Island Hospice & Healthcare

by Island Hospice and Healthcare
Island Hospice & Healthcare
Island Hospice & Healthcare
Island Hospice & Healthcare
Island Hospice & Healthcare
Island Hospice & Healthcare
Island Hospice & Healthcare
Island Hospice & Healthcare
Island Hospice & Healthcare
Island Hospice & Healthcare
Island Hospice & Healthcare
Island Hospice & Healthcare
Island Hospice & Healthcare
Island Hospice & Healthcare
Island Hospice & Healthcare
Island Hospice & Healthcare
Island Hospice & Healthcare

Introduction and background

Island uses several models to deliver palliative care services namely (i) home-based care; (ii) hospital-based care iii) Rural and community outreach iv) Roadside services (v) therapeutic and comprehensive bereavement care, including for children; and (vi) capacity-building for doctors, nurses, community caregivers and others. The bereavement service offered by Island is aimed at those who are grieving after any death whether the family has lost a patient who died in our care, or a sudden unexpected death such as a car accident, suicide or heart attack. The advent of COVID-19 and the subsequent national lockdown has seen Island intensifying virtual support through telephone, WhatsApp, Zoom and other electronic platforms.

Intervention and impact

Between January 2022 and March 2022, Island operated under conditions of relaxed national lockdown following decrease in COVID-19 cases in the country. Island continued to work with reduced face-to-face clinic contacts, roadside clinics, hospital visits and home visits and increased virtual contacts. Island staff adhered to WHO guidelines on the use of personal protective equipment, social distancing and sanitisation where physical contact was unavoidable.

Successes of these interventions included holistic provision of PC services through innovative means, especially virtual (telephone, zoom, WhatsApp call) and limited one on one contacts. Island intensified tele medicine through rolling out of a system for patient information collection and health outcome measurement. The system was embraced by community caregivers who are responsible for administering the tool together with Island nurses and social workers. They were particularly happy with the system for real time reporting of patient outcomes and for triggering intervention from a qualified health professional.

A story of change below depict typical changes to people’s lives after Island interventions.

Story of Change: I feel relieved

I am a nurse who lives in one of Bulawayo's suburbs. I contracted Covid-19 and became ill at work. At once informed the staff wellness centre personnel that I was not feeling well, and I wished not to mix with other people since I was unsure what this was; I suspected it may be covid-19. Following that, I was prescribed medication and was instructed to take two days off. During this time, my body felt weak; I have never experienced such fatigue before. After two days, I returned to work and there was not any significant improvement. I had shortness of breath and chest tightness; I could not lie flat. They gave me more medication and another three days off. After three days nothing changed. I went for a PCR test, and I was confirmed to be Covid-19 positive.

Unfortunately, for this life-threatening situation, it was handled casually; and the manner I was informed was uncompassionate. Meanwhile, matrons approached me and said, "welcome to the Covid-19 club." All of this only added salt to the wound. The prospect of living in seclusion without contact with my family was terrifying. It had a profound effect on me. I was in a panic mode, my mind was going into turmoil and there was no one there to say it is okay, to reassure me. My daughter was in panic and fear with what was going on. My world crumbled. There I am on my own, they did not check if I have somebody and if I could manage to handle such news. I was expecting empathy, someone to be compassionate as they are giving such news. So that was the entry point of my mental unwellness.

I told our HR department that I needed counselling and that is when she contacted Island Hospice and Healthcare (Island). That is how I got the services from Island. At first, I had concerns about how confidential our sessions would be, but the social worker assured me that she would not share any detail to anyone. I felt I was in safe hands and it made me open up to her. We did series of counselling sessions and we would meet once a week. She helped me revisit my past and address unsettled issues which contributed heavily to me being uptight even on small issues. The pain of seeing my parents separated while I was young, and I had a miscarriage when I was 18 years old. These were areas I had just shut down, but she helped me to address these issues. At times I could even choose not to go to these counselling sessions to avoid facing this pain, but she would always call me and encourage me to come. She also helped me to improve my relationship with my daughter. My daughter was incredibly supportive and positive throughout the whole period I had covid-19.

