Holistic care

Choose hospice

We recently interviewed the daughter of a patient. The patient had died late in 2020 and the daughter, Francisca, agreed to be interviewed detailing her experiences of the care that we provided.

Many people think about Hospice care in a limited way, limiting their experience of the care that we provide to Home Based care that focuses on clinical issues/problems.

There is so much more to the work that we do. There is so much more for your to experience as a patient at Msunduzi Hospice.

Palliative Care is holistic care. We provide the anticipated clinical services. These tend to focus on pain control, the alleviation of symptoms associated with the illness or the treatment of the illness. They focus on helping the patient to understand their illness and the treatment that they are undergoing.

Alongside these services we provide emotional support to both the patient and their families (households). A great deal of this support is provided in the form of counselling services with the aim of developing resilience. Counselling to help the patient prepare for their own death, counselling to help the family prepare for the death of their loved one, counselling to help children come to terms with the changes in their circumstances. These services are initiated by the nurses but continued by our team of social workers.

There is so much more to Hospice and Palliative care.

Take time to listen to this interview with Francisca where she sets out her experience at Msunduzi Hospice (Click here).

For more information on the services available to our patients and their families (households) please give us a call on 033-3441560 or 0607173949 or email Sheila on pcmanager@hospicekzn.co.za.

We care because you matter. Help us to care for you.

TB month

End TB

TB month and Palliative Care.

March is a month during which there are a number of special days, all of which attract attention in one form or another from Non-profits such as ourselves. I thought I would write an article in which I try to address as many of these special days as possible.

The whole month of March is dedicated to TB awareness and its eradication with a special TB awareness day commemorated on 24 March. Together with TB, we commemorate Human Rights Day (21 March) and World Social Work Day (26 March). There are a number of other significant days to commemorate as well. However, lets focus on these for now.

Msunduzi Hospice has had a small TB programme for a number of years. Between 2015-2018 this was significantly expanded with the assistance of HPCA and funding from USAID. A programme was introduced in support of the Department of Health to encourage adherence to TB treatment, in particular Multi-Drug Resistant TB(MDR-TB). This adherence support was combined with the principles of Palliative Care which showed that Palliative Care can have an impact on people with TB. Support, encouragement, and quality Palliative Home Based Care can lead to greater adherence and can encourage people to be tested and as a result to commence treatment where necessary.

TB, like many other illness, can have a debilitating impact on the lives of individuals and their families. There is a certain amount of stigma associated with TB. This is evident amongst our own staff and volunteers, where TB screening is an annual practice and the resistance to this is rather remarkable. Stigma can often lead to tensions within the community, possibly impact on the ability to work and simply feeling vulnerable. This vulnerability is so important to address. Illness can and does have an impact on our rights as individuals and so it is with this in mind that we also mention Human Rights Day.

The 21st of March is a day where we remember the violent destruction of the human rights of many individuals and communities. Furthermore, we must remain aware of the impact that ill health has on Human Rights as well. We have a right to good, comprehensive health care that should include Palliative Care. We have a right to be free from pain and suffering caused by our illness and Palliative Care addresses this by advocating and providing for effective pain control. In everything that we, as Msunduzi Hospice do, we aim to help patients and their families through specialised care to live and die well. We may not be able to address all the gaps that our patients experience, but we do what we can with the resources available to us.

One of these resources is the skill and ability of our team of social workers. This month we also commemorate World Social Work day. The theme this year is Ubuntu – I am, because we are. The impact that social workers make on our patients is massive. This work is supported by the care provided by the nurses, care givers and memory workers. Social workers are able, in complicated contexts, to help patients and their families to chart a way through their illness to wellness. Wellness is not necessarily about getting better. Wellness is about a holistic understanding and relationship with yourself as a person, family, community who has a particular diagnoses. This wellness is also a human right, and is something we are all entitled to.

So during this special month of March. We mark a year of lock-down due to the Coronavirus Pandemic, but we also mark these important health days and celebrate the work that Msunduzi Hospices offers in response. We care because you matter. Help us to care for you.

World NGO Day

World NGO Day

February 27 is World NGO Day (#worldngoday).

Can you believe that NGO’s have a history dating back to the late 18th century and have been at the forefront of social movements and changes. World NGO Day is celebrated in 89 countries on over six continents.

“World NGO day aims to celebrate the successes of the more than ten million NGOs worldwide and to allow many small grassroots organisation to gain the recognition they deserve.” (FIFA – Fédération Internationale De Football Association).

Msunduzi Hospice as a leading NGO in the Msunduzi Community and within the Hospice and Palliative Care community of South Africa celebrates this day as a day in which to honour all NGO’s that play such a vital role in shaping our society. We call on government to support and continue supporting the work done by NGO’s towards assisting our communities and people in need.

Msunduzi Hospice is proud of its role in the local municipality and celebrates the support received from so many (individuals and businesses). The care that we provide is well received and reflects the compassionate and holistic nature that is Palliative Care and is needed by so many. A few reflections on this care can be found at the Msunduzi Hospice YouTube channel (here)

Msunduzi Hospice celebrates 38 years of providing holistic care and support to the wider community of Pietermaritzburg and the Msunduzi municipality. We celebrate the support that has enabled this. We thank the wonderful founders of our Hospice who had the vision to create this organisation. To our ancestors, we are forever grateful. To our care team who tirelessly continue this tradition of providing care and support to almost 250 patient each month (and an additional almost 300 family members). To those who ensure that the money comes in to support this mission. The fairs, functions, events, late nights and early morning. Thank you for making it happen. Thank you for making it happen during the very difficult circumstances created by the Coronavirus Pandemic.

An NGO would not be complete without volunteers. So often overlooked in the wider scheme of things, yet vital to the success of so many. Thank you for you compassion and enthusiasm for Msunduzi Hospice and the work that we do.

A fitting way to end this reflection is to quote the founder of the modern Hospice movement, Dame Cicely Saunders, ‘You matter because you are you, and you matter to the end of your life. We will do all we can not only to help you die peacefully, but also to live until you die.’

We care because you matter. Help us to care for you.

A short account on how the Pandemic has affected some of our activities

Children being together
Due to the pandemic, many activities for children were cancelled.

A short account on how the Covid Pandemic is having an impact on some of our services.

Msunduzi Hospice provides a Paediatric programme which focuses on the provision of Memory Work for the children of patients with a life-threatening or life-limiting illness. This is alongside the clinical care provided to children who have a diagnoses. This programme is made available by two trained memory workers (Benard and Vuyisile) and is co-ordinated by a social worker (Pretty). During 2020, the programme was heavily affected by the pandemic which spread all over the country and resulted in the lock-down of the whole of South Africa.

It is customary, as part of the memory work programme, to host ‘Healing sessions’ at the conclusion of the memory work activities undertaken by the children. These ‘Healing sessions’ generally take the form of a gathering where various activities are undertaken. For obvious reasons all the gatherings for children were cancelled during 2020. In addition to this, limited visits were provided to children in order to limit the risks associated with Covid (most of the children on this programme do not have a diagnosis, their parents and guardians do). Visits by the Memory workers and social workers to children resumed in June and many concerns were raised by families. They were very worried about the future of their children’s programme but they received explanations from the social workers and nurses who continued to visit families in the absence of the Memory workers.

All the large gatherings of children were cancelled through 2020 including the end-of-year Christmas party, although presents were organised and distributed to the 50 children who were selected as the most needy out of a large number of children who were on the programme during 2020.

Some additional concerns were noted by the care team as they visited the patients and their families. When families were visited during lock-down, the children were all at home and the need for groceries increased. The families were struggling to have enough food for the children and make ends meet. Msunduzi Hospice only receives a limited amount of food parcels per month to distribute to the most needy families. This is inadequate to serve the huge need prevalent in our community. Msunduzi Hospice was able to partner with Food Forward (a food distribution programme) in order to try and help with this situation. This made a difference during the lock down and families were very grateful for this initiative. It made a big difference to an already destitute community.

During the lock-down some families lost loved ones as well as employment because of the economic climate. A lot of counselling was provided to grieving families and extra time spent just listening to family’s misfortunes. Lots of questions were asked about school reopening and learners were stressed about the end of the year results especially for those completing matric.

Complied by: Pretty Zondi - Social worker

Resilience in the face of Covid 19.

Chose Hospice

A story of resilience

Cheryl (all names have been changed), is an 85 year old Hospice patient diagnosed with cancer of the colon and gall bladder as well as arthritis. Cheryl was admitted onto the Hospice programme in October 2019. At the time of her admission she was facing eviction from a small holding as the previous owner had sold the property. Cheryl was then living with her 64 year old son (Malcolm) and he was her primary carer. Mother and son share a close bond and Malcolm has her best interests at heart. Malcolm is the eldest son and is the only family member who lives close to mother as his two younger siblings live abroad. He makes a concerted effort to spend quality time with his mother on a regular basis.

Cheryl was eventually placed at a local home for the Aged in Pietermaritzburg on an emergency basis. She had difficulty adjusting to the cramped space at the Home as she had the complete opposite on the small holding where livestock and other animals would walk pass her window daily and she cherished that interaction. Cheryl is well read, loves reading autobiographies and relates these without error. Her mind is very agile and she enjoys being challenged, is very assertive, dislikes being treated like an invalid and is sometimes misunderstood by staff (at the Home) for her boldness. Cheryl impresses as a staunch Christian who is not scared to voice her opinions and defends her faith admirably.

Prior to the lock-down (March 2020), Cheryl joined our weekly Daycare programme in January 2020, where she enjoyed being away from the Home and interacting with other patients with cancer. Her health started deteriorating during the lock down and Hospice staff were not allowed to visit her due to the pandemic restrictions. I noticed that she was becoming disillusioned with her situation and so began making regular telephonic contact in order to lift her spirits. This also gave her the space to talk about her upbringing, marriages, previous employment which she seems passionate about, her two deceased husbands, relationships with her adult children and their differences in personality, behaviour and demeanour as well as the latest book she is reading. I also prepared a goodie bag for the patient and had it delivered to the Home via security. I was only allowed to visit the patient once in Hospital despite being admitted on numerous occasions.

From July to December 2020, Cheryl has been admitted six times to Hospital for various medical interventions including pneumonia and a back operation. Before admission and on discharge from hospital, she has had to have a Covid test done. She tested negative on all occasions and on one occasion contracted the virus at a step down facility. On each occasion, when she returns to the Home she is isolated for 10 days and finds this experience demoralising but enjoys being away from her cramped room (This is the policy of the Home). Thus far she has had nine Covid tests done (the tenth will be done on discharge soon) as she is currently admitted at a local hospital. Despite all this she remains resilient and looks forward to her monthly visits/outings with her son (they have lunch together, go shopping and she has her hair done. Malcolm was refused any contact with his mother on Christmas day and on other occasions the Home would not give permission for Malcolm to visit because of the lock-down.

