Dr. Parag Bharadwaj only learned that he was the IAHPC’s first Lifetime Member last year, 13 years after joining. His ‘thank-you gift’ for signing up was a coffee mug. ‘It’s the most expensive mug in the house!’ he quips with Liliana De Lima, whose compelling description of the organization’s purpose convinced him to write a check that seemed pretty large at the time, for a student.
Parag Bharadwaj’s understanding of palliative care was profoundly shaken during his first class with Frank Ferris at San Diego Hospice, where he elected to do a fellowship after completing his geriatrics training at UCLA.
‘My definition of palliative care was construed as taking care of end-of-life patients, but the disparity at San Diego Hospice was stark. Patients received chemotherapy and were aggressively treated for diseases that conflicted with end-of-life care,’ recalls Bharadwaj.
Ferris remembers him clearly.
‘The very first day that Parag sat in our classroom, I presented a definition of hospice and palliative care,’ says Ferris. ‘It was very much the expanded definition: care for anybody during the illness experience.
‘He came up to me after class and said, “Is that right? I didn’t sign up for that!” He needed to adapt and change. You can see that he has done so, dramatically. For me, Parag is one of the strong — albeit quiet — persuasive health care system leaders in the country.’
Bharadwaj recently left Southern California’s Cedars-Sinai Medical Center where, as Medical Director, he developed innovative models of care, such as involvement of palliative care within the heart transplant program and with each bone marrow transplant patient admitted to the hospital. He calls it the ‘Care and Cure model.’ He joined the Virginia-based Sentara Healthcare. Sentara, with 300 sites of care including 12 hospitals, represents a major expansion of his sphere of influence. His new position, System Clinical Chief of Palliative Care Medicine, opens the door to enacting widespread change across the system.
‘It increases the scope of impact,’ says Bharadwaj, adding that ‘it is a great opportunity to grow as a leader.’ He guided Sentara Healthcare to become the first system in the country to publish system level outcomes data, by demonstrating the value of palliative care for a system.
Throughout his career, Bharadwaj has been drawn to act internationally, as well as locally. It was triggered when he spent an elective month in India during his fellowship.
‘When I returned, I used a video conferencing program’ to train a doctor in the suburbs of Mumbai. Bharadwaj was fascinated with the ability to remotely mentor a physician who, in turn, would use that palliative care expertise to alleviate a patient’s suffering on the other side of the world. ‘I thought, “If I can do this, others can do the same.”’
Education became Bharadwaj’s ‘biggest driving force.’ It spurred him to create the Palliative Care Network, a free, online platform for health care professionals to connect and be an educational resource for each other. ‘The Network’s projects have led to policy changes,’ he says, ‘to the increased availability of opioids, and to a superior understanding of how current medicines can be used — like ketamine, for pain.’ Palliative Care Network makes a significant global impact through its initiatives.
With all this achieved by age 44, it is clear that Bharadwaj is not fond of wasting time. ‘I strive to get things done, because you never know how much time you have left.’
Yet Bharadwaj has high hopes for the future, and ‘participating in a more fluid exchange of knowledge — locally and internationally. In this information age, we have considerable knowledge to gain from our colleagues. Let’s do more of that.’
A lifetime devoted to palliative care following personal tragedy isn’t an unusual phenomenon. In this, Dalitso Mzinganjira’s story is distressingly familiar.
When diagnosed with incurable throat cancer, his beloved grandfather was sent home with nothing but panadol and ibuprofen pills — both useless, as his grandfather could not swallow them. ‘I saw my grandfather cry like a baby every day and every night with pain. It was so traumatic. It still haunts me.’
Years later, while working as a nurse, he met a visiting doctor who spoke of palliative care. It lit a fire, and Mzinganjira signed up for a week-long training session locally. It didn’t feel like enough, so ‘I started googling, and the Palliative Care Network popped up.’ Within a few days, he had connected to experts and asked them what he should do to pursue a career in palliative care. Their suggestions led to an IAHPC grant that took him to Makrere University in Uganda.
Now working at a hospice in Canada, Mzinganjira uses his time in North America for fundraising and establishing new partnerships to garner resources and support for a community-based, traveling hospice program he instituted back home in Malawi with the help of friends. He eventually hopes to return there to take care of the program.
The Yathu Hospice program (yathu means ‘ours’) provides at-home visiting, companionship, and care coordination. Mzinganjira helps with planning; five people on-site (including a director of care, social worker, and governess) enact the care. He hopes to eventually add a residential hospice and the ability to dispense medicines.
Mzinganjira also created two projects — Tilinawo (‘they are not alone’) and Hope Builders — to support families of patients, most of whom are the breadwinners. Tilinawo helps families start small businesses; Hope Builders helps people find shelter and build homes (‘They mold the bricks, we supply a builder and iron sheets for the roof’).
He still uses the Network, attending its conferences ‘by the click of a mouse. It’s very important that it’s free,’ as it removes a barrier to cash-strapped individuals and organizations. Most of all, he cherishes the person-to-person contact. ‘It connects individuals with the same aspirations. For me, getting information from others, in answer to my specific questions, was huge.’Read the list of individuals who joined/renewed their membership with IAHPC during the past month.
| Name | Country |
|---|---|
| Narine Movsisyan | Armenia |
| Edier Arias | Colombia |
| Ximena Pozo | Ecuador |
| Sajeevan Kunivayalil | India |
| Manjula Bhagavatula | India |
| Sanghamitra Bora | India |
| Sanket Mehta | India |
| Shiv Pratap Singh Rana | India |
| Fad Abu-Farsakh | Jordan |
| Phanice Jepkemoi Tom | Kenya |
| Dalitso T Mzinganjira | Malawi |
| Thamboo Pragasam Devaraj | Malaysia |
| Poonam Pokherl Sapkota | Nepal |
| Evangeline Barbara Go | Philippines |
| Boubacar Poulho Sow | Senegal |
| Ranjan Mallawaarachchi | Sri Lanka |
| Monika Obrist | Switzerland |
| Elizabeth Namukwaya | Uganda |
| Ludoviko Zirimenya | Uganda |
| Patrick Coyne | USA |
| Stephen Connor | USA |
| Ronald Crossno | USA |
| Alexander Nesbitt | USA |
| Katie Addicott | USA |
| Ellen Csikai | USA |
| Patricia Bonilla | Venezuela (Bolivarian Republic of ) |
| Name | Country |
|---|---|
| Tim Luckett | Australia |
| Yelena Vainilovich | Belarus |
| Katherine Dambrowski | Brazil |
| Ann Thyle | India |
| National Cancer Center, South Korea | Korea |
| Krishna Sagar Sharma | Nepal |
| Sabita Panthee | Nepal |
| International Children's Palliative Care Network | South Africa |
| Dorothy Wholihan | USA |
See the full list of IAHPC members
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