Botswana Anglicans are hospice service trailblazers

By Bellah Zulu
Posted Mar 20, 2013

[Anglican Communion News Service] Walking into the Holy Cross Hospice in Gaborone, Botswana, one may be greeted with charming smiles and the sweet aroma of food emanating from the kitchen. The environment is so full of life and welcoming. This is not exactly what most people would expect.

For many people, a hospice, being a place for the terminally ill, would be a sombre and lifeless place. But not at Holy Cross.

“When I came to this place, I was not able to walk but now I can,” revealed David Brasso Matlhoki with a smile. He is one of the terminally ill patients at the hospice. “This hospice gave me the care, support and treatment I needed. I would like to see it grow since it’s very important to us.”

He added: “I encourage other churches in Africa to come to Botswana and see how this place operates so that they can go back and open hospices.” Matlhoki is just one of the more than 20 clients currently benefiting from medical, nursing, spiritual and nutritional care provided by the hospice.

The other patients were waiting for their lunch in the courtyard while playing board games. The volunteer staff also were busy performing various tasks meant to help the patients “live their last days with dignity by making the best of each day.” Smiles, courage and hard work are evident even in the face of one of life’s most daunting psychological challenges.

“I almost committed suicide before coming to the hospice because I didn’t know I was going to make it,” revealed another patient, Boitumelo Mabolola. “Before coming to the hospice, I was always home alone because I was bedridden and had no one to take care of me. Coming to the hospice made me meet other people that are going through similar circumstances and it helped me grow spiritually and accept my status,” she said.

HIV/AIDS still remains a major challenge for Africa and the world as a whole and ranks highly among terminal illnesses suffered by people on the continent. Botswana is no exception, having one of the highest HIV prevalence rates in Africa.

According to reports, it is the second highest in the world, topped only by Swaziland. Though the government has put in place various mechanisms such as massive sensitization programs and the provision of anti-retrovirals (ARVs) and other services to address the spread of the virus, the general scenario is still worrying.

For this reason the Anglican Communion makes health issues a top priority, and through the Anglican Health Network the church is a major and strategic partner in working towards the Millennium Development Goals (MDGs) and delivering health improvements to the poor. In the face of such challenges, Anglicans in Botswana did not turn a blind eye to the HIV situation in their country. They responded by drawing from the Gospel call to “go out and heal the sick.”

In 1994, members of the Holy Cross Cathedral of the Anglican Diocese of Botswana, in conjunction with the Rotary Club, founded the Holy Cross Hospice using volunteers and the strengths of a common Anglican identity in mobilizing resources and expertise. The hospice is a registered welfare and non-governmental organization based in the capital Gaborone and established specifically to “respond to the palliative care services” for persons living with terminal illnesses.

Running a hospice is a unique calling and hospices are important to the dignity of any society. Erik Isaksson, acting manager for the hospice, agreed.

“Meeting a person who is in the final stages of their life often gives access to the very important, personal and urgent needs of a person and this, to me, is like being given a very special gift,” he said. “We are now putting more emphasis on end-of-life and focusing on people with life threatening and progressive illness. We direct our services to all, regardless of race or religious affiliation.”

Despite the ability of the hospice to provide holistic care and also to address the physical, spiritual, social and psychological needs of the patients at no cost at all, it faces a major financial challenges. All the clients are from impoverished backgrounds and could never afford to pay even if they were asked to do so.

It goes without saying, therefore, that financial support would increase the hospice’s capacity to handle clients and help them spread their reach beyond Gaborone, which is currently the only city from which they accept clients.

Pearl Ncube is the volunteer resource mobilizer for the hospice and has been working hard to source funding. She is proud about the success of the hospice over the years and explains the work model that has helped the hospice thrive.

“This hospice totally relies on donor funds. We have always chosen to deal with volunteer workers because we cannot afford to have fully employed and paid experts due to financial challenges. We also like to work with interns from colleges and universities,” she said.

The Holy Cross Hospice may be facing challenges but this has not lessened its resolve to help people, many of whom are living the last days of their life. It has received awards for its exceptional service and commitment to supporting the people of Botswana.

“We are the first hospice to operate in Botswana,” explained Ncube. “We have been a leader in the provision of palliative care throughout the years and have been able to rehabilitate our clients, most of whom have been able to go back to their families and live normal lives.”

Though small, the hospice has a gym, a massage room and a lounge area. Clients are encouraged to eat healthy foods and also take time to mingle with others. They are also taught various skills such as basketry and other artistic skills to help them settle down well and also for them to have a source of income.

Immaculate Tambala is a volunteer social worker at the hospice. “Since most of [the clients] are HIV positive, we teach them a lot about what the disease is all about and how it should be managed,” she said. “We also counsel the clients and find out what they really need. We do a comprehensive assessment of the support system that they have in their homes to make sure they are well embraced and supported in their own homes and communities.”

The hospice has also tried to tackle some of its challenges by cooperating with other hospices in Botswana as manager Isaksson explained. “We are cooperating with another hospice in Metsimothlabe run by the [Roman] Catholic Church. They are a state-of-the-art inpatient hospice and help us with patients who need 24-hour care,” he said. “We are also in close dialogue with the oncology department at the local hospital, Princess Marina, for referrals. We can proudly say that we have been an active part of the formation of the Botswana Hospice and Palliative Care Association.”

Social worker Tambala added: “Working with the terminally ill can be stressing and tiring. Some situations are so sad but I get to learn a lot from the clients. It gives me an opportunity to try and understand what the clients are going through. I wish other people would also see the value of this.”