Cheryl’s story is one of survival, courage and perseverance amid the turmoil of a pandemic which has stripped people of their dignity and caused havoc amongst our elderly patients with life threatening illnesses. This story in its own way highlights the value of developing resilience among our patients. This work is undertaken by all members of the care team and each member has their own contribution to make. A patient who, despite all the set backs and difficulties that she has experienced in 2020, is still able to face each day with some optimism is a great achievement by our care team and in particular by Letitia (social worker).

Often we are asked about what does Hospice do. In many instances this can be answered by referring to the care we provide inter terms of managing and controlling pain and other distressing symptoms associated with a life-limiting and/or life threatening illness. However, there are instances where the simple answer to the question About what we do is simply put as, ‘we help patients (and their families) through specialised care to live and die well.’ Resilience is about helping people to live, to get up each day and face the challenges of that day without sinking into despair and despondency and giving up.

We care because you matter, help us to care for you.

Written by: Letitia Marais Social worker

(30 December 2020)

Thank you

Thank you

To all our wonderful supporters.

This year has been challenging in so many ways, but you have helped us win through. Your support has truly enabled our care.

Msunduzi Hospice would like to thank you for your support and assistance this year. The year of Covid will be long remembered, but your support is more appreciated.

May this time of relaxation and festivity be a blessing to you and to all those you hold dear.

The Msunduzi Hospice Team.

World AIDS day 2020

AIDS ribbon

The global epidemic that is still with us

World AIDS Day on 1 December is intended to shine a spotlight on a virus that has been a subject of scientific research and debate since the virus was identified in the 1980s. The Human Immunodeficiency Virus (HIV) timeline shows the worst and best of human nature. From fear, inequality and exclusion to hope and determination. ​Despite the huge success South Africa has had in fighting HIV/AIDS, many people still get infected with HIV every year.

Hospices provide care for about 100,000 patients each year. Today, 44% of those patients are HIV positive. Many suffer from more than one diagnosis such as co-infection with TB, cancer and other chronic conditions.

Hospices have a very long history of providing care to HIV Patients.

They were one of the first organisations to start to respond to the HIV pandemic - long before anti-retrovirals (ARVs) were available. According to Bishop Kevin Dowling, who worked with the Tapahoho Hospice: “Back then the HIV epidemic was calling for holistic end of life care in the most challenging of conditions, shocking conditions, and this holistic care had to embrace every facet of the life of the person and their psyche, including the spiritual dimension of dying people who had no hope at all because they were succumbing to Aids-defining diseases for which there was no remedy yet. This holistic end of life care in those conditions was, in fact, palliative care”.

ARVs have changed the face of the disease, with those who start on it, and stick to it, often living healthy lives. Yet there is still a stigma around the disease that prevents many people from getting tested.

Hospices have reports from those who have a minimal support structure in their life of their fear of discrimination and rejection in their families when they are informed that the test has shown they are HIV positive. People also have fears and anxieties about their future when they are diagnosed with HIV. Women can be fearful about informing their partners on whom they may depend for survival, and sometimes fear bringing ARV drugs home in case they are discovered. And if you are desperately poor, it is very difficult to find adequate, nourishing food.

And still, the death rate at Tapoloho Hospice dropped from 36% in 2004 to 2% in 2019, which signifies the move from a death sentence to a life-threatening illness with the provision of ARVs.

Today the focus is on keeping patients in care, bringing back patients that stopped treatment to care and supporting them though their journey. “While we know that ARV’s change the dynamic of the disease, we believe that ARV therapy alone is not enough,” says Ewa Skowronska, CEO of the Hospice Palliative Care Association. “Holistic care that includes psychosocial, spiritual support and bereavement are all needed to offer people a better quality of life and to help them comply with the medication schedule. It’s a complicated disease as it carries with it the psychological challenge of a lifetime on medication and combatting stigma. A support system that assists people to mentally and emotionally work with the diagnosis is really important.

“Hospices care for patients of all ages, including teenagers. Some of them may have got infected via MTCT (Mother to Child Transmission) at birth or later in life. Some of the hospices care for the Orphans of parents who were hospice patients and who died of AIDS. They monitor their health, school performance, helping with navigating the social system of grants and reduced fees, provide nutritious meals and support those children psychologically so that they can effectively participate in a future healthy life and embrace optimal living.”

Says Zodwa Sithole, Head of Advocacy of CANSA: “HIV infection can lead to a weakened immune system and a lower number of CD4 cells that help fight viruses, such as human papillomavirus and Kaposi sarcoma herpesvirus. A stronger immune system provides very important protection against many types of cancer. It’s important that people take all of their medications on schedule and not skip doses. If you do have both HIV and cancer, palliative Care can help by managing your symptoms and treatment side effects. These include pain, fatigue, shortness of breath, depression, anxiety, nausea, vomiting and diarrhoea. Palliative care provides extra support from a dedicated team of specialists to help you or a loved one get through a serious illness.”

Today Hospice care aims to improve the quality of life and wellbeing of patients diagnosed with a life-threatening or life-limiting condition. It helps people live as fully and as well as they can to the end of their lives, however long that may be and when the times comes, to support dignity in dying.

About the HPCA

The Hospice Palliative Care Association (HPCA) is a registered NPO in South Africa. Founded in 1987, the HPCA is a member organisation for South African hospices. As a national charity, the association champions and supports more than 108 member organisations that provide hospice services to more than 120,000 people per year. There are nine regional hospice associations that are members of the Hospice Palliative Care Association, representing each province in the country. These are located in the Western Cape, Eastern Cape, Kwazulu-Natal, Free State, Northern Cape and the North-West province. The Association of Northern Hospices represents hospices in Gauteng, Limpopo and Mpumalanga. www.hpca.co.za

About hospice

HPCA’s mission is to promote quality in life, dignity in death and support in bereavement for all living with a life-threatening illness – which includes Covid-19. This entails providing medical care, psychosocial care, and spiritual support, as well as end-of-life support. Each hospice has a multidisciplinary health care team that includes a medical doctor, professional nurse, social worker and home-based carers. All hospice staff are trained in palliative care which aims to ensure a good quality of life for patients who have been diagnosed with life -limiting illnesses and to prevent and relieve unnecessary suffering. Care also extends to families, especially after their loved ones have died and as they process their grief. Hospices provide holistic care to people affected by life-threatening diseases, regardless of whether they can afford to pay for this or not. To date only 18% of patients who need palliative care are able to access these services.


CANSA offers a unique integrated service to the public and to all people affected by cancer. CANSA is a leading role-player in cancer research and the scientific findings and knowledge gained from our research are used to realign our health programmes, as well as strengthen our watchdog role to the greater benefit of the public. Our health programmes comprise health and education campaigns; CANSA Care Centres that offer a wide range of care and support services to those affected by cancer; stoma and other clinical support and organisational management; medical equipment hire, as well as a toll-free line to offer information and support. We offer a Tele Counselling service in seven languages free of charge and we also supply patient care and support in the form of 11 CANSA Care Homes in the main metropolitan areas for out-of-town cancer patients and CANSA-TLC lodging for parents and guardians of children undergoing cancer treatment.

Visit www.cansa.org.za or contact the nearest CANSA Care Centre, call CANSA toll-free 0800 22 66 22 or email: info@cansa.org.za. In addition to online resources and Facebook support groups, CANSA offers multi-lingual support on WhatsApp: 072 197 9305 for English and Afrikaans and 071 867 3530 for isiXhosa, isiZulu, siSwati, Sesotho and Setswana and free Tele Counselling per appointment on 0800 22 66 22 in English, Afrikaans, isiXhosa, isiZulu, siSwati, Sesotho and Setswana. Follow CANSA on Facebook: CANSA The Cancer Association of South Africa, Twitter: @CANSA (http://www.twitter.com/CANSA), Instagram @cancerassociationofsouthafrica, LinkedIn and Pinterest

World Hospice and Palliative Care Day 2020


On 10th October, hospices and palliative care providers across the world will be working together for the annual World Hospice and Palliative Care Day. They will be sharing a simple message, “Palliative Care: it’s my care, my comfort”.

With this in mind, Msunduzi Hospice have made available a few videos showing the impact of the care that we provide. These videos are accessible on this link.

Palliative Care is about helping patients and their families through specialised care to live and die well. How is this done? The theme for World Hospice and Palliative Care day is ‘Palliative Care: it’s my care, my comfort.’ This can best be expressed by a few short sentences describing how Palliative care is delivered and received. My care, My comfort is:

  • respecting my autonomy in the fragility of the disease and at the end of my life;
  • the ability to chose how I would like my condition to be managed. I am able to chose what and who I feel comfortable with in my care team. This provides me with the comfort of knowing that I am in control;
  • to continue to grow as a person in spite of my serious illness;
  • a fundamental human right to be free from pain, to enjoy a good quality of life, to enjoy interaction with my loved ones, and to carry out the activities that give me pleasure;
  • my right to be accompanied during my illness and not have to face it alone;
  • my right to dignity, to respect for my beliefs or absence of them, to recognise that my principles and values should guide the decision making process;
  • psychological and spiritual support to enable me to live with my illness with equanimity;
  • spiritual support that is based on my needs and beliefs, not those of my care givers;
  • optimal management of pain even if complete relief from pain is not always possible;
  • accessing palliative care at an early stage in illness journey so that I can live with my illness in the best possible way for as long as possible;
  • compassion, kindness, respect from my care givers, both health care workers and others, as a person, not just an illness;

(my thanks to Drakenstein Palliative Hospice).

Palliative Care is about walking alongside, not leading, nor following, just being with.

We care because you matter, help us to care for you.

Patient care interviews

On Wednesday 15 July one of our patients consented to be interviewed. This interview (a two part video) is available on our Facebook page as well as on our You Tube page (https://www.youtube.com/channel/UCd6aLZU5cisztycH_LL-ZpA).

What follows is a summary translation of the interview which was conducted in isiZulu.

Summary translation of the interview with T Xulu (patient of Msunduzi Hospice Association). The patient has signed documents allowing us to use this interview to promote the services provided by Msunduzi Hospice. The video is in two parts due to an unfortunate interruption and we did not have the heart to ask the patient to start her story over again.

Social worker (Zamaswazi Kunene): Greets the patient and explains to the patient the reason for this particular visit. She explained to the patient that there are questions she would like to ask the her.

• Social worker: Please tell us how you felt when you were told about your illness?

• Patient: In 1996, I found out that I was HIV positive, by that time my condition was still fine. The nurse at the hospital explained to me that even though I am sick with this disease, life goes on. I must not feel ashamed of myself. The nurse gave me the courage to live my life to the fullest. In 2003, it is where it started to show that I am sick. All the symptoms showed up and I was admitted to Appelsboch Hospital.

• Doctors there done some test to see if I have TB, but the results came back negative. They explained to me that even though the results are negative, I was going to start with the treatment right away. That will take 8 months. There was nothing to do but to obey what they were saying in order to be better.

• In 2007, I was visited by Hospice staff, they explained to me how they work. They provided me with all required necessities. Leaving me in a good condition all the time when they visited me. When they were not visiting me, they will call me to check on how am I doing.

