In February this year, the Compassionate Leadership Fellowship came to its conclusion, marking the end of a year of growth, learning and development for our cohort of palliative care leaders from across India, Nepal, Kenya and Rwanda. I reached out to two of our fellows, George Varghese and Keshav Sharma to ask them about their experience of the CLF course and to find out what impact it has had on them, personally and professionally.

Firstly, George and Keshav introduce themselves and their work to our readers and supporters.

George

Hello, I'm George Varghese, a highly experienced healthcare leader with more than two decades of experience, cutting across palliative care, hospital administration, and community-based public health. I am presently working as the Director of Community Health Projects at Kachhwa Christian Hospital, Uttar Pradesh, overseeing multi-village interventions for communicable & non-communicable disease and palliative care.

Keshav

I’m Keshav Sharma, Psycho-oncologist and Grief therapist with over a decade of experience supporting patients, caregivers, and healthcare professionals across India. My work lies at the intersection of mental health, palliative care, and compassionate leadership, and I’m deeply committed to creating spaces of dignity, presence, and healing in cancer care.

I’m focused on integrating mental health into palliative care through presence, dignity, and culturally sensitive care.

Beyond clinical practice, I find deep meaning in teaching what I learn from the therapy room. I’ve had the privilege of mentoring hundreds of students and professionals and serve as faculty for national and international palliative care training programs. For me, sharing knowledge is a way of sustaining the work of planting seeds of empathy, dignity, and presence in those who care for others.

1. What impact has the CLF had for you?

George

The Compassionate Leadership Fellowship (CLF) has profoundly and multifacetedly impacted both my personal and professional life. It provided a structured process for deep self-evaluation, helping me become more self-aware and intentional on my leadership journey. The course fostered a safe space for reflection and growth, leading to significant positive changes in my relationships—especially with my daughter—and in my emotional resilience. It helped me recognize unhelpful patterns like perfectionism and taught me to embrace vulnerability, humility, and authenticity. Most importantly, it instilled in me a renewed sense of purpose and a stronger, values-driven leadership identity. The CLF has been a transformative journey for me. It was not just a training program but a deeply personal and spiritual experience. It acted as an eye-opener, leading to profound self-realization and a deeper understanding of others. Each session challenged and equipped me to face greater challenges in life with empathy and strength. The stories shared, the bonds formed, and the lessons learned have left a lasting impact on my heart and mind. CLF didn’t just educate—it healed, inspired, and provided me with a new lens to view myself and the world around me.

Keshav

Compassionate Leadership Fellowship has had a profound impact on my approach to both my personal and professional journey. The fellowship helped me integrate compassion into the structural framework of my leadership style, rather than viewing it merely as an emotional response.

The most profound impact has been the recognition that vulnerability and strength are complementary rather than contradictory. Working in psycho-oncology along with grief therapy, I've always acknowledged the emotional weight our patients carry, but I previously maintained professional distance as a leader. The fellowship taught me that authentic leadership requires embracing my own humanity and sharing appropriate vulnerabilities with my team.

This paradigm shift has allowed me to create deeper connections, both with patients facing cancer diagnoses and team members navigating the emotional complexities of clinical work with the patients. I have moved from a mindset of "leading from the front" to "walking alongside" my team, which has fostered greater trust and collaboration.

Another important area of learning for me was on role of mentorship, owing to how my mentor guided and mentored me through the process of learning throughout the year with his patience and presence.

2. How has the CLF changed you as a leader?

George

CLF has completely transformed my approach to leadership in both mindset and practice. I have become more reflective and patient, choosing to listen deeply and act with compassion rather than react impulsively. The Leadership Practices Inventory (LPI) and tools like personality and conflict style assessments have helped me identify key areas for growth and develop a leadership style grounded in empathy, courage, and collaboration. I now prioritize nurturing others, aligning with team strengths, and creating space for shared decision-making. The mentorship I received has also built my confidence and provided me with a clearer, more strategic approach to navigating challenges. CLF has allowed me to rediscover and redefine myself as a leader. It has illuminated previously concealed aspects of my leadership journey and clarified my purpose. I have learned that vulnerability is not a weakness, but a powerful strength. I now approach leadership with greater empathy, humility, and authenticity. Observing the diverse teaching styles of various mentors and learning from their heart-led leadership has inspired me to lead with compassion, integrity, and boldness. I have embraced my brokenness and use it as tool to encourage and uplift others.

