We at IAHPC know that advocating for, and implementing, palliative care programs is challenging, uphill work. This is why we love to celebrate your successes and inspire our readers, who can learn from your experience. Progress Reports focus on the successes and challenges of your regional, national, and local palliative care programs.
After 9/11, a Baptist minister in Memphis, Tennessee, asked his parishioners a question that pierced the hearts of Dr. Zack Taylor and his wife Cindy: What can we do to help the people of Afghanistan? The gastroenterologist and neonatal intensive care unit nurse were in a unique position, as they had organized medical clinics in India. When their minister followed up by inviting over Afghan diplomats, a local institute held a mock leadership training session for them. “They said, ‘We have nothing like this in our country.’” Zack and Cindy decided to conduct regular leadership training sessions in Kabul.
Eventually, the Taylors founded Silk Road Development, a nonprofit with three goals in mind: leadership training, medical training, and humanitarian aid. The evident need for hospice care — the country had none — caused them to start a home hospice care initiative in 2009. They offer the organizational and financial support necessary for Afghans to provide home hospice care services.
The fact that Hamdardi (the home care program) now receives 95% of Silk Road Development’s donations, and has served about 350 Kabul residents, may lead you to believe it was an easy sell to the people of Afghanistan. You would be wrong. Acceptance came very slowly.
“There was no hospice care in the country at all,” recalls Cindy. Aside from having to explain the concept, “Why would you want to put money and resources into dying people?’” was a common question. Also, “there were a lot of hurdles with family members not wanting strangers coming into their home.”
Resistance to foreigners was particularly strong, which is why Silk Road hired a local medical coordinator, Mohammed Arif Hemat, who had travelled the country for many years treating those with leprosy and tuberculosis. He trained a half-dozen caregivers to take vital signs, administer pain medicines, and teach the family how to care for the patient.
“We want to help people die with dignity and grace, free of pain as much as possible, and have the family feel more relaxed, so that they’re not rushing to the hospital if they hear the patient gasp,” said Cindy.
Hamdardi gained traction with help from users. “One mullah’s wife who had cancer, a patient of ours, had an incredibly difficult time. We do bereavement care, and at the funeral — in front of the whole community — the mullah pointed to Arif and spoke at length about how his wife had been spared pain and died peacefully, thanks to Hamdardi hospice care.”
Perhaps Cindy’s favorite success story, though, is how most of their current caregivers are family members of former Hamdardi patients. “They’ve seen the beauty of it. They understand how they felt and what worked for them, and they want to help other families. Mostly women, but some men and even teenagers want to be involved. We’re hoping that some of these young people go into medicine.”
As befits a retired NICU nurse, Cindy sums up the whole experience neatly: “It’s been remarkable.”