• In 2017, I got very sick and I was admitted to hospital, Hospice staff (nurse, care-giver & social worker were visiting me in hospital). They did not stop rendering their services. Social worker helped me to applied for my pension grant. When I was discharged from hospital, Hospice will visit me they will bring food parcel, medication and other necessities.

• With their visits they will bring hope that everything will be fine. I will feel the recovery from my condition through their services they provide. They work very professionally. It was my first time in my life receiving care like this. I believe that they were sent by God, because God work through people. Hospice staff gave me courage, hope and strength to be strong at all times and have courage to see things positively as I am sick, but that my condition was getting better and better (spiritual, physical, mental and emotion) I always pray to God to assist Hospice in all their needs, to give them strength with the work they do in the community.

• Hospice is not only assist with health issues, the social worker brought a bag of wool for me. I love hand work. That helped me to keep myself busy then sleeping in bed. By doing the hand work that helped me with my condition.

• Hospice also provided me with clinical equipment so things will be easy for me.

• Patient added that she would like to thank Hospice for all they have done for her through her hardship. She also wish hospice to assist people out there who are sick and need help.

• Social worker: Thanked the patient for the information and she explained about the video that is been taken, they will share it with other people to know about Hospice the services they rendering to the community.

We care because you matter. Help us to care for you.

CEO's reflection on 2019

Chose Hospice

In preparation for our AGM to be held on 16 July, I post today the CEO's report to the AGM.

Please contact our offices for more information on the AGM and any additional details you may require.

A reflection on the 2019 financial year.

As I write this report, we are in the midst of one of the greatest challenges to our way of life that has occurred in, at least, the past 100 years or so. The Coronavirus pandemic will forever reshape the world in which we live and how we live in it. What the world will look like is at this stage, unknown. However, this is meant to be a reflection on the 2019 financial year. A year before the pandemic, but itself, a year of great achievements and change.

I am very pleased to say that we have continued to provide quality palliative hospice care to our patients during the year. This is despite some changes and challenges in the care department. Towards the end of 2019 we bid a sad farewell to Heidi Collyer who had ably lead the care team for many years. This was a sad occasion and there were a number of tears shed. Heidi had embraced the need for good strong, flexible leadership and taken the care team to a place of strength and the ability to deliver good quality care. As sad as it is was to say farewell to Heidi, it was a joy to be able to welcome Sheila back to the Hospice family in the role of Palliative Care Manager. Sheila had resigned earlier in the year, but expressed her willingness and availability to return in this new role. Sheila has brought a slightly different dynamic to the care team. She is well versed in Palliative Care and has a wealth of knowledge from the private sector that is slowly but surely being expressed in the functioning of the care team. Indeed, through this viral pandemic, Sheila has shown strong and decisive leadership that has stood the care team, our patients and the entire organisation in good stead. Leadership in changing times is not easy, but Sheila has risen to the occasion and we remain grateful for this.

2019 continued to see the development of our relationship with the Department of Health in KwaZulu-Natal and in particular in the Umgungundlovu District. Despite the lower numbers of candidates participating in the Palliative Care training, the relationship continues to grown and develop. We have been able to apply for a renewal of the Service Level Agreement with the Department of Health, a response to which has been delayed during the current pandemic. It is to our credit and the credit of the department of health that Palliative Care features so prominently in the care of patients. This support has played a significant part in ensuring that we have provided quality care to a number of patients. In 2019 we cared for 497 unique patients during the course of the year. 1788 family or household members also received interventions of some form during the year. Of these patients only 15 were children. However, of all the family members close to 400 were children. The wide scope of the care that we provide is evident in these numbers. A total of 27869 visits resulted in 94383 interventions being delivered. Most, if not all, of our patients have multiple diagnoses, including cancer, HIV, TB, and various chronic conditions.

The cost to provide care to one patient for one month is approximately R1330.00. This can be broken down to approximately R440.00 per visit.

Always a challenge, and even more so now, has been the income generation. I must commend the team in its wide diversity and ability to rise to the challenge of raising funds for our organisation. 2019 can be considered a successful year in terms of finances (more can be seen in the treasurer’s report). The Income Generation team is broken down into a number of departments and each of these has performed admirably. If we are to examine our total income for the 2019 financial year, the following are noticeable and worthy of mention. 46% of our income is made up of Specific donations (proposals) and general donations. This is a significant number. The balance of our income 54% is made up of our own activities. Of this a total of 45% is income from retail and events. The rest from training and telemarketing in the most part and sundry income.

Despite this success we still showed a net deficit for the financial year.

Occasionally I spend time reflecting on the work of Richard Rohr (https://cac.org/category/daily-meditations/) Recently he had a week long reflection on Liminal space. Liminal space is that space between one certainty and another. The journey between where we are and where we want to be. It is ‘in between’ space. It is space that most of us fear and avoid. However, it is the space of the journey. It is the space of change. It is the space of rebirth.

In many ways what we currently experience in these uncertain times is liminal space. The space of change. What we will become is uncertain, but we will become something new. I recall reading a book many years ago called ‘When the heart waits’ by Sue Monk Kid. In this book she reflects on the chrysalis that the caterpillar ‘enters’ into and the emergence of the butterfly after due process. The chrysalis is the liminal space. A space of ‘I don’t know.’ It is a necessary space and it is a space that I encourage us all to enter with a willingness to embrace the process and the change.

There is no doubt that what will emerge this year for Msunduzi Hospice will be different. Our care will continue to be delivered with passion and compassion, but the way it is delivered may change. We will need to embrace technology and explore the ability to provide remote counselling to lower the risk of exposure for patient, family and staff. The way we raise funds will be different. We will continue to act responsibly with the funds that are donated, but the process of raising them will have to change. We are currently exploring ideas around online sales for some of the donated items.

Funding remains difficult and we need to operate in a less liquid environment. This too is a liminal space with a great deal of uncertainty.

It is in times of upheaval that questions about purpose arise. What purpose does Msunduzi Hospice serve? Is it still necessary?

During these liminal times, it is perhaps even more necessary. One of the defining characteristics of Hospice and Palliative Care is the ability to walk alongside a patient (and their family) as they journey towards death. This is a liminal journey, a journey from the state of living to a new state of being (whatever that may be). It is a journey of change. This is what we do. We journey with you through times of change. Clinically we will help control your pain and various distressing symptoms. Necessary so that you are not distracted from the journey by pain and these symptoms. Emotionally, we will try to help you process some of the emotional and psychological challenges and difficulties you may be experiencing. The occasional fear of change, the need to come to acceptance of what is happening to you as a patient. These are aspects of our care that we are good at. Socially, although limited, we will advise and suggest various courses of action that may help your family transition to a new state of being without you a little easier. Spiritually, we will try to help you let go and embrace the time of change. What could be more important during this time of uncertainty and change?

This remains the work of Hospice and we will continue to provide these services to the best our ability within the limits of the resources that we have available.

“The world is indeed full of peril, and in it there are many dark places; but still there is much that is fair, and though in all lands love is now mingled with grief, it grows perhaps the greater.” J.R.R. Tolkien, The Fellowship of the Ring

Msunduzi Hospice and Covid-19

Hospice care

The world has drastically changed around us and we are all struggling to come to terms with this change and wondering what the world will look like once this pandemic has past? We will be left with scars and those scars will change the way we interact with one another and the way we view ourselves. I trust that these scars will enhance the beauty that we see around us and which lies within each and everyone of us.

Msunduzi Hospice, just like everyone else, and all other service providers around us is not unaffected by the Covid-19 pandemic. In saying this, please note that Msunduzi Hospice is still providing care to all of our patients who most need it. There are some patients who for very obvious reasons do not want to be visited (they have self-isolated) and they do this for their own health reasons. This is completely understandable. There are some patients who do not need our care at the moment and for the safety of our own care team they will be contacted and support will be offered telephonically until this pandemic is over. For those of our patients who are most reliant on our services, these services will continue to be provided by our team of dedicated and professional nurses and social workers. The care givers have been asked to stay at home for now and their services will only be called upon if and when we need them most urgently. All our group interactions such as Day care and the children’s groups have been cancelled until further notice. This was decided on a few weeks ago before the lock-down was announced. As a consequence of this decision, you will still see the occasional Msunduzi Hospice vehicle driving around delivering patient care.

Please note that all other services available from Msunduzi Hospice are currently suspended until either the lock-down is lifted or until further notice. In particular the shops are closed and the depot will not be open to receive your donations. The recycling collection bins are also not available. The Wall of Remembrance is not accessible. All our events for the next few months have been cancelled or postponed such as the Easter Fair (cancelled), Art exhibition (postponed) and Night of the Stars Jazz evening which has been provisionally postponed until November. This has had a noticeable impact on our cash flow.

While we are on lock-down the following are the best means of communication:

  • Cellphone – 0826999105 – please do not call the land line as no one will answer it.
  • E-mail – hospice@hospicekzn.co.za will be answered once or twice a week and the e-mail forwarded to the correct person to deal with.
  • Other e-address that can be used are:
    • vijaya@hospicekzn.co.za
    • warren@hospicekzn.co.za
    • pcmanager@hospicekzn.co.za
    • financemanager@hospicekzn.co.za

As with many NPO’s during this difficult time our resources are being stretched to the limit and we call on the community of Pietermaritzburg and all our supporters around South Africa and the world to continue your support of our programme of care in whatever way you can. To this effect our telemarketing programme will continue and you may be contacted in this regard. Please note that there will be no collections of money. Please make all deposits by EFT. You will be provided with the relevant banking details. On this webpage is a ‘DONATE’ button which will take you to our Payfast account and you can make a donation through that portal. A crowd funding drive will be launched in the next day or two and your support for this fund raising avenue and in sharing it as widely as possible will be appreciated.

For the most up to date information please visit our Facebook page often, as all relevant information can be found there. Facebook also provides you with a means to contact us and these messages will be responded to within 24 hours.

I leave you with these words quoted by Judith February quoted in a Daily Maverick article on 24 March, by Seamus Heaney:

“Believe that a further shore is reachable from here.

Believe in miracles and cures and healing wells.

Call the miracle self-healing:

The utter self-revealing double-take of feeling.

If there’s fire on the mountain

Or lightning and storm

And a god speaks from the sky

That means someone is hearing

the outcry and the birth-cry

of new life at its term.”

With kind regards

Warren Oxford-Huggett


A little goes a long way in Palliative Care

Hospice care

“Improved quality of life through relief of pain and other distressing symptoms” this is one of the primary goals of Palliative Care and is what we strive for in the care provided by Msunduzi Hospice. I would like to share the story of a patient we admitted recently to demonstrate how simply this can be achieved with patient, family co-operation and effective team work.