Keshav

The fellowship has reshaped my leadership identity in several meaningful ways:

First, I have developed a more nuanced understanding of strategic planning that balances organizational objectives with human considerations. Before the fellowship, I often approached challenges primarily through the lens of efficiency and clinical outcomes. Now, I incorporate the emotional and interpersonal dimensions into every decision-making process.

Second, the mentorship component was transformative. Observing established leaders in palliative care demonstrate vulnerability while maintaining effectiveness challenged my preconceptions about authority. I learned that acknowledging limitations and seeking input creates stronger solutions than projecting infallibility.

Third, I've become more intentional about creating psychological safety within my team. The conflict management component of the training provided practical approaches for addressing tensions in ways that honour all perspectives while moving toward resolution. This has been particularly valuable in the emotionally charged environment of mental health professional work in palliative care.

Finally, I've embraced a more balanced view of leadership that values grassroots involvement alongside strategic direction. The fellowship helped me recognize that effective leadership in palliative care requires both vision-setting and direct engagement with day-to-day realities.

3. How have you seen the skills learned on CLF impact on your work?

George

The skills and insights I gained through the CLF have significantly impacted my work. I have improved team dynamics through personality assessments and 360-degree feedback, and I have incorporated technology such as AI tools for more efficient project management. As a result, my leadership has evolved in every aspect. I am now better equipped to support the nursing team by identifying training gaps and providing hands-on orientation in palliative care. Our multidisciplinary team meetings, guided by SPICT indicators, lead to more thoughtful and coordinated care planning. Overall, I have witnessed the emergence of a more empowered, collaborative, and motivated team, driven by trust, clarity, and a shared purpose. The skills I learned in the CLF are already influencing how I interact with others and respond to situations in my work environment. I have become more empathetic and intentional in my communication and actions. I actively listen more, remain present with those I serve, and create space for meaningful relationships to develop. The leadership tools, frameworks, and personal stories shared during the training have enriched my ability to support, mentor, and accompany others on their journeys. My work now feels deeper, infused with a sense of purpose and compassion that I carry with me every day.

Keshav

The skills I gained through the fellowship have had a tangible impact on my daily work, whether in navigating difficult family conversations in a clinical setting, supporting colleagues through emotional burnout, or strategic planning for psycho-oncological services, I now approach each task with greater clarity, collaboration and compassion. Conflict management which once felt daunting is now a space for growth and dialogue. Strategic planning is no more just about outcome but about aligning efforts with shared vision.

With my clinical team, conflict resolution skills have transformed potential disagreements into productive dialogues. Recently, when team members had differing approaches to supporting a particularly complex grief case, I facilitated a conversation that honoured diverse perspectives while developing an integrated care plan that drew from multiple therapeutic approaches.

Organisationally, the strategic planning training has helped me develop more sustainable programs. A bereavement support initiative, which I developed during my fellowship as part of my Leadership Development Plan, intentionally addresses both immediate emotional needs and long-term healing through a carefully structured progression, resulting in better outcomes and resources which remain sustainable.

Perhaps most significantly, the emphasis on authentic leadership has allowed me to model compassionate presence for newer psycho-oncologists. By demonstrating that we can acknowledge our emotional responses while maintaining professional boundaries, I've helped create a culture where clinical excellence and human connection are equally valued.

The fellowship's focus on values-based leadership has been the most impactful part for me personally which clarified my decision-making process, particularly when facing difficult resource allocation questions. Having a clear framework for prioritizing compassionate care while acknowledging practical limitations has led to more consistent and principled choices.

Thank you to George and Keshav for sharing their perspectives on the CLF, and for making clear the value and effectiveness the course has had for its participants! 

Our Medical Director, Dr Mhoira Leng, shares an update on the situation in Gaza. Sharing testimony from Cairdeas partners and graduates in Gaza on the bombing of hospitals, forced displacement and starvation, Dr Mhoira and our partners call upon all of us to keep telling of Gaza, and give practical advice on how to respond in solidarity.

