Traditionally Hospice cares for people in the final stages of an illness that no longer respond to curative treatment. The philosophy is that the dying are still living and deserve to both live and die with dignity. From inception until the late nineties, more that 90% of referrals were advanced malignancies. However, HIV/AIDS has radically changed both the scale and the nature of the challenge Hospice is faced with in the new millennium.

  » In 1996 Hospice commenced in a room of a cottage manned by volunteers one day a week. To this day volunteers are the backbone of this organization.

  » In 1990 B.O.N.D. was donated and a company not for gain, registered in terms of Section 21 of the Companies’ Act was established. In the same year a Board of Directors was elected and a Daycare program started at B.O.N.D. House.

  » In 2002 Knysna Hospice received accreditation and became an official ICHC (Integrated Community Based Home Care) site.

  » In 2006 we received full COHSASA accreditation. Since implementing ICHC 4 years ago the service has grown from 35 to 320 patients and from 8 staff to 38 staff necessitating appointment of our first fulltime Palliative Doctor/CEO.

As a NPO the mission of this Hospice is to, without discrimination, serve the community and its surroundings by providing first class holistic home based care to the terminally ill, especially those suffering from AIDS, and their families, prior to and during the bereavement period. It is also committed to the implementation of training and projects to enhance the ICHC program. This includes development of care for staff/volunteers, the mentoring of other health workers, networking collaborating with and building capacity with other relevant organizations.

Analysis of the Situation

South Africa is considered to have one of the fastest growing rates of HIV in the world with approximately 50,000 people affected every month. It is estimated that 6 million South Africans are infected and almost 1 million orphans under the age of 15 years whose mothers have died of AIDS.

The area we serve covers 1060 square kilometers and includes the towns of Sedgefield, Knysna, and eastwards to Harkerville bordering Plettenberg Bay with all the inland settlements such as Karatara, Barrington, Buffelsnek, Rheenendal up to the border of the Karoo.

Due to continued influx of non-resident people from other provinces seeking medical care, especially the Eastern Cape, it is difficult to provide exact numbers of those infected in this area. Currently the MTCT (Mother To Child Transmission) statistics indicate that the Garden Route area has the highest prevalence in the Western Cape at 21% against a 15.7% Cape provincial average. Research undertaken by Knysna Municipal Clinics and private laboratories from early 2000- January 2007 show that of the persons who have come forward for voluntary testing, over 3,240 have tested HIV+.

Compounding the enormity of the increasing prevalence of AIDS is severe poverty. The circle of individual pain and suffering on every dimension (physical, economic, emotional, spiritual, social) is vicious. Not only is the infrastructure of government welfare services inadequate to deal with these issues, but the hospitals and clinics are overwhelmed and can barely cope with increasing loads due to severe cutbacks in resources and staff.

Our response to the HIV/AIDS pandemic is to effectively care for and reach more AIDS patients and their families in our community by expanding and enhancing the ICHC home-based care model. Growth in numbers of people needing this service has grown to the extent that is has been necessary to employ the services of a fulltime palliative doctor.

There is a dire need for quality, professionally supervised, collaborative palliative Hospice home-based care to be taken beyond the borders of the area we serve. This Hospice has been identified as a key resource center and mentor hospice to play a key role in facilitating development of other organizations offering home-based care in the Southern Cape.

Aims and Objectives of the Organization

  » Enable seriously ill patients to have equal access to a continuum
     of quality care.

  » Ensure bedridden patients receive good management of
     opportunistic infections and quality pain/symptom control.

  » Link quality home care to prevention by using powerful teaching
     methods in the home to educate patient and family regarding
     HIV/AIDS and thus reduce the incidence.

  » Empower individuals, their families and primary care workers with
     basic home nursing skills and accurate knowledge regarding HIV/AIDS.

  » Enhance the life quality of patients and to enable ‘dying with dignity.’

  » Provide continuum of holistic care including bereavement support
     and access to social services.

  » Provide emergency food relief, clothing and bedding where necessary.

  » Continuously identify infected and affected children. Facilitate
     placement of these orphans and vulnerable children.