The counselling sessions brought to me peace of mind. The peace of mind translated into better sleep at night and improved output at work. I feel relieved.

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Introduction and background

Island uses several models to deliver palliative and bereavement care services namely (i) home-based care; (ii) hospital-based care iii) Rural and community outreach iv) Roadside services (v) therapeutic and comprehensive bereavement care, including for children; and (vi) capacity-building for doctors, nurses, community caregivers and others. The bereavement service offered by Island is aimed at those who are grieving after any death whether the family has lost a patient who died in our care, or a sudden unexpected death such as a car accident, suicide or heart attack. The advent of COVID-19 and the subsequent national lockdown has seen Island intensifying virtual support through telephone, WhatsApp, Zoom and other electronic platforms.

Intervention and impact

Between August 2021 and November 2021, Island operated under conditions of relaxed national lockdown following decrease in cases of COVID-19 in the country. Island continued to work with reduced face-to-face clinic contacts, roadside clinics, hospital visits and home visits and increased virtual contacts. Island staff adhered to WHO guidelines on the use of personal protective equipment, social distancing and sanitization where physical contact was unavoidable.

Successes of these interventions included holistic provision of PC services through innovative means, especially virtual (telephone, zoom, WhatsApp call) and limited one on one contacts. Island intensified tele medicine through rolling out a system for patient information collection and health outcome measurement. The system was embraced by community caregivers who are responsible for administering the tool together with Island nurses and social workers. They were particularly happy with the system for real time reporting of patient outcomes and for triggering intervention from a qualified health professional. In the last thirty days, mean patient quality of life improved 54.1% to 62.9%.  

Two stories below depict typical changes to people’s lives after Island interventions.

 Story of Change 1:

Mr. James (not real name) aged 83 was referred to Island for pain management. He had been diagnosed with cancer of the prostate. He did not understand his condition and did not want to go for surgical operation. The nurse started by explaining his condition to him. The information had to be shared slowly, repeatedly and in simple language so that he could understand. He asked many questions and he made a decision that he didn’t want active treatment but to have pain controlled so that he could go back to his homestead in the village. He also brought in his son and wife so that they could also understand his condition to enable them to support him at home. The son offered to pay for the operation, but he eventually respected his father ‘s wishes. The family was grateful for the explanation about his illness stating that it could help them plan for the future.

Pain medication was prescribed with emphasis on adherence, which greatly helped to ease the severe pain that Mr. James described as unbearable. He was pain free after a few days of commencing medication and after a week he decided he wanted to go back to his home in the village. Mr. James requested to go back to his village home and the Island team discussed care at home with the patient and family. The nurse and social worker follow up the patient telephonically every month to find out how the patient is faring at home, monitor his pain, provide counselling and provide caring support for the wife and family.

When the patient and family had any problems they would phone; for example, when Mr. James was constipated they were advised on how to manage the constipation. At one time Mr. James was depressed and the social worker provided telephone counselling weekly. Last year his condition deteriorated, and the nurse supported by giving frequent guidance and emotional support. The patient’s condition improved, and frequent follow ups continued.

 Last week the patient visited Island with his wife, daughter and son to express their gratitude for the support that had been rendered.

“When I came to island last year in April I didn’t know what was happening. I just saw the white nurse and the black nurse. I was in so much pain that I never thought I will be alive today. I decided to board a bus from the village and come here solely to thank you for the assistance that you provide me and my family. I thank you for the monthly assistance and for supporting us each time we call asking for help”

  Story of Change 2

I am a 62-year-old man who suffered a stroke in 2019. I was diagnosed with hypertension and have been taking Anti Hypertensive’s for 5 years up until the time of stroke. I used to work for the City of Mutare as a driver. In 2019, upon arrival at home, I suddenly collapsed and was rushed to the hospital, only to wake up the next morning unable to do anything at all. The doctor highlighted that the tests showed that I suffered a stroke. The doctors said that it was going to be a long time before I could walk, or even perform any activities of daily living. My life completely changed for the worst and I struggled to settle with reality as I was in so much pain, physically, emotionally and even spiritually.

