HIV and AIDS Science, Research & Innovations Social Services

Extending hospice care into homes

Hospice care does not just end with tending to the health needs of the sick. While following a home-based care-giver from the Mofolo Hospice in Soweto, it’€™s evident that care-givers often deal with social problems of their patients.

KHOPOTSO: From the Mofolo Hospice in Soweto, you drive for almost four kilometres to get to S’€™godiphola, another township north of the hospice. Here, Phindile Nhlapo, a home-based care worker is to see a recovering patient. We find Queen sitting on the edge of her bed in her one-roomed tin-house. She invites us to have a seat beside her. The house is hot from the mid-day sun and two teen-age girls lie lazily on another bed on the other side of the room listening to a small radio. Queen is still dressed in her nighties and looks tired. She weeps as she speaks to us.


QUEEN: uManinganginceda nje ngokuthol’€™ indawo. Angikhoni ukubahappy. uMntanami womfana umakafika la uyangivuruvaya, angivuruvaye afun’€™ ukudla ngenkani. Athi why ngingam’€™nikezi imali’€¦ Bheka mina ngiyathenga amaplastic. Angithi ngithenga ukudla and izinto zala endlini. Yena utsotsi uzoyithola imali yakhe’€¦ Ngihambe ngiyo reporta ngiye eJabulani (police station) ukuthi abantwana bami’€¦ eJabulani bazamvalela only three days. After three days simubone ukuthi ukhona, asazi ukuthi kanjani. So, hhayi,  ngineproblem man, serious. Kakhulu. Kakhulu. Ngisinye isikhathi ngiyangala nje nokuy’€™ eclinic ngithi kuyafana. But, ngijike ngibeneworry ngithi lomntanami we nine years uzoyaphi yena?


TRANSLATION: Please help me find a place to stay. I’€™m not happy. My son is fighting me all the time demanding food and asking why I don’€™t give him money, saying that I always buy things. But I buy food and things for the house. He is a criminal. He will get his money. I would go report him to the Jabulani police that he’€™s assaulted my younger children. They would lock him up for only three days and then release him. How? We don’€™t know. Oh, I have a problem, really. Sometimes I stop going to the clinic, thinking nothing will change. But then, I’€™d think of my youngest, the nine-year old. Where would she go?    


KHOPOTSO: Queen’€™s most pressing worry is her youngest child. But she’€™s also deeply   concerned that her two older daughters, aged 16 and 14, will become easy prey for men.


QUEEN: Ngiyafuna ukuphilela abantwana bami ngoba nakubobaba wabo ababafuni. Nobaba wabo uhamba ehlala nje nabafazi.                  


TRANSLATION: I want to live for my children because their father’€™s family doesn’€™t want them. And their father is always with all sorts of women.


KHOPOTSO: All the while as Queen tells her story, community care worker, Phindile runs her hand gently up and down her back to comfort her.


PHINDILE: We always give isupport. Sim’€™lethela izinto, ukudla uyabo? Njengoba ekutshelile iindaba zaboma indlu. The problem was indlu ye RDP bekungeke vele azayithole because bekasendlini and engakadivorci nendoda yakhe. But isituation yakhe njengabe seyiso sekumele ayihendlishe futhi bazame ukuthi bam’€™ncede’€¦ And into emkhosayo vele nje ukuthi aye down uQueen amafamily conflict ‘€“ eworse ke umntanakhe lo akhuluma ngaye omfana’€¦ We never decide ukuthi umuntu makaye le ayenzeni. We just guide ukuthi enza 1, 2, 3, 4, 5. Lapho sikhona khona ngezandla, then we do, ngaloku ukuncane esibanakho.              


TRANSLATION: We always give support and bring her things such as food. And as she told you that she needs help with a house, the problem was that it’€™s an RDP house. She couldn’€™t get it because she was staying in her marital home and was still married to her former husband. But her situation now means that she can get help. Another thing that causes Queen to go down is family conflicts, especially the son that she is talking about. We don’€™t decide what people must do. We just guide them to do this and that. Where we can physically help, then we do with the little that we have.


KHOPOTSO: Queen is HIV-positive, but she’€™s not on antiretrovirals yet. She says she’€™s still deciding on that. Her home is one of many in the Mofolo area, which comprises four other townships, that Phindile visits every week. As a community care worker, Phindile is not a qualified nurse. Her role is to counsel and monitor the progress made by patients and then report back to a nursing sister. The Mofolo Hospice admits and offers home-based care to patients with incurable diseases from all over the bustling Soweto area. Sister Sibongile Mafata, co-ordinator of the service, has been with the hospice for the last nine years.


SISTER SIBONGILE MAFATA: We’€™ve got 33 community care workers that are based throughout Soweto. So, what happens is (that) this community worker will visit patients her or his own area’€¦ The community care worker will, depending on the condition will visit more regularly. And if there are any changes then, she will or he will report to the home care sister’€¦ We look at the person in totality. It’€™s unlike a hospital. We look at the physical problems. We look at the social problems. At times the person becomes too ill because of the social problems. We look at the psychological problems. We look at the spiritual problems’€¦    



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