Cape Town - When Andile Kota of Gugulethu was discharged from Groote Schuur Hospital 10 years ago with a CD4 count of less than 50, he thought it was the end of the road for him.
“If I say I was weak that’s an understatement… I was literally at death’s door. Doctors had given up everything… they said I must go home to die. I weighed less than 40kg… I could not walk, bath myself or eat on my own. It was the lowest point of my life,” he recalled.
While his family initially cared for him after he was discharged from hospital, they eventually booked him into a hospice nearby. Today, 10 years later, the 42-year-old, who is HIV-positive, has not only defied death, but is a living testimony that hospices are not necessarily places for people to die.
“Today I am living because of the care I received at St Luke’s Hospice. If they didn’t take me at that stage and make sure that I took my antiretroviral medication, I would have died. I always had a perception that hospices are places where people go to die, but not anymore,” he said.
Hospice care came under the spotlight last week as the country celebrated Hospice Week from May 3 to 10. The week highlighted the role of providing support and care for people with life-threatening illnesses and recognised the achievements of hospice and palliative care programmes, which involve family members, carers, service providers, funders and the government as fundamental to providing quality care.
Hospices believe that every person with a life-threatening condition has the right to quality of life and dignity in death.
Dr Liz Gwyther, chief executive of Hospice Palliative Care Association of South Africa, said while hospices were an important part of the health-care system through the provision of compassionate and respectful care , there was a shortage of this service.
“Although we are working with the government to develop palliative care services in hospitals and clinics, palliative care is not widely available in South Africa. We just don’t have enough,” she said.
While 100 000 patients made use of hospice services in the country, Gwyther said this number was only 2 percent of the people who could benefit from this care. “Our hospices are currently working to capacity. We need palliative care services in hospitals, clinics and old age homes and hospices. The main challenges faced by hospices are limited funding, not enough nurses, social workers and doctors available to work in hospice care, and not enough health-care workers trained in palliative care.”
Gwyther also spoke against euthanasia, following the Pretoria High Court ruling which ruled in favour of assisted suicide of terminally ill Cape Town advocate, Robin Stransham-Ford. The court ruled that Stransham-Ford had the right to commit suicide with a doctor’s help.
Two weeks ago, Judge Hans Fabricius ruled that Stransham-Ford, who had since died as a result of natural causes, was entitled to be assisted by a medical practitioner either by the administration of a lethal agent or by providing the applicant with the necessary lethal agent to administer himself.
Gwyther and other medical organisations argue that if euthanasia was legalised, the right to die might be abused.
Jessica Perrins, spokeswoman for St Luke’s Hospice where Kota was cared for, said the success of hospice model could be attributed to its approach of focusing on a patient’s physical and psychological aspects.
While hospitals focused on a curative model and prescription of medication, palliative care offered in hospices not only focused on the patient, but also on family members who were allowed, in consultation with the hospice team, to decide on a course of treatment they were comfortable with.
“We focus not just on physical symptoms, but also psycho-social and spiritual concerns, which affect not only the patient but also those who care for and love them. We are looking after someone as a whole person… not only a physical being,” she said.
Cape Argus