What is closest to my heart at this time is Gaza and the people of Palestine as they face almost unbearable catastrophe and suffering. Just over a year ago, I was in Rafah and was an eye-witness to the unfolding genocide that has continued and deepened to levels which are hard to fathom. Genocide is a stark word, however this conclusion is not my own, but that of many experts in international law, human rights organisations and even many holocaust scholars.

Telling and hearing the truth of what is happening on the ground is extremely difficult with a total block on international journalists, a lack of transparency in many of the international news outlets and a fog of propaganda. Doctors have become conduits, directly verifying eyewitness information from trusted colleagues in Gaza. Life expectancy has dropped by 35 years as the numbers with horrific injuries rise daily. The total blockage of food, humanitarian aid and medical supplies which leads to no treatment for basic medical problems such as epilepsy, or high blood pressure and even less for cancer. Now we are seeing the horrific scenes of forced starvation stalk this tiny strip of land and the weakest being the most vulnerable; the young, the elderly, the sick.

Listen to Randa, a nurse and one of our Diploma graduates as she speaks of the bombing on the European Gaza Hospital.

'As a nurse at the European Gaza Hospital, I am trying to reach out and let the world know that the hospital is now out of service. Since yesterday, we have been relentlessly bombarded with missiles and shelling that has not ceased. This forced all patients, the injured, children, and every department in the hospital to flee — along with the medical staff. We left carrying only our bags and our tears, helpless and devastated. There is nothing we can do — the occupation spares no one: not the sick, not the staff, not the wounded, and not even children. We evacuated, but there are still patients in the ICU, along with nurses and doctors who chose to stay behind to care for those on ventilators. They could not be evacuated due to the lack of available ICU beds and life-support equipment in other hospitals. We have stared death in the face more than once, unsure each time whether we would survive the next strike or not.

Bearing witness to what is happening has taken me to many different places, countries and people; from churches, solidarity vigils, interfaith groups, to a wonderful conference in Malaysia with the Asia Pacific Hospice Network. I am part of the executive of PallCHASE (www.pallchase.org) and also the Scottish Palestine Health Partnership (www.scotpalhp.org and see the next conference flyer) through which we seek to build networks, and hope and plan for the day when we can start to rebuild but also commit to telling of Gaza and each and every day. (see the wonderful poem by Khawla Badwan, featured to the right)

Advocating for better access to care for people living with chronic disease has been a major part of our work. Imagine having no access to medications to control your heart problems or kidney disease or cancer?  We worked hard with the WHO to try to ensure pain control was available for those injured in bombs and fires, for those with cancer, for those needing surgery. Sadly all our efforts have come up against the almost complete blockade of food and medical supplies and has led to NO oral morphine. I continue to work with colleagues all over the world not only for Gaza but also to ensure this has a much higher priority in any emergencies such as Ukraine, Myanmar and Sudan through a network for palliative care in humanitarian settings.

Let me share some reflections from our Gaza colleagues, ways you can be informed and also ways to be involved.

Our dear friends have moved from asking for our help to speaking of their exhaustion and endurance yet also a deep sense of abandonment from the international world.

"They say “a difficult night”?! As if during the day, flowers are showered upon us…As if the nights before were calm?! All our moments are harsh…All our moments are painful…From the break of day to the end of night…All our time is stained with blood, filled with body parts and corpses…There is no calmness here. We are dying every second. ��" Suha Sulima Shaatt

"My dear Mhoira asked me for some moving words about the situation in Gaza... I couldn't find anything in the dictionaries of Arabic, English, or any other language in the world that could describe what happened and is happening in Gaza. These are summarized to reflect the values of the modern world, proud of the values of justice, humanity, and dignity. We recently realized in Gaza that these words and terms are only valid for use by the powerful in this world. So let us be silent and not disturb any of the evils of the civilized Western world.’" Suha Sulima Shaatt

I speak with Dr Khamsi Elessi, our Cairdeas partner in Gaza, regularly. He has now been forcibly displaced along with his extended family 16 times, just imagine the upheaval! He spoke just after the terrible bombing of Ahli Christian Hospital to encourage healthcare colleagues in solidarity.

