Hospice and Home-Based Palliative Care

Hospice and palliative care in Africa was adapted from the western hospice model to cope with an impossible clinical overload of inpatient facilities. The HIV/AIDS pandemic has crippled the hospital services that are underequipped, understaffed, and incapable of coping with large numbers of patients. Neither the hospitals nor the patients can afford the cost of inpatient treatment, so hospice and home-based palliative care providers have emerged as the only solution for patients who are too sick, poor, or isolated from the hospitals to receive the care they require.

African palliative care providers are using the WHO definition of palliative care: “An approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial, and spiritual.” Palliative care aims to provide relief from pain and other symptoms so patients can live as fully as possible until death. The hospice networks use home-based support groups to enhance the patient’s quality of life while simultaneously helping the family cope with the illness and eventual death.

These home-based palliative care providers have proven essential in the fight against the HIV/AIDS pandemic. The February 28, 2008 issue of the Lancet reported that “the implementation of home-based care could significantly reduce mortality among adults living with HIV/AIDS in developing countries, as well as children within their families.” (BBC News, February 29, 2008) Many of these groups employ trained palliative care doctors and nurses who are directly involved in testing for and treatment of HIV and are authorized to dispense antiretroviral therapy (ART) treatment to enhance and prolong the lives of HIV-positive patients. They are also involved in preventing opportunistic infections and ameliorating the pain and discomfort that HIV patients live with daily.

Direct Relief International is providing home-based palliative care providers with the products they need to assist HIV/AIDS patients. These products include rapid HIV tests, pain relievers, antibacterials, antifungals, soaps, diapers, mattresses, vitamins, nutritional supplements, wheelchairs, and walkers. Direct Relief distributes these items to hospice sites approved and accredited through the African Palliative Care Association (APCA) or the Hospice and Palliative Care Association of South Africa (HPCA). We are currently supporting sites in South Africa, Zimbabwe, Uganda, and Kenya.

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