Cancer and other terminal illnesses are usually treated with multiple medical disciplines around the world. Most have come to expect high technology and delivery of sophisticated surgery, chemotherapy, and radiation treatments for malignancies and life saving dialysis for kidney failure. For those unfortunate enough to be incurable, palliative care has become a science, providing comfort and dignified care through the dying process.
What is to come for those in a country with no oncologic services, chemotherapy, radiotherapy, and an absence of comfort care during the final days of life? Misery, pain, desperation, financial ruin, and agonizing deaths are the commonplace paths. Afghanistan, despite great strides in medicine and surgery, remains such a country. Silk Road Development has begun an effort to reverse this hopelessness of the dying.
A vision for Palliative –Hospice care was born out of seeing patients die with families and neighbors pouring their efforts into giving care, with no support, teaching, or knowledge of how to make their loved one comfortable. After several months of networking, brainstorming, and studying, SRD presented a plan for Hospice services to the Ministry of Health in Afghanistan in April 2008. A memorandum of understanding was signed, and the MOH agreed to support a pilot project to begin in 2009.
During the Feb. 2009 trip to Kabul, 4 Afghans were enlisted to serve as direct home caregivers under the direction of doctors and nurses for terminally ill patients. As there is no existing law in Afghanistan regarding palliative medical care, the Ministry of health asked SRD to draw up guidelines and submit them, with the hope of incorporating them into law. A name, which conveys more accurately the heart and meaning of this type of care was decided on with the help of our Afghan workers…Hamdardi. Hamdardi translates a sense of empathy, sharing hurt and hope.
We are awaiting the final pieces of our team coming together and hope that Hamdardi will be providing hospice care to 1-3 Afghans in 2009. Donations have been made, but much more is needed to buy medicines, build home care kits, and assist our Afghan caregivers with expenses of travel and training. This is a cultural shift for most Afghans. Our intention is to incorporate the family, neighbors and religious leaders into the delivery of care. Enabling, teaching, relieving suffering, and extending compassion will be the driving goals. SRD will continue to look for assistance and partners in this challenging project.