"After 17 months of this barbaric carnage against our people in Gaza strip, which has left more than 60000 deaths and more than 120000 injuries, still there is a major disaster that is always overlooked by the mainstream media which is the forced eviction of people from their houses, tents or shelters. Being evicted suddenly with your family under fire again and again feels like a relentless cycle of fear, despair, and exhaustion. Every time I think I’ve found some safety, it’s ripped away after a short while, leaving many Palestinians displaced, vulnerable, and struggling to hold onto hope. This constant fatal uncertainty wears us all down, making survival feel like an endless battle with no safe refuge in sight.

To doctors and healthcare workers in Scotland who stand in solidarity and want to help Palestinians in Gaza strip, I say, your compassion and support mean more than words can express. In times of crisis, knowing that people across the world care and take action brings strength to us in Palestinian hospitals and to the hundreds of thousands facing unprecedented carnage,  eviction, and hardship. Your willingness to send doctors to treat patients and injured...your determination to stand with those in need, whether through advocacy, donations, or simply raising awareness about the injustice being committed against our innocent people in Gaza, makes a real difference. Once again, thank you for your kindness, your humanity, and for reminding us that even in the darkest times, solidarity shines through."

How do we respond in solidarity?

Firstly, there is so much confusion that I suggest humble listening and being informed and even being willing to have views challenged and changed. Here are some suggestions:

• Rev Munther Isaac’s new and brilliant book ‘Christ in the Rubble’ is just out and highly recommended.
• Peter Beinart’s clear and short book ‘Being Jewish after the Destruction of Gaza’. 
• Watch one of the excellent films which show the reality in West Bank such as ‘Where Olive Trees Weep’, ‘No Other Land’ or the recent Louis Theroux documentary ‘The Settlers’.
• Watch Daniel Munayer, from Musalaha video on hope. https://youtu.be/BTpKubN8j1I
• Link with others and join the movement of solidarity which includes vigils, interfaith events, professional conferences, charitable giving and engaging with elected representatives.
• We are supporting colleagues in Gaza and Sudan through Cairdeas IPCT so please consider giving generously if you are able.
• Look after one another and let us not turn away even when it is hard.

I believe God shows us the way of justice, reconciliation and peace and we trust in him for yesterday, today and tomorrow. I love this statement by Daniel Munayer whose family have been involved in reconciliation ministries in Palestine for many years.

‘People have turned hope into a means of evading responsibility and becoming passive. Hope is not optimism. Hope should not be a topic that makes us passive. Hope draws us from passive comfort into costly solidarity.’  Daniel Munayer, Musalaha.

Vicky Opia, a palliative care nurse specialist and one of our Cairdeas scholars, writes on the integration of compassionate palliative care practises into Adjumani Hospital in Uganda. Vicky takes us through the journey she and her team took, highlighting the importance of training existing staff, building relationships with district stakeholders and engaging with the community to raise awareness and reduce stigma. Vicky tells us about the impact the integration of palliative care has had on the local community, particularly for the refugee communties living in and around Adjumani, and looks to the future with intent to grow and develop palliative care services in Adjumani and beyond.

My journey: Integrating Palliative Care Services at Adjumani Hospital

As I reflect on my journey as a palliative care nurse specialist at Adjumani Hospital, I realize how much we’ve accomplished in integrating palliative care into the healthcare system here. This has been a challenging but deeply rewarding path. When I first began working in Adjumani, I quickly recognized the significant health challenges faced by both refugees and host communities. Many patients were suffering from chronic, life-limiting illnesses like cancer, HIV/AIDS, and other terminal conditions, and there was little support for their emotional, psychological, and spiritual needs.

It became clear that we needed to do more than just treat the physical symptoms of these illnesses—we needed to provide comprehensive care that addressed the whole person. That’s when I began advocating for the integration of palliative care services into the hospital's services, and over time, we began to see real changes.

Building a Foundation: Training Health Workers, Village Health Teams, and Caregivers

One of the first steps in the process was providing training for health workers, Village Health Teams (VHTs), and caregivers. It wasn’t enough just to offer palliative care services; we needed to ensure that everyone involved in the patient's care, whether in the hospital or at home, had the skills and knowledge to provide the best possible care.