Mr Samuels [not his real name] is an elderly gentleman who developed a tumour on his spine and subsequently became paralysed from the waist down due to spinal cord compression. On our first visit we found him with severe pain in his back and legs. His legs and feet were grossly swollen due to lymphoedema, his bowels had not acted for many days, causing abdominal pain, he had bad oral thrush, causing mouth pain and he subsequently had no appetite and had lost a lot of weight. As a result of his immobility he had severe bedsores the length of his spine, plus a necrotic sore on his heel, which, when the dressing was opened, was found to be full of maggots. He was extremely despondent and his family were anxious and distressed.

Basic interventions were initiated to treat the constipation and oral thrush, and within a week there was a big improvement. The pressure sores were dressed appropriately and the family and carer were shown how to do the dressings themselves. We liaised with the doctor at the pain clinic at his local hospital, who commenced him on morphine syrup, and a few days later Mr Samuels told me that the syrup was “magic”, that he had gone from being in constant pain to being basically comfortable.

Despite the fact that our interventions have not changed the course of the disease nor the poor prognosis, life for Mr Samuels and his family looks brighter, thanks to effective team work, with full buy in from the patient and his caring and supportive family, and backup from the hospital doctors.

This then is what ultimately makes Msunduzi Hospice work so rewarding - making a difference in the lives of our patients and their families. Helping patients and their families through specialised care to live and die well.

With thanks to Sr Jenny Reynolds.

The value of Palliative Care Standards


The Hospice Palliative Care Standards have been with us for a number of years now. I have been privileged to have been connected to these standards in some way since they were first rolled out to the various Hospices in South Africa in 1998 (when they were known as ‘Standards for the Provision of Palliative Care in Hospices).

I have witnessed the evolution and development of these standards over time and how they have to a greater or lessor extent had an impact on various Hospices. There has been the outright rejection of the need for these standards all the way through to the passionate embracing of them as key for the future development of Palliative care as well as it delivery. I find myself in the passionate embracing camp.

Currently, as CEO of Msunduzi Hospice, I am fortunate to be part of a wonderful governance and leadership team who also embrace the need for the Palliative Care Standards and can see their value. I have always been transparent in my enthusiasm for these standards. Msunduzi Hospice has been continually accredited by Cohsasa since August 2009 (at least as far as I can go back), and we are currently at the mid-point of our first 4 year accreditation cycle. Being able to use and proudly display our external accreditation status has been immensely helpful in maintaining relationships with a number of funders as well as developing lasting networks with others. Having an external accreditation status is something that not many (if any) other NPO’s can boast about and we should be boasting about it.

As a requirement of our current accreditation we were subject to an interim survey in early February. This was conducted by Cohsasa and went very well. As I had never participated in an interim survey before, I did not have much feel for what would be happening and how the assessment would take place. My thanks to Cohsasa for all the assistance they provided and for the surveyor who was very approachable and open to comment and suggestion. On the whole the interim survey was a wonderful experience for our organisation, our leadership team and for me personally. The focus of the interim survey was on processes and systems. In particular Risk and Quality systems. About tracing issues through the entire organisation and not dealing with issues in silos. About the marriage of care and administrative systems and the need for both. Quality Improvement activities, audits and assessments and the impact of these activities and their measurement and recording. I find it difficult to put this into words, but the interim survey focuses on the wholistic bigger picture and we, as a site and we as Hospices in South Africa, need to move away from navel gazing to see this bigger picture. How care links to management, how networking links to care and sustainability. How Quality systems are a means to sustaining the entire system of care. I trust we can get there? There is a phrase from Galileo Galilei - ‘Measure what is measurable, and make measurable what is not so.’ The Palliative Care standards give expression to this. We measure what we do and we make measurable those aspects of our programme that seem to be beyond measure.

Currently the 3rd edition of the Palliative Care standards is begin reviewed. I am part of the team involved in the review of our standards and it is exciting to see how the themes spoken of above are finding their way into the next edition of the standards.

The often repeated challenge levelled at the Palliative Care Standards is that the time and effort that needs to go into them does not translate into funding for the individual Hospices. I beg to differ on this matter. The time and effort that goes into developing and implementing policy and procedures that give expression to the Palliative Care Standards has a direct relationship with the sustainability of Msunduzi Hospice. It is these standards that guide the policies that guide the care that we provide. It is these standards that ensure that we provide Quality Palliative Care for all our patients and their families. It is this care that we market to our community and to our potential funders. It is this care that directly results in the income from numerous private and corporate funders. It is this care that speaks so highly to the Department of Health and ensures that we are reliable partners in efforts to increase the footprint of Palliative Care in South Africa. It is the standards that set the goal post for all our systems and processes. It is the standards that enable us to be measured (externally by Cohsasa) and to proudly say that we are accredited. Without them, there would be no measurable Quality Palliative Care. We proudly measure what we do and boast about it as well. The standards are about our care and our sustainability.

For all Hospices in South Africa, time and resources spent on compliance with the standards and using the Self Assessment Tool (make enquiries with HPCA) are not wasted. The fruit will be harvested.

The following link will take you to the Cohsasa website showing those site currently accredited in South Africa: http://cohsasa.co.za/health-quality-improvement-south-africa/

Warren Oxford-Huggett


Festive greetings


Msunduzi Hospice would like to take this opportunity to thank all our wonderful supporters for their loyalty and commitment during the year. It is indeed because of your support that we are able to celebrate a year of achievements. During this year we have provided Palliative Hospice Home-Based Care to approximately 260 patients each month. We have conducted approximately 16100 home visits to patients in the 11 months to the end of November. All of this and so much more because of your support. We care because you matter.

Furthermore, to all our patients and their families and in particular to those families who have lost loved ones this year, may this time of festivity be a time of remembrance for you. Remembrance of lives shared and remembrance of love held close together in the sacred bonds of family and friendship. Take this time to find meaning and value in your experiences that will sustain you during the year to come.

To our wonderful board members, staff and volunteers, may you be blessed during this time of festive activity and find peace in the stillness of holidays and rest.

Please take note of our trading and office hours over the festive season:

  • December 16 – closed;
  • December 25 & 26 – closed;
  • December 27 – care and reception will be closed but the shops will be open;
  • December 28 – shops open;
  • January 1 – closed;

I would like to leave you with this quotation as we end one year and begin another - “You cannot swim for new horizons until you have courage to lose sight of the shore” - William Faulkner.

Light and blessings

The Hospice team.

World Hospice and Palliative Care Day


Today is World Hospice and Palliative Care Day (#WHPCD19).

The theme this year is: My care, my right.

What is Hospice and Palliative Care?

Palliative care is a fundamental part of healthcare – and a human right. It is about relieving suffering and pain at any point in a patient’s diagnosis from a life-limiting illness. When a patient and family receive palliative care services, the aim is to improve their quality of life, regardless of their age or stage of the disease.

The World Health Organization defines palliative care for adults and children as follows: “Palliative care is an approach that improves the quality of life of patients and their families facing problems associated with life-threatening illness, through the prevention and relief of suffering, the early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.”

According to The Lancet Commission on Global Access to Palliative Care and Pain Relief: Each year, more than 25.5 million people die with serious physical and psychological suffering as a result of disease, injury or illness. This figure includes 2.5 million children. More than 80% of these cases are in low- and middle income countries, where access to immediate release morphine, an essential and inexpensive medicine to alleviate pain, as well any other type of palliative care, is severely lacking.

What is world Hospice and Palliative Care Day? World Hospice and Palliative Care Day is a unified day of action to celebrate and support hospice and palliative care around the world.

We share the story of Betty as an example of the work of Msunduzi Hospice is providing Palliative care and some of the challenges we face on a daily basis.

Betty's story:

Our patient, Betty (not her real name), was referred to Msunduzi Hospice by the local War Room.

Betty was diagnosed with meningioma in 2013 (a meningioma is a tumour that develops on the membranes that line the brain and the upper spinal cord). On our initial visit Betty’s condition was very poor. She was bed bound and nursed in nappies with no pain tablets or any other medication at all. No follow up appointment had been made for her to return to the hospital since 2013. Betty has four children. Two older sons, who have not been seen by the Hospice team, and two younger daughters. The two older sons are reported to be out of the house from early morning and do not take any responsibility for the care of their mother or the rest of the family. The younger daughter is the primary care giver and often misses school to provide this care. Hospice has informed the teachers of her home situation. She is in grade 11. The older daughter is epileptic and also needs care at home. For unknown reasons she is not able to walk. There is a seven year grand-child at home as well, she does attend school and is in Grade 2. A friend assists with the care of the family at home as needed. The family and the patient decided that she was no longer going to go to the clinic or hospital because she only comes back with ten (10) Panado tablets (paracetamol), yet her condition is poor.

This case was reported to and discussed with the Palliative Care Manager who then communicated with our networking contacts at a local hospital for advice and assistance. Through this networking an appointment was made for Betty for some tests to be conducted and assessment to be completed (scheduled for 4 September 2019).

One of the challenges facing the family and our care team was getting Betty to the hospital for this assessment. The family had no funds to hire a car to take Betty to the hospital and Betty was unable to sit upright in a taxi. Betty is the recipient of a grant and this is the only income for the household.

Additional care challenges were addressed by our social workers who were involved with Betty and her family in order to provide emotional support and counselling for the daughters as well as exploring options for placement for Betty. Our memory workers have been working with the younger daughter, helping her compile a memory box and memory book. The family is mocked severely by the local neighbourhood as everyone in the house is sick and there is a constant smell of urine.

Betty attended her appointment at the local hospital as Msunduzi Hospice had provided funds to hire a vehicle for her to use. The follow up admission for an MRI scan was missed because various traditional rituals needed to be conducted before she was admitted. This was on the understanding that if these rituals were not conducted she would not return home from the hospital. The Palliative Care Manager was able, in discussion with the local hospital, to have the admission postponed to a more suitable date for the family. Unfortunately a new appointment will need to be made when this happens and it may take some time to obtain another appointment for an MRI scan.

Our social worker continues to work closely with the older daughter who has epilepsy and is mostly immobile due to complications. Our social worker has managed to secure an appointment later in September for this daughter to see the doctor at the local clinic for an assessment. Following from this appointment with the doctor, the social worker has also managed to secure an appointment with the SASSA doctor in October for the possible commencement of a grant.

Why this story?

This story speaks to some of the complications involved in ensuring that patients are correctly diagnosed and then remain on treatment. In addition, as we approach World Hospice and Palliative Care Day in October, this story highlights the need to ensure that Palliative Care and UHC (Universal Health Care) are made more available within our country.

The referral was received by the local War Room which highlights the importance of local networking. Msunduzi Hospice attempts to ensure that care givers and nurses attend local War Rooms as often as possible (not compromising patient care). At the War Rooms discussions take place with relevant role players (Health, social development, political and other CBO’s) around the needs of that particular community.Referrals are made as necessary. Frequently these meetings are poorly organised and valuable time is then lost by our care team. However, they remain an important link between our care and the local community.

