Miriam Israel

Ashoka Fellow
Mexico City, Distrito Federal, Mexico
Fellow Since 2010


This profile was prepared when Miriam Israel was elected to the Ashoka Fellowship in 2010.
The New Idea
As a Mexican native, Miriam was first exposed to the specialized palliative care of a hospice while visiting her stepfather, who was dying of cancer, in the U.S. In that moment she realized the complete lack of similar end-of-life care for patients in Mexico, where death and suffering are simply accepted by the majority as an intricate part of life against which nothing can be done. Aside from Miriam’s organization in Mexico City, the only other places where palliative care is offered are Guadalajara and Tijuana, where a handful of Mexican doctors underwent medical training in the U.S. However, these services are usually priced out of reach of many of the terminally ill patients in Mexico. Even pain clinics that have purportedly begun offering end-of-life care do not address the psychological and emotional toll both on the patient and his or her family. Miriam therefore became determined to create a culture of palliative care in Mexico’s health care system, founding the Centro de Cuidados Paliativos de México, IAP (CECPAM—Center for Palliative Care in Mexico).

CECPAM’s palliative care model centers upon the delivery of integrated services through an interdisciplinary team consisting of a doctor, a nurse, a thanatologist (i.e. a health worker who specializes in death and dying), and a social worker, who is sent to the patient’s home to provide an initial assessment of the patient’s and the family’s needs, followed by regular home visits. CECPAM also offers psychological services to family members dealing with grief for up to one year after the death of the patient. The care model ensures that the patient enjoys the highest quality of life possible at the end of his or her life and that the family is trained, sensitive, and aware of their own needs as well as those of their loved one.

CECPAM has become a leading voice in Mexico’s nascent palliative care sector, and it is establishing its presence in numerous clinics and hospitals. Since the vast majority of Mexicans are unaware of palliative care, Miriam is working to spread the word about CECPAM’s services and to have her two current teams working at full capacity. In time, she plans to expand beyond Mexico City and the Estado de Mexico, where her services are currently offered, through the National Palliative Care Network that she launched in Mexico to integrate more medical professionals, academics, and the general public into her association. Her goal is to create a citizen-led national palliative care movement—where all Mexican states are represented—to spread this culture and establish national palliative care standards and certifications.
The Problem
The Strategy
The Person


Recently, Miriam has focused on launching the palliative care model, such as the care provided for those living with a terminal illness. She also aims to drive forward, to teach and diffuse this care model using different means of communication, conferences and workshops, so that it can be copied and applied in the patient's home throughout all states of the Mexican Republic. Support the families of those in need of medicine, support and anything else necessary for the patient to be as comfortable as possible at home. Their goal is to prevent the physical, emotional and material exhaustion of the family in the face of terminal illness.

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