Island Hospice & Healthcare

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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