizations like the Rotary and the Lions Clubs, charitable trusts, industries, schools, etc. The Head, Deputy Head and some other staff members occasionally give talks at their meetings in order to increase contacts, with the ultimate aim of benefit to the patients of the KEM Hospital

   
 
  Enquiries and correspondence should be addressed to :  
     
 

Department of Medical Social Work,
KEM Hospital,
Rasta Peth, Pune 411 011

 
     
 

Email : kemhrc@vsnl.com
Tel : 020-66037369

 
     
     
     
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