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Brief Communication
2 (
2
); 108-109
doi:
10.25259/WJWCH_31_2023

Cleaning is also caring – Dignity of the child even after death

Pediatric Palliative and Supportive Care Unit, Bai Jerbai Wadia Hospital for Children, Mumbai, Maharashtra, India
Corresponding author: Veronique Dinand, Pediatric Palliative and Supportive Care Unit, Bai Jerbai Wadia Hospital for Children, Mumbai, Maharashtra, India. verodinand@gmail.com
Licence
This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

How to cite this article: D’souza KP, Karegar AF, Dinand V. Cleaning is also caring – Dignity of the child even after death. Wadia J Women Child Health 2023;2(2):108-9.

Abstract

Bai Jerbai Wadia Hospital for Children in Mumbai is known for its specialized care for children. Its Pediatric Palliative and Supportive Care Unit works toward improving the quality of life for seriously ill children and enhances end-of-life care. This article focuses on the important role of “Maushis” (cleaning staff) in ensuring dignity for deceased children and supporting families at the hospital. Two workshops with “Maushis” led to positive changes in their practices, including attention to detail, cultural sensitivity, and the introduction of a comfortable trolley for transporting deceased children. This initiative promotes respect and dignity for non-medical staff, enhancing the overall care experience in the hospital.

Keywords

Palliative care
Quality of life
Pediatrics
Bereavement
Respect
Feedback
Family
Patient care team
Staff

INTRODUCTION

Bai Jerbai Wadia Hospital for Children (BJWHC) in Mumbai is renowned for its specialized healthcare services for infants, toddlers, and children. Non-medical staff who do the work of cleaning are referred to as “Mamas” and “Maushis” (uncles and aunts) in Maharashtra, reflecting the value of labor and inviting respect to the workers. This article focuses on the crucial role played by the “Maushis” responsible for cleaning and packing in the event of a child’s death in the hospital. It highlights the efforts to ensure dignity for the deceased child and support grieving families.[1,2]

In 2019, BJWHC established a Pediatric Palliative and Supportive Care Unit (PSCU) to focus on improving the quality of life for seriously ill children. The multidisciplinary team also provides end-of-life care and bereavement care. The PSCU refurbished the hospital mortuary trolley, painting it in blue with a matching mattress, to allow parents to take away their child’s body with dignity.

METHODS

Two workshops were conducted with the Maushis to understand their experiences, knowledge, and attitudes toward their role in caring for the deceased children. The first workshop aimed to gather insights and discuss their cleaning and packing practices, while emphasizing the importance of their role in supporting grieving families. The second workshop, held 12 weeks later, aimed to assess any attitude and practice shifts among the participants.

RESULTS

Final exit from the hospital with dignity

  • Participants mentioned the hospital’s culture-neutral packing norms, using a white cotton shroud for the mortal remains.

  • Maushis now pay attention to details and consider parents’ wishes, such as using specific clothing for the child.

  • The introduction of a new trolley with a comfortable mattress received positive feedback from the Maushis.

  • Participants ensure that the mortal remains are not left unattended, exposed to the elements, or visible to other children.

  • When shifts change during a death in their ward, Maushis patiently waits for the next staff member to explain the ongoing process.

Appreciation and recognition

  • The workshop certificate served as the first formal appreciation the Maushis received for their work, bringing happiness to their families.

  • Participants expressed pride in displaying the certificate at home, with one participant’s daughter even laminating it, and other family members wishing they received similar recognition in their respective jobs.

Challenges faced by participants

  • Moving the trolley on the outdoor ramp to the ambulance posed difficulties due to its steep and narrow design.

  • Participants suggested using a strap to secure the body and prevent sliding. The PSCU implemented this solution post-workshop.

CONCLUSION

The hospital’s practice of referring to non-medical staff as “Mamas” and “Maushis” promotes respect for adults and dignity of work among children. Conducting interactive workshops with these staff members enhances their sense of dignity and appreciation for their vital role. Such initiatives improve the last hours bereaved families spend in the hospital and ensure quality care during the final goodbye. By recognizing and supporting non-medical staff, health-care institutions can create an environment of dignity and respect for all those involved in the care process.

Declaration of patient consent

Patient’s consent not required as there are no patients in this study.

Conflicts of interest

There are no conflicts of interest.

Use of artificial intelligence (AI)-assisted technology for manuscript preparation

The author(s) confirms that there was no use of artificial intelligence (AI)-assisted technology for assisting in the writing or editing of the manuscript and no images were manipulated using AI.

Financial support and sponsorship

Nil.

References

  1. , , , . Promoting the dignity of the child in hospital. Nurs Ethics. 2003;10:67-76.
    [CrossRef] [PubMed] [Google Scholar]
  2. , , , , , . Dignity of the patient--family unit: Further understanding in hospice palliative care. BMJ Support Palliat Care. 2022;12:e599-606.
    [CrossRef] [PubMed] [Google Scholar]
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