Once referred, an initial visit is conducted and the assessment made (as described above). The various issues that need attention are detailed, prioritised and our team begin to try and assist both the patient as well as the family. In this particular case these needs and the related challenges were significant. The lack of follow up after diagnosis and regular checks on Betty’s medical condition meant that the care was limited to start with. The additional complications of a daughter with epilepsy who also needed care and the primary care giver being a child who should be at school meant that the entire team needed to be involved. Msunduzi Hospice has limited resources and was unable to meet all the needs of this family. However, where we are not able to do so we make use of an extensive list of networking partners who assist in ensuring that the family and the patient receive the care that they need. The support of the local hospitals, clinics and social service agencies is acknowledged in this particular case.

The continued value of having, developing and maintaining networking relationships is also highlighted. The contacts developed at many of our local hospitals ensured that we were able to secure an appointment for Betty that would have provided us with the relevant investigations and we would then have been better able to provide care for her. The fact that she was unable to go for admission due to religious and/or cultural reasons was an unknown complication at the time. The value of palliative care is that we recognise the need to ensure that holistic care is provided to all our patients,. This holistic care includes cultural and spiritual care as indicated. We rely on the care team to offer this care as indicated. In this case these cultural needs delayed the assessment needed. This is often the case with many of our patients.

The access to care is an additional factor that complicates the care that our patients need. Betty was unable to sit in a taxi and unable to afford to hire a dedicated vehicle. Msunduzi Hospice was fortunate enough to be able to assist in providing these funds in this instance. But we are not always able to do so. Msunduzi Hospice does not have a suitable vehicle to transport bed bound patients to and from hospital (or other) appointments. All our vehicles require the patient to be able to sit up.

We wait now for a new appointment for the admission of Betty to the local hospital after which we should have a clearer picture of the care needed. In the meantime we do our best to ensure that Betty is pain free and her symptoms are managed. We work closely with the family (those that we can) and try to help them in meeting their particular needs as well. Additional nutritional support is provided as we have resources available.

Holistic Care

Palliative care

Msunduzi Hospice Association – “Mending lives because you matter.”

The story of Linda*, presented below speaks to some of the complications and challenges faced by our care team in delivering quality Hospice palliative care to our patients.

Very often our patients will have a number of small successes in their journey with their illness and these small successes add up to contribute to the overall experience of their illness. I would like to share the story of one our patients, Linda, and her family.

Linda has been with Msunduzi Hospice since July 2018 when she was referred to us. She was diagnosed with HIV in 2002 but has been defaulting her ARVs for the last 6 years and was not well and very weak when we first visited her. With encouragement from our Hospice staff she is now back on her ARV’s and her condition is improving.

Linda was very emotional about her condition and was referred to our social worker for counselling and support. During these sessions it became apparent that she had lost contact with her siblings and her children also missed their immediate family. The social worker made contact with one of her sisters and asked her to visit Linda. In September 2018 Linda received visits from her sister and her brother also phoned her. Thereafter her emotional state improved and her daughters commented on her being able to do much more in the house and care for herself. It was a huge burden for her after she lost contact with her siblings and she had felt very lonely.

After this intervention with Linda’s siblings it became apparent that there were underlying issues between Linda and her daughters, with one in particular, that was causing a lot of tension in their family relationship. Our social worker has been working on improving these relationships and was having some success when Linda started showing signs of being confused and hallucinating. This started around mid November 2018. Linda saw a traditional Healer (a common practice among many of our patients) who told her she was bewitched. By December 2018 Linda’s behaviour had become more aggressive and she often screamed at her family and threatened them. In mid January 2019 her behaviour had become even worse and her daughters were afraid of her. She was put on some medication by the clinic doctors but it was not helping.

Msunduzi Hospice has monthly meetings with the doctor in charge of the clinics and we discussed Linda’s condition with him at our February meeting. He advised us to increase her medication and suggested that the family take her back to the clinic. He wrote a referral letter to take with them when seeing the clinic doctor. Our nurse gave the family the advice from the doctor and the letter. The family managed to get their mother to the clinic, from there she was admitted to hospital and treated. On her discharge from hospital Linda has improved and is on treatment which appears to be effective.

We will continue our journey with Linda and hope to have many more successes going forward. With her condition being more stable we are hopeful that the relationship with her daughters will be one of those successes.


The above story explains clearly the complicated factors that impact on a patient’s adherence to medication. It is seldom a simple matter of taking said ARV’s as prescribed, but often the emotional state of the patient plays a role in their willingness or ability to adhere to a treatment schedule. The value of the care provided by Msunduzi Hospice to our HIV+ patients is that this care is holistic and, where possible, addresses the psychosocial needs of the patient/household, thus building resilience within the patient and strengthening the ability of the patient to adhere to treatment protocols. The care is also supportive of the family/household and in this way strengthens their ability to help care for the patient.

This story demonstrates the complexity of the work of Msunduzi Hospice. These services described above are provided entirely free of charge to our patients and cost Msunduzi Hospice a considerable amount of money. In our last financial year (to the end of December 2018) the cost of care for a patient was in the region of R1,280.00 per month. The care is provided by a team of nurses, social worker, care givers and memory workers, all of whom are passionate about Palliative Hospice care and are deeply committed to their patients.

The funds to pay for this care are generated by our team here at Msunduzi Hospice and we rely heavily on our corporate donors, our retail activities and you, the members of the public, who make such generous donations to keep the services we provide free.

We care because you matter.

* The name has been changed to preserve confidentiality.

Night of the Stars


The annual Msunduzi Hospice Night of the Stars Jazz and Comedy Dinner is almost upon us. As with past editions of this event, audiences can expect an entertaining evening that is jam packed with world class jazz and belly aching comedy accompanied by exquisite cuisine. Over the past several years this event has grown into one of the premier events in Pietermaritzburg and the KZN midlands region. This edition will feature South Africa’s premier jazz artists including Melvin Peters, Karen Devroop, Chats Devroop, Bruce Baker and Philani Ngidi with nationally recognized comedian Arnotte Payne.

Widely considered to be South Africa’s preeminent jazz pianist, Melvin Peters needs no introduction to concert attendees in the city. His performances in Pietermaritzburg go back over 30 years when Melvin first began establishing himself as an artist. Peters has performed with South Africa’s foremost jazz artists and travelled widely to the UK, USA and South Africa. Joining Peters will be the Devroop brothers Karen and Chats who have a long affiliation with Msunduzi Hospice. Both of them have performed with most artists, jazz and pop to emerge from the city. Karen Devroop recently returned from several international concerts most notably his performance with the Orchestra del Teatro Traetta in Italy where he performed as soloist with the orchestra. His quintet also performed at the Seychelles Kreol Festival in November and in February of this year he performed with the Cape Town Philharmonic Orchestra and South Africa’s leading house group MICASA. His recent CD recording The South African Jazz Songbook is receiving widespread publicity internationally.

Not to be outdone by his younger brother, Chats has also released his newest CD recording and returned from performances in Cape Town and the UK. Complementing these three artists will be Bruce Baker on drums and Philani Ngidi on bass who are both acclaimed artists and widely recognized nationally. Collectively these artists have performed with most of South Africa’s leading jazz and contemporary artists. Audiences can expect a riveting concert on Friday 21 June 2019 at the Golden Horse Casino and Conference Centre when they take the stage.

The night of the stars will also include the hilarious comedian Arnotte Payne who for the past 15 years has performed with some of South Africa’s leading comedians including Trevor Noah. Payne has a stellar reputation having performed on some of South Africa’s most iconic stages and events. In addition to being a top class comedian, Payne is also an actor, speaker and singer who recently performed at the Comics Choice Awards.

The Night of the Stars has become synonymous with fine music, comedy and food. The event sells out really quickly due to its popularity and appeal to audiences from young to old. Bookings are essential due to the limited number of tickets available hence attendees are encouraged to book early. Tickets are now on sale at R325.00 per person and corporate tables of 10 are available at R3250.00. Tickets can be purchased online via Quicket, or directly from the Msunduzi Hospice Association. For more information please contact Tanya Roux on 082 699 9105 or email fundraiser@hospicekzn.co.za

Day Care Family Day

Family Day

Day Care Family Day.

Occasionally during the year our Day Care patients gather with their family members to spend a morning together.

What is Day Care?

Day Care is a programme of care offered to our patients who are better able to move about. Those who are able to attend a short morning of fellowship with other patients who find themselves in a similar position. These days are spent together with a tea and eats being provided (in most cases sponsored by volunteers and other organisations who support Msunduzi Hospice). A few ‘outings’ are organised during the year depending of the availability of funds. Patients derive great benefit from these days spent together. The ability to talk about one’s illness and treatment with others in a similar position lends support to the resilience that we encourage in our patients.

Family Day.

Once or twice a year a day is arranged with the families of our patients. The family members who can attend are specifically invited to join their loved ones for tea and lunch. Again the focus is on time spent together as a family, but also on time spent talking about themselves and what they are going through. It is an opportunity for the family members to also experience some of the supportive care offered by Msunduzi Hospice.

This programme is necessarily limited to those patients who are able to move about and due to a shortage of resources we limit this programme to our traditional patients as well. Volunteers are arranged to collect patients from their homes and bring them to Msunduzi Hospice for the morning’s programme. These same volunteers then assist in transporting the patients back home. We are deeply grateful to our volunteers who assist in this programme as they receive no support from Hospice in the way of reimbursements. Given the current high cost of fuel this is doubly appreciated.

As mentioned other activities are arranged for our Day Care Patients. These include trips to various places of interest in and around Pietermaritzburg. For more information on this programme, please contact our offices.

A word of thanks to the staff and volunteers who make this programme possible.



A general reminder to all members of the community and members of Msunduzi Hospice.

The Msunduzi Hospice AGM will take place on 23 May 2019

Time: 15:00

Venue: 200 Zwartkop Road - Msunduzi Hospice Conference Centre.

Only paid up members will be allowed a vote (if necessary).

Please ensure you have paid your membership fees for the current year.

Easter Fair

Easter fair

Are you ready for the wonderful, fantastic Msunduzi Hospice Easter Fair.

Join us  for this firm favourite and enjoy a day of fun with the whole family.

  • Date: 6 April
  • Time: 08:00 to 13:00
  • Venue: Msunduzi Hospice - 200 Zwartkop Road.
  • Cost: R5.00 entrance fee.

We care because you matter.

Open Day

Open day details

Have you ever wondered about the work of Hospice?

Do you wish to play an active role in our community?

Come and find out more at our Open Day:

  • Date: 8 March 2019
  • Venue: Msunduzi Hospice Association (200 Zwartkop Rd
  • Time: 09:00 - 11:00
  • Tea will be provided.

We care because you matter

Amanda's story

Amanda in the dress from Msunduzi Hospice

This is a short story about Amanda.

It is the end of the year and excitement is in the air. For the grade 7 class of a local school their farewell is just around the corner and the anticipation is mounting. For one pupil there is a bit of a cloud over the whole affair. Amanda does not have a suitable dress to wear to the farewell and sadly there is no money to spend on a new dress.

