Hope for the dying
Less than 300 kilometres inland from the West Coast the environment changes from semi-dessert to lush vineyards where award-winning wine is produced and fruit trees strain under the weight of summer fruit.
Ashton is a village sandwiched between Montagu and Robertson, along Route 62, an increasingly popular detour for Cape Town holidaymakers heading towards the Garden Route.
With no traffic lights and two stop streets, Ashton is an almost insignificant village – residents mostly eke out a living by working for two huge factories, Tiger Brands or Ashton Canning and the seasonal work on the fruit and wine farms.
Just off the main road, behind the factories with the Langeberg Mountains in the distance, a simple face brick building has brought hope to the sick and dying.
Started in 1999, the Kayce Meulenbroek BRAM Care Centre had its humble beginnings in an eight-bed building with hardly space for a mouse.
Dutch immigrant and retired Robertson resident Kayce Meulenbroek raised funds to start the BRAM Care Centre when he came to hear of an ill HIV-positive patient who had to give up his hospital bed for another patient due space constraints.
The patient was sent ‘home’ to die. Meulenbroek discovered that ‘home’ for this terminally ill patient was under a bridge.
Already an Aids counselor, Meulenbroek was determined to allow people to die with dignity and in a short space of time found a site where he started the hospice. In the meantime he raised funds with the help of his family in Holland and the brand new 20-bed centre was opened last year, sadly a few months after the tireless activist died of cancer.
‘We are seeing more and more Aids patient, but they are in a much better condition than previously,’ remarks Sister Francis Eksteen, who has worked at the centre for the past five years.
‘The patients are mostly in stage one or two of their HIV infection and present with an opportunistic infection. Where in the past their condition would deteriorate rapidly and we would have many deaths on a weekly basis, we are now able to nurse them and assist them in accessing anti-retrovirals. So most of them go home. It’s our cancer patients who end up dying,’ says Eksteen, one of two professional nurses working at BRAM.
Previously, BRAM was run with help of donations and some money from the Western Cape Health Department. But money from the Global Fund to Fight Aids, Tuberculosis and Malaria has enabled BRAM to cover all the running costs with plans to build a daycare centre for those patients only needing care during the day, a voluntary counseling and testing (VCT) facility and a bigger staff room.
Eksteen said stigma was still a big problem in the community, but something they were hoping to address in the future by being able to offer VCT in a caring environment where the patient’s privacy is respected.
‘We have had people who have died at home without being tested. They would rather die at home than face up to going to hospital and having to deal with their HIV status,’ says Eksteen.
She says an Aids-related death was now an exception at BRAM. ‘When people do die it is because they have either defaulted on their anti-retroviral medication or because they have refused to take the medication in the first place,’ explains Eksteen.
Eksteen, who left her better paid job in the state sector, to nurse at BRAM said she always wanted to work with terminally ill patients.
She remembers a nine-year-old girl, one of their first patients, as one of her favourites.
‘She was HIV-positive, orphaned and very ill. Her lungs had almost been destroyed by her untreated tuberculosis, so by the time she accessed ARVs it was too late and she passed away. But she was always so positive and when you came on duty she often had a little poem or a picture she had made,’ recalls Eksteen.
‘Stigma will remain our biggest challenge in this community. Some HIV patients will rather claim they have cancer,’ says Eksteen.
‘Most of the people who end up here have been shunned by their families. It means a lot to them to be in an environment where they are loved and touched, you can see the gratitude in their eyes,’ says Eksteen.
* To contact BRAM, Pam Verrall can called at 072 4269817