Integrated Community-Based Home Care (ICHC) Knysna Sedgefield Hospice

The Garden Route, in the Western Cape has the highest HIV/AIDS prevalence in the province (21%). Hospitals and clinics are overwhelmed by the number of patients and do not have the capacity to treat them all effectively. The Knysna Sedgefield Hospice (KSH) is an organization committed to providing quality home-based palliative care to the terminally ill, especially those suffering from HIV/AIDS and their families. This project serves Sedgefield, Knysna, eastwards to Harkerville bordering Plettenberg Bay, and all of the inland settlements such as Karatara, Barrington, Buffelsnek, Rheenendal up to the border of the Karoo. It covers 1060km2. Knysna Sedgefield Hospice (KSH) ICHC not only provides home-based palliative care, but also educates patients and families about HIV/AIDS prevention, teaches individuals and their families basic home nursing skills, provides accurate HIV/AIDS information, identifies infected and affected children and facilitates their placement through a social worker. It also provides economic and social relief where possible by facilitating access to grants, food parcels, clothing, bedding, beds, toys and school fees.

Innovation

While the ICHC Home-Based Programme is based on the South Coast Hospice model it is relatively new to this area. It is innovative in the numerous and interdependent networking relationships it shares with relevant service delivery organizations. Its partnerships allows it to provide 24-hour in-patient facilities. The ICHC programme has been included in the National Department of Health’s “Best Practices” series.
 

Effectiveness

KSH ICHC cares for 350 patients per month. On an annual basis: KSH ICHC provides 3217 beneficiaries with food, clothing, bedding and/or school fees; reaches 1489 children through interventions providing play therapy, meals and other needs; conducts 599 doctor’s consultations; aids 303 beneficiaries in applying for social grants and identity documents; conducts 745 Total Home nursing visits; receives 590 weekly visits to day care and clinic; counsels 685 beneficiaries; helps 245 beneficiaries with the bereavement process; plans and provides for 265 orphans and vulnerable children. In the past year KSH ICHC received 537 new referrals, which represents a 40% growth in patient load. In addition to few paid staff, 252 volunteers form the backbone of this organization. It has received accreditation from the Home Palliative Care Association (HPCA) and the Council of Health Services Accreditation of South Africa (COHSASA). KSH ICHC has been identified by HPCA as a resource centre and mentor hospice to play a key role in facilitating the development of other organizations offering home-based care in the Southern Cape/Karoo region.

Poverty Impact

KSH ICHC has improved the quality of life for chronically ill and terminally ill patients and their families by providing access to care and support. Social grants and ID documents enable vulnerable people to access funds that help them to meet their daily needs. This project also allows able-bodied family members to earn an income since their HIV/AIDS relatives are cared for by the Hospice.

Sustainability

This project has a R3,2 million budget. 12% of the funding comes from the Department of Health and the European Union through the Provincial Administration of the Western Cape. 30% is raised through the volunteer fundraising committee. Corporate donors supply 40% on the budget and other NGOs/CBOs provide 18% of the budget. Current funding is secure for 1 year and the prospects for further funding are good.

Replication

This project is replicable throughout Southern Africa. The KSH ICHC is already in a position to mentor other home-based care initiatives. The biggest potential constraint is funding. This project also requires the work of a lot of volunteers.
 

Partnerships

• Provincial Administration of the Western Cape (funding)
• Department of Health (funding)
• European Union Home-Based Care Programme (funding)
• Networking and service-exchange partners: Hospice Association Western Cape, Hospice Palliative Care Association of South Africa, DeKalb Count Hospice, Knysna Provincial Hospital, Municipal Clinics, Family and Marriage Association of South Africa, Cancer Association of South Africa, Child Welfare, Dorothy Broster Children’s Home, Black Sash, Knysna Caring Services, Vermont Frail Care Centre, AIDS Council, Mad About Art, Sinethemba Youth, Masitandane, Disaster Fund, Red Cross APD, faith-based organizations, Knysna Alcohol and Drug Abuse Centre, Epilepsy South Africa
• Corporate donors: Anglo American Chairman’s Fund, AngloGold Ashanti Fund, Community Chest, DG Murray Trust, Elton John AIDS Foundation, FirstRand Foundation, Fuchs Foundation, National Lottery Distribution Trust Fund, Woolworths

Visit www.hospiceknysna.org.za for more information