Amanda is one of the children on the Hospice Memory Work programme, her parent being a patient receiving Hospice care. The programme looks at helping children to cope with illness and loss within their family. Amanda also does not have an ID or birth certificate so this complicates her application to proceed to grade 8. It also means that she does not receive the Child Support Grant that would help to meet her financial needs. Our social workers have been advising the family and have made appropriate referrals to help Amanda receive a birth certificate and ID book. This can be a lengthy and difficult process.

In the meantime our Memory Workers approached us to see if we could not help with making her farewell special. With aid from our Depot workers we were able to find three outfits suitable for her farewell and she was allowed to choose and keep one. Other staff members helped with the finishing touches, and to the delight of Amanda and her father, Amanda was also able to dress up and enjoy her farewell.

Hospice care is more than just pain control and symptom relief. At Msunduzi Hospice we attempt to provide care that is holistic and works with the entire person. Palliative care.

We care because you matter.

Starting the year


On 2 January I came back to my office after a short, but appreciated break. Having my PA on leave at the same time meant that I also checked the e-mail on her computer. Amongst the numerous e-mails was a wonderful letter written by a family member of a patient who had died shortly before Christmas. The letter was very complimentary and expressed a great deal of thanks and appreciation to the staff of Msunduzi Hospice for the care that their family member had received.

What a wonderful way to start the year.

As I write this first blog of 2019 and I reflect on this letter I am very aware of the need that so many of our patients have for good, quality hospice/palliative care. This care is provided by a team of very dedicated and committed nurses, social workers, memory workers and care givers. Supported by a team of fund raisers, admin staff and financial staff who make sure that all the other details are taken care of. Yet so often people do not know what we do and why we provide the care/services we do!

At the beginning of this year, I would like to pay tribute to these team members who put the name of Msunduzi Hospice out there, who tirelessly and with great dedication work to achieve the fundamental principles of palliative care:

- To provide relief from pain and other distressing symptoms – this is probably what Hospice is best known for. Hospice is not about death or dying, it is about enabling and empowering patients and their families to live pain free for as long as they have life to live;

- To affirm life in all our interactions with patients (and their families) and to regard dying as as normal – In all our interactions with our patients and their families we affirm life;

- To neither hasten nor postpone death;

- To integrate the psychological and spiritual aspects of patient care – we recognise that all illness is more than physical. That every illness has some impact on the psychological and spiritual aspects of the patient/family. We will offer what support we have in these areas of the patient’s life;

- To offer a support system to help patients live as actively as possible until they die – the main work of our care team is to offer support, support to the patient and to the family to enable them to develop resilience to their illness and to progress towards a dignified death;

- To offer a support system to help the family cope during the patient’s illness and in their bereavement – we recognise that for many a period a bereavement will take place after the death of a loved one. We will offer support to the family of patients who have died in their bereavement;

- To make use of an inter-disciplinary and multi-disciplinary team approach to address the needs of the patient and the family;

Here at Msunduzi Hospice we are not always skilled in providing all these services all the time. It is one of the challenges that is inherent when funding and resources are scarce. However, we do attempt to apply these principles as often as they are indicated and as often as we have the resources to do so.

We rely on donations of money and other items to try and meet these needs. We rely on the support of the community and professional members of our community to help meet these needs. We rely on our good relationships with various networking partners, including the department of health and private health care facilities. In short we care because you enable us to care.

Ahead of us lies a challenging year full of opportunities. Please make use of our services. For any information on patient care, please contact our Palliative Care Manager, Heidi on pcmanager@hospicekzn.co.za or give her a call on 033-3441560. This includes information on how to become a patient and details on the various services we offer our patients and their families.

Please support all our fund raising activities, our shops and events. Please make donations of pre-loved items to our depot that we can sell to generate income to support our services. For more information on these events and activities please call our Income Generation Manager, Vijaya on 033-3441560 or vijaya@hospicekzn.co.za. Additional information will be available on our Facebook page and you are encouraged to like our page in order to stay up to date on events and happenings here at Msunduzi Hospice.

If you wish to volunteer in some of the support areas of the organisation such as the bookshop, the depot, the garden etc., please give us a call to set up an interview. Please contact Shiloh on 033-3441560 or hospice@hospicekzn.co.za for more information.

By Warren Oxford-Huggett (CEO)

Reflections on care

Hospice care

This article was written by our Palliative Care Manager - Heidi Collyer and appeared in our November 2018 newsletter.

As always, I cringed when the request for newsletter articles came through for what seems like the hundredth time this year. But then I got to thinking…. don’t sweat the small stuff. And then I got to thinking…. it’s the small stuff that really matters. I was then reminded about my English teacher who always said that we should not start a sentence with “but” and “and” …. The small words we need so much!

But in all seriousness, I am learning to both not “sweat the small stuff” and to appreciate that the small things in life do matter. So, as you probably have realized already, I am talking about two different types of small things. On the one hand you have those negative small things, that could really ruin your day if you let them, and on the other hand you have those positive small things that can just make your day. For each of us the “small things” that trigger us will be different. Knowing ourselves and what those negative small things are that trigger us, can help us to put them into perspective. Understanding our reaction to them and changing our attitude towards them can save us a whole lot of stress. I am learning this slowly but I am sure my husband wishes I could learn faster. “Don’t sweat the small stuff” has become a bit of a motto for me as I look at the bigger, more important things in life. Something that I have learned from our patients here at Hospice.

Working at Hospice I have also learned to appreciate the small things that we often take for granted. Last month one of our nurses, Nobuhle, started visiting a teenager who was sleeping on the floor with not even a mattress. Nobuhle came back to the office and asked for a mattress for the patient and fortunately we had one. We also asked the Depot to look out for donations of a bed. About a week later a donation of two single beds was made to our Depot and Nobhule with the help of Sipho, one of her nursing colleagues, delivered one of the beds to the patient. She was absolutely delighted. A bed, a small thing we probably don’t even think about – taking ours for granted. A small thing that our nurse could have ignored but decided to do something about, and thanks to the donation made to our Depot, is now a big “small thing” in someone’s life.

Small things are also not limited to material things. Have you ever had one of those days when you felt like the world and everyone in it woke up this morning with a personal grudge against you? One of those days when everything is going wrong and you simply want it all to be over and then suddenly someone says something nice to you? Or does something kind. What a difference a kind word or act can make to that day and your experience of it. We just never know when someone is having “one of those days” or if they are going through a hard time. We never know when a kind word or act from us can change someone’s day. Perhaps it seems silly but if you can make that difference why not make it?

Anyway, these are probably all thoughts that you have heard before but I was reminded about all the little things that our Care Team does for our patients and their families. These range from organising beds to simply being present and listening to a kind word of encouragement. Often, we cannot change the bad things that are happening but we can offer the support and kindness that is so desperately needed and that makes all the difference in the world. Small acts, that don’t take much time and often don’t cost anything, that can make a huge difference. Well done and thank you to the Care Team for all you do.

A few words about training.

Although we speak formally of training I like to believe that training is about learning and that life itself is a learning experience. Even when we are facilitating courses we learn from the participants who share their life experiences, ask questions and make comments that get us thinking. So long as we have an inquiring mind we are never too old to learn something new. I find this rather exciting.

Something else which has been rather exciting is the opportunity to share our palliative care experience with the Department of Health in the form of introduction courses for caregivers and professionals. We always say that palliative care is a team approach and it has been really good to see a variety of disciplines attending the professional’s training, these include nurses, dietitians, physiotherapists, psychologists, chaplains, audiologists and social workers. Although a lot of extra work for the staff of those Hospices involved, it is the beginning of a greater awareness of palliative care. We are hoping this will grow into palliative care being available for all. This may still be a long way off but we have to start somewhere, doing what we can.

Our community trainer, Winnie Gasa, is still offering the Home-Based Care course to community members but this has slowed down a bit and Winnie has been assisting with the caregiver’s course for the Department of Health. We are grateful to have her on board as she makes a valuable contribution with her understanding of the caregivers and the sometimes-difficult work environment they face.

We regret not being able to run our usual course, (e.g.: Grief and Bereavement Workshop, Counseling Workshop and Basic Hospice Course) but hope that next year may bring more opportunities to do this. We will still run these courses on request if a group of ten or more participants can be arranged. For any queries please contact me, Heidi Collyer on 033 3441560 or pcmanager@hospicekzn.co.za

In closing just, a word of thanks to, not only the training team (Warren, Jenny, Letitia, Winnie and Nola from Howick Hospice) who have helped so willingly with the training for the Department of Health but also to the whole team that stays behind and copes with the added workload of colleagues who are “off training again”. Thank you to a remarkable team.

(Heidi Collyer)

Reflections on Palliative Care - Hinduism

Hindu reflection on Palliative Care

At Msunduzi Hospice most of the patients who are referred to us or refer themselves to us are living with a life threatening illness. An illness that places them in a vulnerable position. Most of the work of Msunduzi Hospice (after pain and symptom control) revolves around trying to help the patient (and family) live in a vulnerable space. We call this developing resilience.

One of the vulnerabilities can be an existential crises. A crises that begs the question, ‘Why me?’ Why am I suffering this illness? Why did this have to happen to me or my loved one?

For some these and similar questions promote a series of reflections and self examinations which have a beneficial spiritual effect on the life of the patient (and their families). For other this can be increasingly difficult with no spiritual benefit as the questions lead them down ever darker pathways of despair. Participation in religious rituals can have a beneficial impact on this process of reflection and for as long as the patient is able these rituals should continue to be performed. If possible in a place of sacred importance, or if the patient is bed ridden, then in the patient’s room (if possible).

“Spiritual well-being influences psychological functioning, such as anxiety and depression, in individuals with life-threatening diagnoses. Specifically, patients with serious disease are more likely to experience significant psychological distress if they do not have a high sense of spiritual well-being. While lack of belief in an afterlife has been associated with end-of-life despair (desire for death, hopelessness and suicidal ideation), spiritual well-being has been shown to have a more powerful effect on psychological functioning than beliefs about afterlife.” (Bauer-Wu S, Barrett R, Yeager K. Spiritual perspectives and practices at the end-of-life: A review of the major world religions and application to palliative care. Indian J Palliat Care 2007;13:53-8)

In November the festival of Deepwali takes place and to honour this festival a short reflection on Palliative care from a Hindu perspective (the following extract is from: Bauer-Wu S, Barrett R, Yeager K. Spiritual perspectives and practices at the end-of-life: A review of the major world religions and application to palliative care. Indian J Palliat Care 2007;13:53-8):

“Hinduism comprises a wide variety of religious traditions that have diffused throughout India and the world. Yet despite this variation, certain major themes are commonly shared by most Hindu religious traditions such as the primacy of the Vedas, notions of cause and effect (karma), a cyclical model of death and rebirth (samsara) and spiritual liberation (moksha). Likewise, there are common themes surrounding the dying process that may be relevant for effective palliative care delivery.

