Despite various challenges the relationship with these Traditional Healers has developed and is slowly becoming a focal point of palliative care and support within the communities that the Traditional Healers operate in. Slowly, referrals are being made to Hospice and slowly, Hospice is beginning to draw on the expertise of the Healers within the communities. A relationship of trust is beginning to develop.
One of the challenges that needed to be addressed was the issue of ongoing mentorship. After the initial training the gap of mentorship was identified and from the middle of 2013 a plan was put in place. Regular meetings of those Traditional Healer who were trained were
set up with members of HPCA staff to ensure that matters pertaining to palliative care were addressed on an ongoing basis. These short mentorship sessions are being hosted by Msunduzi Hospice. This has the effect of providing the required ongoing mentorship, as well as developing relationships with the care team from Msunduzi Hospice who receive referrals from the Traditional Healers on a regular basis.
The last such meeting held in October this year solicited the following story from one of the Traditional Healers (Makhosi Nomthandazo Mayisela):
“Makhosi Mayisela had a patient, a young man, who she had been seeing for 2 months, she realised that he wasn’t getting better and decided to ask a hospice caregiver to help her to refer her patient to Msunduzi hospice. The caregiver called in the professional nurse who did an assessment of the patient.Makhosi Mayisela related the questions that her patient was asked: firstly, the patient was asked if he gave consent to be cared for by hospice, he was asked about his healthhistory, about what the clinic had told him about his disease – he was at that stage vomiting blood and was very weak, about his family and what support he had – his mother was his carer, whether he or his children had a grant as there was no one employed in the house and about his spiritual connection.The nurse also gave him education about his illness and about infection control.
The hospice nurse arranged for admission to hospital as he needed medical intervention for his severely swollen abdomen and vomiting blood. The hospital drained the ascites and he was subsequently discharged after further treatment, back to his home, where the traditional healer and the hospice staff both continue to care for the patient collaboratively.The traditional healer was happy to share this success story with the meeting where HPCA and the group of healers meet to get feedback and provide mentorship after training that was given in 2012.The admission interview and assessment that was done by the hospice nurse was confirmation to the healer about the palliative care training that she had received.”
Further to the above account, there were some discussions about a few problems that had occurred in referring patients to hospice care. Msunduzi Hospice has, in response, agreed to act as a central referral point for any patient referred by the Traditional Healers within the province of KwaZulu-Natal. Msunduzi Hospice will refer the patient on to the relevant hospice within the province as necessary. It will remain the prerogative of the hospice to admit the patient or not.
In response to a concern about the Traditional Healers being exposed to dying patients on a frequent basis, Msunduzi Hospice extended an invitation to the Traditional Healers to join in their structured Care of the Carer programme from January 2014 onwards.This care of the carer programme is run by a retired nurse and provides an opportunity (every two months) for the care givers (and now the Traditional Healers as well) to gather together for debriefing, supervision and training. The implementation of this programme iseagerly awaited and will be assessed during the course of 2014.
The development of partnerships has been a key activity of HPCA over the years and member hospices have been encouraged to develop local partnerships as well.Partnerships have been formed with various government departments over time and now a formal relationship has been implemented with the Traditional Healers. This relationship is currently being rolled out in other provinces in the country and we are all eagerlyawaiting it success.
Support for this relationship and participation with the Traditional Healers in extending palliative care and support is strongly encouraged.For more information please contact Zodwa Sithole (firstname.lastname@example.org) who co-ordinates this project on a national level and Sheryl Wüst (email@example.com) who co-ordinates within the province of KwaZulu-Natal. For details of the relationship between the Traditional Healers and Msunduzi Hospice, please contact the CEO (Warren Oxford-Huggett – firstname.lastname@example.org).
Click here to read the South Africa edition of ehospice to learn more about palliative care in South Africa.