More and more young people, particularly in their early 30s, are needing palliative care. This is mostly due to HIV, which people in their 30s probably picked up when they were much younger and are getting ill with AIDS-defining conditions after years of infection. Since 1997, the death rate in South Africa has gone up by 87%. More deaths now occur in the 30 ‘€“ 35 year age group than in people aged over 60, says the head of Wits University’€™s Palliative Care Programme, Dr Natalya Dinat, as she flips through a Statistics South Africa report which lists AIDS as the leading cause of death in South Africa.  

‘€œYou see, this is age 30 ‘€“ 34. You’€™ve got more people dying in that age group’€¦ This dying ‘€“ a lot of it is not to do with war, some of it’€™s to do with violence, but it’€™s a lot to do with diseases that are associated with a lot of pain ‘€“ HIV, Tuberculosis’€.

Dinat says the advent of antiretroviral therapy has helped, but adds that it is too soon to expect illness and death due to AIDS to abate, thus making palliative care essential.

‘€œEven though there are antiretrovirals and even though we try and access our patients antiretrovirals, there are still far too many people dying and there are still far too many people suffering. Yes, we need antiretrovirals. There’€™s no doubt about that. We should step up the antiretrovirals, but there’€™s no reason why, alongside that, we can’€™t attend to people’€™s pain and symptoms’€¦ Eventually when everyone’€™s on antiretrovirals and when we’€™ve got great prevention, then our job in palliative care would be looking after the elderly who are dying of cancer and dying of illnesses which we can’€™t do anything about’€, she declared.

Palliative care, says Dinat, ‘€œstarted being provided as a specialised service in the 1970s. It focuses on three things: curing patients – if possible, relieving their pain and offering them much-needed comfort’€.

The Gauteng Health Department has committed to making palliative care part of the health package in the public health sector. Tomorrow, the Department will officially partner with Wits University’€™s Palliative Care Unit which has been operating at Chris Hani Baragwanath Hospital since 2003, and more recently at Helen Joseph and Johannesburg hospitals, to deliver services. The unit will now be a provincial Centre of Excellence in Palliative Care and will serve to train doctors and nurses, conduct and support research and will continue offering palliative care service.


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