For instance, Hindu patients and family members may be reticent to seek pain relief and other physical symptoms if they consider suffering as a form of austerity (tapasya), an opportunity to achieve spiritual liberation by burning away the karma accumulated over multiple lifetimes. Under such conditions, the needs of the body and soul may be at odds with one another. However, people often recognise that they cannot remember the actions of previous lives and therefore cannot determine whether there is a karmic need for further suffering. Under these conditions, it may be the sacred duty (dharma) of the physician to heal the pain, just as it is the collective duty of the family to insure that their relative dies an auspicious death - which often precludes dying under traumatic circumstances.

In addition to the absence of trauma, Hindu notions of an auspicious death often entail that the person leaves the world having lived a long and prosperous life with many children and a significant period of time near the end for spiritual development. In many instances when these ideals cannot be achieved, adherence to rituals can play an even more important role. Patients may listen to prayers or recite their mantra up until the moment of death or travel to a place of religious pilgrimage. Families may arrange for a particularly auspicious cremation rite (anteyeshti samskara), ensure that the celebratory feast (bhojan) is well-attended 12 days later or that the ashes are disposed of in a sacred geographic area. Although these latter rites occur post-mortem, advanced awareness and preparation may reassure a spiritually oriented patient or help the family with anticipatory grieving.”

It is the role of the Palliative Care team to facilitate some of these processes, most often by working closely with relevant ministers of religion. Where necessary to help the patient participate in the appropriate rituals. When it comes to pain relief and the use of analgesics and opioids (such as morphine) a frank and clear discussion with the patient and the family is needed. The Palliative Care team is well placed to have this discussion and/or to facilitate this discussion with the appropriate role players, most specially the patient.

“Palliative Care supports human dignity by relieving the sever physical, emotional and spiritual suffering of patients and families facing a life limiting illness. As a bio-psycho-social-spiritual approach to suffering it affirms life while regarding dying as a natural process.” (Palliative Care Ticks All the Boxes: UHC — PHC — SDGs — NCDs — UDHR By: Katherine Pettus, PhD Advocacy Officer, International Association for Hospice and Palliative Care)

It is this promotion of human dignity in the face of increased vulnerability that is so important in Palliative Care and sets the practice of Palliative Care apart. To approach the patient with the entirety of the patient’s being as a primary concern, is the mark of quality Palliative Care. Not only for Hindu patients, but for all. All patients want to have a peaceful and dignified death. Palliative Care professionals are obligated to promote a good death with dignity and with minimal (if any) suffering. Palliative Care professionals should be sensitive to the needs of their patients and facilitate those needs as may be best for the patient.

As we continue to remember World Hospice and Palliative Care Day and the theme for this year – Palliative Care – Because I matter. It becomes important and ever more relevant that in all instances the Palliative Care team places the patient in the centre of care, because the patient matters. We care because you matter.

Foot note – an attempt will be made at appropriate times in the year to reflect on Palliative care from the perspective of different religions.

(Warren Oxford-Huggett)

World Hospice and Palliative Care Day.

Breast cancer brunch

During the month of October there are two significant events and celebrations that are commemorated by Hospices. The first is World Hospice and Palliative Care Day on 13 October and the second is Hats on for Children’s Palliative Care on 12 October Same week and a very similar focus.

Commemorating health days like these is important and the various events that go into making them a success highlight the need for the services provided by these organisations.

World Hospice and Palliative Care Day is a ‘unified day of action to celebrate and support hospice and palliative care around the world.’ The theme this year is “Palliative Care – Because I Matter.” The aims of this commemoration are as follows:

  • “To share our vision to increase the availability of hospice and palliative care throughout the world by creating opportunities to speak out about the issues;
  • To raise awareness and understanding of the needs – medical, social, practical, spiritual – of people living with a life limiting illness and their families;
  • To raise funds to support and develop hospice and palliative care services around the world.”

The International Children’s Palliative Care Network uses a “Hats on for Children’s Palliative Care” event to raise awareness not only for the need for palliative care for children, but to also bring to our attention the rights of very sick children with incurable and life threatening illnesses to receive palliative care.

The theme "Palliative Care – because I matter," speaks to the heart of palliative care and links this years event to the iconic quote from the founder of the modern Hospice movement Dame Cecily Saunders, ‘You matter because you are you and you matter until the end of your life.’ We also celebrate the 100th anniversary of the founding of the modern hospice movement this year.

“We chose ‘Because I Matter’ as this year’s theme, because it centres on the lived experience of people affected by serious illness, looking at what matters most, including the often-overlooked financial impact of palliative care needs on individuals and households. The theme also contains elements of human rights and justice, asking: If I matter, then why am I not getting the care I need?”

Support your local Hospice as they raise awareness around the need for Palliative Care and provide Palliative Care services to those who need them the most. The need is continually greater then our ability to meet it. This speaks to our lack of resources and creates the space wherein you can support us and the work we do. As one of the key priorities in quality palliative care is to address pain and symptom control there is no need for anyone to experience chronic pain. Palliative care can address this and herein lies the link to palliative care as a human right. No one should suffer chronic pain. The need for palliative care in the lives of so many people is vital and you can help us to meet this need.

The work of Msunduzi Hospice in the greater Pietermaritzburg area is to create a centre of excellence in Hospice and Palliative care, to meet the needs of our patients and their families. The need outweighs our ability to meet it, even with the wonderful support of so many individuals and businesses. We call on you, our supporters, to continue your faithful support and to encourage others to do so as well. Help us ensure that no one here in the uMsunduzi municipality suffers needless chronic pain, that their various symptoms are addressed, that the psychosocial and spiritual needs associated with life limiting and life threatening illnesses are addressed. We care because you matter.

Our own celebration of World Hospice and Palliative Care Day will take the form of a brunch to raise awareness about breast cancer and Palliative care on Saturday 27 October. Please contact our office for more details on this event and our line up of speakers.

Culturally Sensitive Palliative Care

Culturally Sensitive Palliative Care

In South Africa during the month of September we celebrate Heritage day (24 September). This public holiday is an occasion when South Africans are called upon from across the spectrum to celebrate their culture and their diversity of beliefs and traditions. In this way celebrating a nation that belongs to everyone. In KwaZulu-Natal, before 1995, 24 September was celebrated as Shaka day, in commemoration of Zulu King, Shaka.

When we present courses and workshops on Palliative care, one of the aspects that is covered is the importance of culture in the holistic care of patients and their families/households. Care that is presented without consideration for these cultural importances is likely to be missing an important aspect in the lives of the patient and/or family and this may compromise the way care is received.

In the country as a whole, we are encouraged to celebrate our culture, we acknowledge its importance in building a nation and in national cohesion (or possibly lack of cohesion). We are able to speak proudly and openly about our culture and acknowledge its affect on our lives. We may also note how our culture has changed, how, when we gather as family, we see the way our parents/grandparents do things is subtle different to our way as a younger/different generation. Our cultures are dynamic, shifting in response the economic, religious and societal pressure. It is good that we acknowledge this.

The same is true for our patients. When someone is ill, bedridden, diagnosed with a severe/terminal illness, they may feel unable to participate in the cultural traditions/rituals that they are used to. Whether it is setting off a firework, attending the ritual slaughter of a beast, or a regular late afternoon sundowner, the ill patient may somehow be excluded. Either by the nature of the illness or by the family who possibly think that the patient belongs in bed or in-doors. When everyone else is out celebrating their culture, when everyone else is enjoying what it means to be who you are, the ill patient may be excluded. This potentially has a negative effect on the patient’s well-being. This is not wholistic care. To fullest extent possible the patient should be encouraged to participate and to belong. When the care team arrive from Hospice, they should know and understand some of the rituals appropriate for that time of the year and acknowledge and celebrate with the patient (if possible). To greet with ritual greetings, to shake hands in culturally appropriate manner, these all help the patient to feel as if s/he belongs. To feel less vulnerable and/or excluded.

Care provided by Hospice staff (and by family members) should take cognisance of possible cultural differences and issues that may arise. As in much of life, communication is essential to establishing a wholistic and effective caring environment. Clear communication between the Hospice team and the patient/family around cultural matters will go a long way to establishing an environment where the impact of the care has the most benefit to the patient and the family/household. The care delivered is then culturally sensitive. When the Hospice team are able to recognise cultural differences (through good communication and training), then the team are able to communicate more meaningfully with both patient and family and in this way begin to reduce (possible eliminate) some of the stress involved with end-of-life care.

In times of vulnerability, it is our culture that we cling to in order to have, or remind ourselves of our sense of belonging. We do well to remember this as those who provide care and as family members of those who are ill. For the dying patient, the sense of loss of identity can be profound, even for the deeply religious and/or spiritual. The sense of no longer being a part of something here (and, depending on belief about the afterlife, not being part of something in the beyond), can have a profound impact on the patient. Questions of identity, who am I, what is my place in family or culture or society, what have I achieved? These are all profound issues that the ill person deals with in various ways. The value of palliative care, and in particular, hospice care, is the holistic approach to care. The hospice team recognises these profound challenges that the vulnerable patient experiences and is prepared (hopefully) to interact honestly and with integrity with both the patient and/or the family (household). In sensitive ways our social workers can engage these matters. Listening to both patient and family and placing the needs of the patient central to the care being provided. Our nurses can with gentleness and sensitivity express some of the realities of the illness and help patient and family to develop skills and tools that will enable the patient to live their in a dignified manner, and able to be part of and celebrate their cultural heritage.

So this month, as we celebrate Heritage day, celebrate it well. Enjoy the culture you are part of. Whether it is lighting a braai, or visiting Shaka’s grave, or honouring our ancestors in life and struggle. It is our culture and it is what makes us strong. It is what can give some strength to our patients and keeps them part of the greater whole.

Community Food Garden

Produce from the community garden

The following article is written by one of the Care Givers employed by Msunduzi Hospice Association. For the most part the article has not been changed and reflects the words of Bheki. The food garden was started at Bheki's initiative and in collaboration between Msunduzi Hospice and a member of the community in Dambuza. The project aims to be self-sustaining and received little support from Msunduzi Hospice.

"I Bhekinkosi Masikane, as a Community Care Giver employed by Msunduzi Hospice, have decided to start a vegetable garden at Dambuza Area, Ward 21. Many of the community members are suffering at food, most of them they don’t drink their treatment because they can’t take it without food. That makes me take that decision to open a garden, so that those community members would get food.

Another member of the community that I know. She had no food and still took her medicine. She was very sick doing this. People need to have food when they drink their treatment.

How much I helped the community is very much because I told the community member to have their own gardens at their homes so that they can live a great life. Those who I talked to them they said they can’t make a garden because they are not from here, they are from another place, so they can’t make gardens so that makes me start the big garden (Community Garden). I’m helping patients to have healthy food with other community members. They got vegetable. I always encourage the community to attend with us to the garden. Sometimes we faced with problems of soil by not giving us the food we are looking for. But that not turn us down. We always have the power to go to the garden. We are trying to contact with people who have all information about gardens which are those who were doing agriculture.