I was referred to Island Hospice and Healthcare. Ever since that time, I have been working with Island Hospice team who visit me at home providing physical pain management medication as well as counselling me and my family in regard to my condition. On top of all that, Island Hospice has gone an extra mile to engage their volunteer Physiotherapist, who has been very helpful with my daily exercises as well as health education about the stroke I suffered. I was not able to afford any physiotherapy sessions as they are very expensive, and I have since been laid off from work on medical grounds.

I have seen great change physically as well as emotionally and now I’m very grateful since I can now use both hands, turn myself as well as sitting up straight without leaning sideways. Before I started working with Island Hospice, I was always in severe pain but was not able to buy any pain medication, I was depressed about my condition as no one took time to listen to my emotional, social and spiritual concerns.

 I am living comfortably, free of pain and my family is also happy and appreciates the support that we are getting from Island Hospice and Healthcare. My son has also been educated on what to do to continue with the physiotherapy and this has helped a lot towards my recovery and I am truly grateful.


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Introduction and background

Island uses several models to deliver palliative care services namely (i) home-based care; (ii) hospital-based care iii) Rural and community outreach iv) Roadside services (v) therapeutic and comprehensive bereavement care, including for children; and (vi) capacity-building for doctors, nurses, community caregivers and others. The bereavement service offered by Island is aimed at those who are grieving after any death whether the family has lost a patient who died in our care, or a sudden unexpected death such as a car accident, suicide or heart attack. The advent of COVID-19 and the subsequent national lockdown has seen Island intensifying virtual support through telephone, WhatsApp, Zoom and other electronic platforms.

Intervention and impact

Between April 2021 and July 2021, Island continued to operate under conditions of intensified national lockdown following increased cases of COVID-19 in the country. Zimbabwe’s national lockdown was characterised by restricted movement, curfew between 6.30 pm and 6 am, call for social distancing and increased presence of security forces to enforce lockdown measures.

Island adjusted its ways operations and aligned its work to the new environment. This meant reducing face-to-face clinic contacts, roadside clinics, hospital visits and home visits and increasing telephone contacts. Where home visits were unavoidable, the Island team adhered to WHO guidelines on the use of personal protective equipment, social distancing and sanitization.

Successes of these interventions included holistic provision of PC services through innovative means, especially virtual (telephone, zoom, WhatsApp call) and limited one on one contacts. Island embarked on intensification of tele medicine through development of a system for patient information collection and health outcome measurement. The system was embraced by community caregivers who are responsible for administering the tool together with Island nurses and social workers.

Two stories below depict typical changes to people’s lives after Island interventions.

Story of Change 1: The power of communication skills

I am a Community Health Based Caregiver (CHBC) at Island Hospice and Healthcare (Island). One of the most notable cases I worked on involved a young woman experiencing a lot of pain. Her in-laws were accusing her of infecting her husband with the human immunodeficiency virus. Also, due to her HIV status the patient was experiencing stigma and discrimination, with very few members of her family willing to care for and to assist her.

 

When I started seeing the patient, I struggled to build rapport and our communication was strained. I did not get discouraged though and used the skills and principles of communication I had learned through the palliative care training I received from Island. She had physical pain from the disease, experiencing severe headaches and backache that kept her in bed for days on end and unable to work. She also had emotional pain stemming from the marital problems she was having with her husband. Additionally, the patient had social pain due to her inability to work, which resulted in her children not being able to go to school due to monetary constraints. It got so bad that at one point the patient had suicidal ideation.