Our training sessions were comprehensive, designed to equip health workers with the skills to manage pain and control symptoms effectively. We also focused on communication skills and the emotional and psychological support needed to care for patients and their families. These trainings were held at the hospital and in other community settings, including health centers in rural areas. I could see the impact of this training almost immediately as the health workers began approaching patients with a renewed sense of compassion and professionalism.

The VHTs played a critical role in the community, and we ensured that they were also trained to identify patients who might need palliative care and refer them to the hospital for more specialized care. These trainings took place in local community halls, health centers, and even remote areas, ensuring that we reached as many people as possible.

Perhaps one of the most touching aspects of the training was working with caregivers—family members or loved ones who provide much of the day-to-day care for patients at home. We taught them not only how to manage symptoms, but also how to provide emotional support and create a comfortable, nurturing environment for their loved ones. These caregivers, many of whom were exhausted and overwhelmed, now had a sense of empowerment. They could provide better care, knowing that they weren’t alone in the journey.

Seeing the Change: The Impact on Refugees and Host Communities

The impact of this work has been profound, especially for the refugees who have been displaced from their homes and are dealing with trauma, loss, and severe health conditions. Many had no idea that palliative care was even an option, and some had been suffering in silence. But with the training, both refugees and host community members began to realize that they didn’t have to endure pain and suffering without support.

As we trained health workers and caregivers, we also worked on raising awareness in the community. The stigma around palliative care has slowly started to dissipate, and more families are now open to seeking help. Patients are no longer waiting until the very last minute to receive care, and the results have been extraordinary. We’ve seen patients experience less pain and distress, and families feel more supported in their caregiving roles.

One of the most rewarding aspects of this journey has been seeing the shift in attitudes toward compassionate care. Health workers, VHTs, and caregivers are no longer just providing medical treatment—they are also offering emotional and psychological support, something that has made all the difference for so many patients and their families.

Advocacy: Bringing the District Stakeholders on Board

I’ve always believed that for any significant change to happen, it requires collaboration. In this case, the successful integration of palliative care at Adjumani Hospital would not have been possible without the involvement of district stakeholders. Local government officials, health administrators, and community leaders have been essential in ensuring that palliative care services are not only available but sustainable.

We regularly held stakeholder meetings to keep everyone aligned with our goals. Through these meetings, we raised awareness about the importance of palliative care and advocated for its inclusion in the district’s health priorities. It was through these collective efforts that we were able to secure funding, raise the profile of palliative care, and ensure that refugees and host communities had access to the care they desperately needed.

Gratitude: Dr. Mhoira and Cairdeas International

I cannot stress enough how much our work has been made possible through the generous support of Dr. Mhoira and Cairdeas International. Their funding has been the cornerstone of this initiative. Without their financial and strategic support, we wouldn’t have been able to train the health workers, VHTs, and caregivers or provide the necessary resources to support palliative care services in Adjumani. Their commitment to improving palliative care in Uganda has made a lasting impact, and for that, I am forever grateful.

Looking Forward: Recommendations for the Future

While we have made significant strides, there is still more to be done. I believe that the following steps are crucial to ensuring the sustainability and growth of palliative care services:

Ongoing Training: Palliative care is a dynamic field, and we must continue to provide professional development opportunities to health workers, VHTs, and caregivers to ensure they stay up to date on the latest practices.

Community Outreach: It’s essential to expand our outreach efforts to reach even more community members, especially those in remote areas, and educate them about palliative care and its benefits.

Strengthening Resources: We need to invest more in the resources required for effective palliative care, such as medications, equipment, and tools.

Collaboration with Other Districts: Expanding our palliative care model to other districts will create a national network of support, which will benefit even more individuals in need of palliative care.

Conclusion

Looking back, I feel a deep sense of pride in what we’ve accomplished at Adjumani Hospital. Integrating palliative care services has transformed the way we approach care for individuals facing life-limiting illnesses, and the positive impact on both refugees and host communities is undeniable. The training of health workers, VHTs, and caregivers has been pivotal, and we are now able to provide not only medical care but also compassionate support to those in need.

With the continued support of district stakeholders and organizations like Dr. Mhoira and Cairdeas International, I am confident that we can expand and enhance palliative care services in Adjumani and beyond, improving the quality of life for many more individuals in the future.