Tender care in the Home of Life - iKhaya Lobomi Hospice

"Home of Life" might be an unusual name for a place where people come to live out their last days, but at iKhaya Lobomi Hospice in Botha's Hill, KZN, quality of life, however short, and even restored health, are possible in the caring hands of its volunteer staff. The Hospice was set up in September 2001 by Zimele and Patience Mavata, an unemployed couple based in the community of KwaNyuswa, to help those in the area infected and affected by HIV/AIDS.

Relying solely on private donations and their own meagre resources to cover costs, the Hospice was based in a disused shebeen in the Valley, but the roof leaked, and when this year the rent was raised to over R1 000 per month, they had to find an alternative space. Through the Provincial Director-General for Health, Professor Ronald Green-Thompson, the Mavatas secured the interim use of an empty community school building near the Don McKenzie TB Clinic, until new premises can be built for the project on a suitable site in KwaNyuswa. The new facility will be established in collaboration with the Department of Traditional and Local Government’s Rural Development Facilitation project, and is due for completion at the end of July 2004.

Although the temporary site is a great improvement, with space for two separate male and female wards, a storeroom, a kitchen, electricity and running water, there are still constraints. "We are far from our community," explains Patience, "so our volunteers and our patients and their family members have to pay a lot for transport - but at least here we can offer clinic services, with a doctor on duty every Thursday afternoon."

Donations of food, clothing, bedding and medical supplies are always needed. "The British Consulate has provided gloves, and the Westville and Parklands Hospitals have been very generous," says Patience. "They have given us beds, formula-feed for the babies and other nursing supplies. The hospital staff members were so impressed with the level of care being given by our volunteers that they have offered to train them in advanced nursing skills.”

"We currently have 17 beds," says Patience, a qualified staff nurse, "but simply having a bed is not enough to cover a full admission. We have to assess each case to ensure that the terminally ill patient can be given comprehensive care. Apart from food and medicines, depending on individual needs, this might involve extra linen-savers and other supplies, but also the costs of burial if there is no family member able to contribute." The Hospice staff monitor the deaths of adults and try to assist in obtaining social grants for their orphaned children.

When donations in cash or kind are made, these are allocated according to a tiered system, prioritising in-patients, then out-patients, followed by orphans and needy children, then the volunteers and where possible, impoverished members of the broader community. "In some cases, the babies of mothers attending the local clinic are living on water," Patience told Sondela. "We need space for a children's ward, as we have only two cots available right now, but we'd prefer to be able to nurse them in households and not in the Hospice as such - when young children die within view of our adult patients, it causes them deep emotional distress."

The Mavatas' vision for the next phase of iKhaya Lobomi includes "safe houses' for orphans, consisting of two-roomed rondawels, located away from the Hospice itself, and designed to offer vulnerable children a healthy physical and emotional environment within their community. "Each unit would be equipped to house four children in two bunk-beds, with two babies and a house-parent in the second room, along with a small kitchen and bathroom. Community residents would build these structures," says Patience, "and we plan to involve our disabled members by assigning them to duties such as homework supervision."

"It's important that the children are raised with the experience of community life, so that they don't grow up feeling set apart," she explains. "They can live in the safe-houses on a 'weekly boarder' basis, attend school and be protected from possible abuse or neglect during the hours in which their caregivers are at work. They can then return to community households on weekends." The new premises will also have a drop-in centre and a nurses’ hostel for the volunteers, who could stay overnight to ensure 24-hour care for the terminally ill and reduce travelling costs.

The project urgently requires a sustainable monthly source of detergent and bath-soap, household bleach, basic foodstuffs and medical supplies. Baby clothes are always in demand, especially for those being brought into the clinic for care.

"Our volunteers have received wonderful basic home-based care training from Sister Sylvia Williams, funded by the British Consulate,” says Patience, "but they need empowerment in the form of further practical training, and access to information and materials, especially in hospice care, nutrition and counselling. They are devoted to this work, and survive on faith alone to keep going and to do as much for their neighbours as they can."

The Mavatas' oldest daughter, four-year-old Nomana, loves visiting the Hospice and gladly helps with chores in the kitchen. "It's not so unusual," says Patience with a chuckle. "I can remember planting my first mielies with my gogo at that age!"

It is this deep sense of duty and unconditional love that has nurtured many of iKhaya Lobomi's patients back to health. On the day of Sondela's visit, one tired but smiling patient, (who was carried into the Hospice five months earlier with advanced TB and little hope of survival), had washed herself and walked with crutches for the first time since being admitted.

Just as hospice services all over the world use the sunflower for their logo to affirm a focus on LIFE, iKhaya Lobomi's caring and comfort embraces the dying, their family members and the wider community – offering quality of life for all.

Zimele Mavata can be contacted at:
Cell: 082 834 5956
Tel: (031) 702 2979
Fax: (031) 702 4612
Email: mavata@mweb.co.za

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