 

Using the training I received from Island, I was able to engage Island nurses in managing the patient’s pain. Island nurses visited the patient at home and assisted her with pain medication and nutritional supplements. I was also able to offer counselling for the patient and her family, working on reunification. Seeing the improvement in his wife’s well-being, the patient’s husband also agreed to counselling. Through our sessions, the patient and her husband were able to improve their communication, which enabled them to work through their marital problems. I was also able to refer the patient’s children to the Department of Social Welfare for assistance with the payment of her children’s tuition. I also recommended the children to join a support group for young carers, facilitated by Island social workers, for support, advice and information to help them cope with caring for the patient.

 

To this day, the patient and her husband are living a healthy life and are grateful for Island’s intervention in their life. Their quality of life has improved.

 

Story of Change 2: Island restored my hope

I am a 71-year-old widow and I take care of my son (David) and grandson (Tapiwa). I am blessed with 6 children who are now grown-ups and taking care of themselves in their homes. Tapiwa’s father, my seventh child, passed away, leaving Tapiwa and her mother. Tapiwa was diagnosed with a condition called hydrocephalus and unfortunately the family of Tapiwa’s mother rejected Tapiwa and forced her to give her up to me. I became Tapiwa’s primary caregiver and I had no option but to resign from work so that I could take care of Tapiwa 24/7. Life became difficult but my son David whom I stayed with would help financially to make ends meet. The situation worsened when David suffered stroke and was also diagnosed with HIV. The other 5 children rarely communicated with me and did not offer any support. Here I was, a 71-year-old granny taking care of my grandson and son, with little financial support from the place where Tapiwa once worked.

A CHBC from Island who empathised with my ordeal referred me to the organisation for assistance. They frequently visited offering counselling, palliative care advice and medications. I usually wake up early in the morning to go and find food for the family and constantly walking in the morning dew made my feet develop sores. To make matters worse, I am a diabetic and having wounds is never an option but the need to provide for the family drove me past any personal risks to my health. I had no means of buying medication for these sores. Island came through and offered me medication. They also gave medication to David who was also developing dermatitis.

The intervention of Island is greatly appreciated, and it has changed our lives as a family. The counselling sessions have given me hope, improved my coping capacities and increased social support. I always look forward to these sessions because they are a platform where I get to offload any psychological burdens that I might have. There has been improved communication with my children, especially my last two daughters, who have even promised to visit me. The medication we received and continue to receive from Island helps in pain management for David and my sores are also gone now because of the medicines I received from Island. Island, you gave us life.

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Island Hospice and Healthcare Zimbabwe (Island) is an organisation that was established in 1979. Island’s main mandate is to provide palliative care and bereavement service to patients and clients who need our services in Zimbabwe. As Island we  emphasise on quality of care to our patients and their families and it is from our day to day interaction with patients and clients that the following story of change was picked from, of one of our beneficiary.

 

It was during the lockdown, on the 23rd of November 2020 when I took my Dad to hospital after he had suffered another stroke. The doctors ordered a series of tests which included a chest CT Scan as they suspected that he had Cancer. I was not concerned at all as my Dad had had Pulmonary Embolism the year before and had pulled through. The CT scan results confirmed that he had cancer tumours in his lung. A second CT scan of the abdomen showed a tumour in the liver of 12cm diameter and that the ones in the lungs were growing. It was presumed that the tumours were secondary to Colo-rectal Cancer.

On discharge, my Dad could not eat much, and he started to lose weight. The Oncologist that we saw confirmed that the Cancer was now in Stage 4 and that he would not benefit from surgery. She advised us to contact Island Hospice and Healthcare for palliative care. I was not ready for this and we therefore sought a second opinion with another doctor who ran some more tests and concluded that he would try chemotherapy once dad was a little stronger.

In the meantime, we did contact Island and their team pf nurses, social worker and doctor attended to my dad, my mum and me. They always called or physically came in to see how we were doing and by this time my dad was deteriorating so fast it was as if the cancer was literally starting to eat him and due to our fear of losing him, we often called an ambulance to take him to the hospital casualty department. At night l would get up to turn him and to attend to his needs therefore l was not getting much sleep. He, however, never complained and always said “thank you”.

