HAU cares for patients in a variety of settings, ensuring patients are cared for in the most appropriate environment. Most patients prefer to be surrounded by their family and in a place familiar to them when they reach end of life. HAU homecare services are currently suffering a budgetary shortfall totalling €25,970.
Human resources are required to offer professional services to patients and their families. The teams that are daily going out to visit patients include a palliative care nurse, a social worker and a driver. Patients at end of life are often too weak to travel to HAU’s out-patient departments. HAU therefore does home-based care which entails travel of multi-disciplinary palliative care teams travelling to the patients and their families in the communities in catchment areas around the three hospices. Particularly in Hoima and Mbarara teams travel far on poor roads to see patients in need. There is a necessary cost in terms of fuel and wear and tear on vehicles to provide essential care for patients to maintain their dignity at end of life. It is vital to patient care that each hospice has an appropriate, well functioning and fuelled vehicle ready to take teams to patients. HAU teams across the three hospices will travel 45,000 kilometres every year to see patients.
Over 50% of HAU patients live in poverty, many suffering from lack of food or very poor nutrition. Many come to the HAU out-patients department hungry. In the spirit of hospitality which is an important part of HAU’s ethos and in response to a basic human need HAU offers them tea and a snack at the hospices while they are awaiting clinical consultation, review or medications. Currently HAU has the ability to provide tea and a small snack for 660 patients across the hospices. In order to more comprehensively address this issue HAU would like to offer them a nutritious meal.
There are always administrative costs associated with programme implementation. This includes communication, electricity, vehicle maintenance and IT support. Administrative support services are vital to achieving programme goals.
|Palliative care nurse salary||4,600|
|Social worker salary||8,570|
|Vehicle costs to access patients.||2,860|
|Meal provision at site for patients and carers.||4,300|
|Staff refreshment while out the community for home and hospital visits||860|
|Stationary and printing costs.||1,200|
|Contribution to administrative activities.||720|
Linda is a widow with two daughters and one son. She did not know the whereabouts of her son and one daughter. Her elder daughter was the main caregiver as well as the key financial provider, paying her house rent, and buying food and other basic necessities. The HAU team enrolled Linda on its Palliative Care programme and started her on medication to relieve her symptoms. The CVW who first saw and referred Linda continued to follow her up on daily basis to help support the caregivers with bed-bathing, feeding and offering counseling while doing massages of the lower limbs to relieve the pain.
Linda (not real name) is a 56 years old lady who was referred by a Community Volunteer Worker (CVW) to seek health care at Hospice Africa Uganda. Her main complaints on first contact were severe pain and distressing abdominal symptoms of recurrent diarrhoea. Having suffered from poor health for over two years she attended a community-based health centre where she was diagnosed as carrying HIV, the virus that causes AIDS. On being referred to Mildmay, a center specializing in care for person with HIV and AIDS, further laboratory investigations were carried out including a CD4 count whose baseline was revealed to be very low. Linda needed to start taking antiretroviral therapy urgently, and when she finally did her clinical condition worsened. Not only did the diarrhea not stop but she in addition started to suffer severe pains in her legs, her vision became blurred and rapidly deteriorating, she became bedridden.
Slowly but steadily Linda’s health improved and her pain was controlled with strong pain medications. Her diarrhea stopped and her frail body started to regain strength. She soon stated walking again. Unfortunately in the course of Linda’s own recovery care, her elder daughter died unexpectedly and without a caregiver life became difficult to bear. The deprivation of emotional, physical and financial support of her daughter made Linda struggle and dependent on the support of well-wishers. HAU offered Linda counseling and bereavement care. The severity of Linda’s social and financial circumstances led to her enrollment on HAU’s “Comfort Fund”, a small pot of money from which funds can be drawn to provide life’s basic needs. HAU offered Linda food so she could remain complaint with her AIDS medications, and some money for essential household items.
Because of the support Linda received her health improved enough for her to resume work. Using money that she saved from well-wishers she started to sell vegetables at a small stall in her village. She has started to reap humble profits through her hard work there but most especially because with HAU’s support she has consistently had food and medications, and her social circumstances have improved. Linda has since mentioned her gratitude to HAU, “Thank you Hospice; I thought my life had ended but through your support, I have a new lease”.