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
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 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.
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.
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.
suicides, accident cases and burns cases.
premature babies or children with disabilities.
incomplete abortions with resultant complications.
Marital discord / family problems / occupations
problems arising out of the patient's
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.
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.
The Department has conducted a series of workshops
on HIV Awareness, Attitudes and Bio-safety precautions,
for the KEM Hospital staff to :
them to the HIV infected patient.
levels of awareness about HIV among them.
them to practice universal bio-safety precautions.
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.
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.
Visits and Referrals
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 are made to the patient's home, school
or place of work when necessary for the patient's
treatment and rehabilitation.
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.
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
of Medical Social Work has some other important
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
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
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
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
correspondence should be addressed to :
Department of Medical Social Work,
Rasta Peth, Pune 411 011