The Island team tried to explain to us that my Dad was in his last stages of life, but we did not want to hear that and were not ready to accept it. They were however patient and kept trying to get through to us.

 

I remember the Friday the 5th of February 2021, we went to the Island offices where they

sat us down for counselling, by this time, my Dad was on oxygen continuously and we were not getting sleep at all. On this day, I must say, we finally listened to what they had been trying to help us understand.

 

What l took with me on that day-

  • We need to remember that Dad loves us all.
  • That he may have accepted that he is dying and may not be happy with the frequent trips we were making to the local casualty with him and that we should allow him to make decisions about his care.
  • He may have worries and concerns that he was not able to share with us because we were not accepting that he is dying.
  • We need to spend as much time as possible with him, hold his hand and reminisce on the good memories.
  • That it was ok to ask for help from other people.

From that day things changed for the better in terms of us coping as a family and accept the condition of my father.

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Introduction and background

Island Hospice & Healthcare (Island) was founded in 1979 as Africa’s first Hospice. It pioneered the development of expert palliative care and bereavement services. The organisation’s philosophy encompasses a skilled and sensitive way of caring for those suffering from life- threatening and life-limiting illnesses, and their families. The care of patients is provided within a multi-disciplinary approach that focuses on the prevention and relief of suffering by means of early identification, correct assessment, treatment of pain and other problems; be they physical, psychosocial, cultural or spiritual. Island uses several models to deliver palliative care services namely (i) home-based care; (ii) hospital-based care iii) Rural and community outreach iv) Roadside services (v) therapeutic and comprehensive bereavement care, including for children; and (vi) capacity-building for doctors, nurses, community caregivers and others. The bereavement service offered by Island is for those who are grieving after any type of death whether the family lost a patient who died in our care, or a sudden unexpected death such as a car accident, suicide or heart attack. The advent of COVID-19 and the subsequent national lockdown has seen Island intensifying virtual support through telephone, WhatsApp, Zoom and other electronic platforms.

Intervention and impact

Between August and November 2020, Island was operating under conditions of intensified national lockdown following increased cases of Covid-19 in the country. Zimbabwe’s national lockdown was characterized by restricted movement, curfew between 6pm and 6am, call for social distancing and increased presence of security forces to enforce lockdown measures.

Island adjusted its ways of working and aligned its work to the new environment. This meant reducing one on one clinic contacts, roadside clinics, hospital visits and home visits and increasing telephone contacts. Where home visits were really unavoidable Island team adhered to who guidelines on use of personal protective equipment, social distancing and sanitization. Lockdown restrictions started to ease in August and Island subsequently started to increase contacts through roadside clinics, hospital visits, home visits and clinic visits at the same time observing COVID-19 regulations.

Selected highlights of successes resulting from agile intervention approaches include completion of palliative care integration cascade trainings for 120 health professionals (HPs) in Bulawayo province and continuation of the young carers programme. To date 504 HPs from two provinces have received intensive palliative care training and PC teams were established at each hospital to champion PC integration at their respective facilities. The capacitation of young carers to develop competencies in coping with situations and caregiving skills ensured continued care of PC patients within the home setting regardless of the COVID-19 pandemic.

 The story below depicts typical changes to people’s lives resulting from Island intervention.

Story of Change 1: My daughter, my carer

My name is Sharon Phiri (pseudo-name), I with my 12-year-old daughter. I am a divorcee. I became sick in 2016, my eyes were affected, and had poor eyesight. This caused me to not do a lot of chores at home and I relied mostly on my daughter to do most of the house chores. To make matters worse, I started feeling weak and having heart pains. Scans at the hospital showed that I had heart problems and I was given medication which helped. It was also revealed that I was diabetic which had caused the poor eyesight.

The situation caused me to go to the councilor where I explained my ordeal. The councilor then referred me to Island Hospice and Healthcare. It’s been more than a year since I’ve been introduced to Island and they have helped me by providing me with medication and food hampers. Island also liaised with Watershed school to finance my eye treatment, but this didn’t come to fruition because the schools were closed early due to covid-19. Island also took my daughter on a Young carers workshop where she was taught how to cope and care for me. The workshops were very emotional as she cried when she tried to explain the situation at home. She also had difficulties at school as one of the teachers said that she is more worried about me and sometimes thinks that she will come home to find me dead, but she just hopes that it’s not so. Such thoughts are brought up because she sees all the suffering I’m going through and also, she is burdened with this caring role.

My daughter was taught how to inject insulin from the hospital and she religiously and timeously does that. She also reminds me to take my medication and food before taking the medication. Other people besides Island have been assisting me. For instance, this house I am currently living in is not mine, a well-wisher gave me this place to temporarily live in, they also provided me with a diabetic testing kit. Another well-wisher has paid school fees for my daughter.

The trainings she received from Island has emotionally equipped her for this role and she has found meaning, increase of comfort and finds positive experiences during difficult times. I thank Island for all the help they have given me, without which it would have been difficult for me and my daughter. My hope is to one day have my eyes treated, my daughter to finish her education and have proper food that does not compromise my health.

 

Story of Change 2: I’M HAPPY AGAIN BECAUSE I MATTER....

 

My name is John Siri (pseudo name). I live in Natview with my six-year-old son. I am a divorcee. In 2018 my son started developing persistent headaches and sore right eye. I went to the local clinic and they referred me to Mutare Provincial Hospital where he was given pain medications with no improvement. I was later referred to an eye specialist who after several tests referred me to Parerenyatwa Hospital as he suspected cancer of the eye. This was a major blow as I least expected this on my son. I thought cancer is a disease for the elderly. At Parerenyatwa, the worst was confirmed, my son had stage two cancer of the right eye and they recommended several interventions including surgical removal of the affected eye. All this news ate me up. No one dared sit down with me to explain this heavy load. 

 

The operation was done successfully and after nine months we went back for an artificial eye. This was the beginning of my son’s problems. By then he was now five years old and loved playing outside with other kids. Other kids started shunning him and calling him names because of the artificial eye. At times the eye would fall off and all kids would run away. This was followed by isolation. He would go for days without going out to play. My son started again complaining of headaches. I knew his condition was also stressing him as well as myself. I enrolled him at a local preschool and he faced the same problem, other children didn’t want to play with him when they noticed he had an artificial eye. Wamwe wana wanga waakutorovha chikoro kutya mwana wangu. (Other children were no longer coming to school because they were afraid of my son’s condition). My son’s headaches continued, and I visited the local clinic again. 

 

The clinic sister after taking my son’s history referred me to Island for palliative care. The Island nurse who attended to me was so welcoming. We both felt accepted because of the compassion. She assessed my son and took a detailed history. She attended to his headache after rating his pain. We both felt accepted. The Island team explained to me the importance of attending to reviews on time as the artificial eye gets smaller after some time and would slip off the socket hence scaring other children. All this information was important, and no one had bothered to explain this to me. I did not have enough money to pay for Island services, but I got all the support and services I needed.

 

The Island team started visiting my son at home to assess progress and support us. I was surprised how they engaged my neighbors and my son’s preschool teachers through the Island community home-based carer to educate them on my son’s condition. The Island team educated the community especially my neighbors on how they could be a support system. They also did the same to my son’s teacher and all children at the preschool. The teachers were also taught on how they can safely clean the eye and put it back in case it falls off. They are another powerful support system for my son.

 

Today I am proud to say Farai my son lives a normal life although he has a life-threatening condition. He is pain-free as he gets a constant supply of pain medications for his periodic headaches which doctors said are caused by cancer. He is now accepted by the community including the school because of Island interventions. His quality of life has been improved because of Island. Indeed, Island is a place of rest.  


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Organization Information

Island Hospice and Healthcare

Location: Harare - Zimbabwe
Website:
Facebook: Facebook Page
Twitter: @Island Hospice Zim
Project Leader:
Elias Masendu
Harare, Zimbabwe
$9,016 raised of $50,000 goal
 
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