Hospice teams helps us very much to get seed and that makes our work very easier. Event I as a community Care Giver helps me to deal with people who are in the community or diseases in the air because I take a fresh spinach so I can be always healthy. Sometimes problems for being poor I got them on the War Room. Some of them they are not good at food, then I and my team we look/talk how could help them. Sometimes we as workers they are community members who came to the garden while we are working, they come for asking us to give them food with their children because they don’t have nothing at their home, but those members are not coming to work with us, but we give them what we had at that time.

I do all of that with agreed with my colleges and also my supervisor. All what we do we write it down we have a book that we write on it because we meet once a week. I also thank the family of Mokofana who gave me the place to make a garden."

Bhekinkosi Masikane.

In thanksgiving for the women in our lives.

Women's day

On August 9 we commemorate the impressive and persuasive march on the Union Buildings by women in 1956. Rightly so this day is now celebrated locally as Women’s Day and August has become Women’s Month.

At Msunduzi Hospice women play a significant role in the life and well-being of Hospice and in this article a short reflection on this.

Many women are involved in NPO’s and in particular those providing Home Based Care. This is no different here at Msunduzi Hospice. We have about 9 care givers who are women who provide a significant amount and a high standard of palliative/hospice care to our patients. These care givers are based in the community and provide this care to patients who live near to them under the supervision of nurses and social workers. What is significant at Msunduzi Hospice is that our care givers are not volunteers and they are not stipendiary workers either. In 2010 a decision was made to bring all care givers in as formal employees of the organisation thus allowing them access to similar benefits available to other employees within the organisation. We celebrate the work and commitment of our care givers and the difference they make in the lives of their patients.

Most of our nurses and all of our social workers are women. This may be a consequence of the employment roles available at Msunduzi Hospice, but they bring with them a level of dedication and commitment to the care of our patients. Recently, as one of our social workers retired, her passion and dedication were commented on and highly regarded by all who spoke at her retirement function.

At Msunduzi Hospice we recognise that among our patients the burden of care is overwhelmingly placed on women in the community. This has been the case for many years. The women employed by Hospice recognise this and do what we are able to do in order to support the women in the community. We are often unable to make significant change in the gender roles encountered, but we are able to support and empower households in the care they provide.

Moving away from the care that we provide to the vast contribution made by so many women in so many aspects of our organisation. The finance team, the income generation team are all mostly composed of women who not only make a sterling contribution to the mission of Msunduzi Hospice, but do so in their own unique way. The volunteers who make a significant contribution to Hospice are mostly women (about 70%). Their tireless dedication on different levels to ensuring the success of our organisation is deeply appreciated.

So this article is about recognising and giving thanks to the women in the life of Hospice. The founders who gave us life, the shoulders of whom have carried us to the present, the strength of those who continue to support and enrich our daily lives. To all the women in our lives, thank you.

“Wathinta abafazi, wathint’ imbokodo.”

When you strike a woman, you strike a rock. (Zulu saying used during the protests of 1956).

Thank you

Thank you

Recently the Msunduzi Hospice Association held its annual Winter Fair (#winterfair). By all accounts this was one of the more successful fairs that we have held over the last 12 months.

The fair consists of a number of components, all working together to achieve success. Much like a well oiled machine. The planning for this fair (and all our fairs) begins well in advance. Volunteers are approached to produce craft that will be sold. Suppliers are approached to make donations that will be used to produce craft items or prepared in some way that will be sold (particularly food). Plans are made for marquees, tables, and all the minutiae that goes into ensuring success. One of the biggest components of the fair are the volunteers who do so much. Volunteers who produce craft items, volunteers who cook, volunteers who prepare the books that are sold.

Outside stall holders are contacted and offered space. These need to be managed as well so that their expectations are met.

In the week leading up to the fair all these plans need to be brought together and slowly with encouraging words, and gentle massaging they coalesce into a well hosted fair.

On the day of the fair staff and volunteers arrive early (very early for some) and gates opened, stoves turned on, fires lit and general last minute details taken care of. Then the great rush as the gates are opened. The running of the White Elephant puts Pamplona to shame. The crush in the bookshop is something to experience. The number of Bacon and Egg rolls sold keeps the cooks very busy. The heat in the kitchen. People forgetting how to use the credit card machine. The need for change. All these matters are flawlessly dealt with by a team of competent and capable staff and volunteers.

It is the contribution of so many things that makes our fair so successful. All the contributions that together produce something great. Finally it is the members of the public who turn out in their numbers and purchase items of value and importance to them that helps our events make a difference in the lives of our patients.

Often we are told that ‘Every little bit helps.’ We may not realise it at a practical or conscious level, but it is true. So please offer your little bit. Your monthly donation of R50.00 makes a difference. Your donation of old clothes, books, goods, makes a difference. The contribution of your time (even an hour a month) makes a difference. You make a difference.

“There can be no greater gift than that of giving one’s time and energy to helping others without expecting anything in return.” Nelson Mandela

Mandela Day at Msunduzi Hospice

Mandela Day

18 July marks Mandela Day. A day in which the contribution of the great man is recognised and celebrated. It is also a day on which countless organisations arrange for people to help for 67 minutes in honour or recognition of the selfless contribution made by Madiba to South Africa. These contributions take many form from time, to money, to goods-in-kind. This year, in addition, marks what would have been Mandela’s 100th birthday.

This is a noble and respectable activity to participate in and is highly encouraged and valued.

Here at Msunduzi Hospice we have enjoyed less success with this programme then we would have liked. Often we have requests from companies and individuals to offer time, but they want direct access to our patients during this time. This is not possible as we are required to protect the interests of our patients during a time of increased vulnerability.

Often we request participants to make donations of blankets, food, clothing for our patients and these are generously forth coming and well appreciated by our patients (particularly in the cold July months). Contributions towards our sustainability are also deeply appreciated, items we can sell or renovate to sell in order to generate income to sustain a free patient care programme. These donations, and other’s like them help support the ongoing work of Msunduzi Hospice. To provide quality home based hospice and palliative care services to those patients and their families who are experiencing difficulties associated with their illness. Patients (and families) going through extended periods of illness, extended periods on medication often with difficult side effects, are in a vulnerable position. It is for this reason that we limit access to our patients by those who are not employed by Msunduzi Hospice. Our services to our patients and their families are provided free of charge and any and all contributions towards helping us sustain these services will be appreciated. It is often the unthought of items that make the most difference, paper, coffee, milk, tea etc. If you, as an individual, or as a group of people, would like to make a difference in the lives our patients, please contact us for more detail on how you can make this difference.

As we celebrate this Mandela Day and his 100th birthday, it is the vision and ideals embodied by Mandela that we look for in our team and in those who volunteer here at Msunduzi Hospice. Courageous selfless dedication to a goal. The care of our patients is what we prioritize and all we do is directed towards ensuring that this care is sustained, delivered in a professional manner, and well received by the patients and their families. Your can help with this! Your ideas, and contributions towards the organisation will be deeply appreciated. Give your time as a volunteer, be here to help the organisation. Give your talents and skills to assist in our income generation activities, our admin processes and general property maintenance.

In Mandela's own words, 'What counts in life is not the mere fact that we have lived. It is what difference we have made to the lives of others that will determine the significance of the life we lead."

We care because you matter.

Bereavement support at Msunduzi Hospice


The death of someone close to us, throws us into a sea of chaotic feelings. Sometimes the waves of emotion seem powerful enough to threaten our survival; sometimes they feel relentless and never ending; sometimes they quieten down only to arise months or even years later when we least expect them.

I am not sure who made this statement, however in my experience as a grief worker, I think it is the most apt description of how intensely people can be affected by grief. The other purpose of this statement is that it puts grief and bereavement into perspective.

The grief of bereavement is often accompanied by very strong and painful feelings. The business of navigating this maze of feelings and/or emotions manifests itself when the bereaved person does not understand why they are behaving, feeling or responding in a manner which is so foreign to them.

A lot of times the bereaved are worried about these intense feelings/emotions and become anxious when they are unable to describe these adequately and or control what they are experiencing. This begs the question WHY DO PEOPLE NEED BEREAVEMENT?

• To assist them to come to terms with the loss they have experienced.

• To comfort the bereaved as and when needed.

• To ensure that the bereaved does not believe they are going mad.

• To deal with the often unwarranted responses directed at those close to them.

• To answer some of the ‘why me’ questions.

• To provide the bereaved with the insight to make informed choices about their loss experience.

• To provide the bereaved with a safe space to verbalise their insecurities.

• To address concerns about what is sometimes seen as ‘stupid’ thoughts/feelings/questions.

• To encourage the bereaved to take care of themselves whilst they endeavour to cope with the difficulties faced when grieving.

• To allow the bereaved to express their sometimes negative feelings associated with the deceased and not to feel guilty about them.

• To assist the bereaved not to make major decisions which could seem very tempting in order to alleviate the sadness and pain however if necessary to discuss this with a trustworthy and experienced person.

• To assist the bereaved in distinguishing between death and non-death loss.

• To normalise some of the foreign responses/feelings/thoughts experienced whilst grieving.

• To normalise exhaustion, emotional vulnerability, lethargy, social isolation, sleeplessness, forgetfulness, lack of concentration, confusion, loss of appetite etcetera as symptoms associated with grieving.

• To assist the bereaved to deal with the anger directed at the deceased, the doctors, God, themselves or a higher being.

• To explain that the bereaved have certain tasks to complete in order to experience their grief journey as meaningful.

• To encourage the bereaved to hold on to the memories created with the deceased (good or bad) and advise them that anniversaries, birthdays, Christmas and New year can be particularly difficult.

• To assist the bereaved to carve their own path which will assist them to view their grief journey as not necessarily a dreadful experience.

“You cannot prevent the birds of sorrow from flying overhead, but you can prevent them from building nests in your hair.” Chinese Proverb

Bereavement support is available at Msunduzi Hospice to those family members of patients who have died. There is a support group available to members of the public who have not been connected with Msunduzi Hospice previously. Please contact our offices for more details on these services.

Prepared by Letitia Marias (Social Worker)

Books at Msunduzi Hospice


Msunduzi Hospice has a number of income generating activities, one of which is our second hand bookshop.

Our bookshop has become know far and wide as having a really great selection of books at reasonable prices. All the books that we sell have been donated to Msunduzi Hospice and the income generated through the sale of these books goes to support patient care and other costs associated with running the organisation. All donations of books are very appreciated. In particular we tend need children’s books which are very popular at our amazing book stand at our fairs. As Ernest Hemingway said, “There is no friend as loyal as a book.”

I would love to be able to list the books available, but that exercise is beyond our capacity to deliver. However, if you have time, please come and browse through our books.

There are a few special collections, such as Africana, children’s books, magazines, etc. Depending on donations, we have had collections of books about chess, flying, wildlife etc. Keep looking at Facebook (https://www.facebook.com/MsunduziHospice) for updates on these special collections. Also on our Facebook page will be details of our fairs and some pictures of books available at the fairs.

The bookshop is well managed by a staff member, but a great deal of the work that goes into the bookshop is performed by volunteers. Our volunteers remain a very important part of the work of Msunduzi Hospice and if you would like to assist as a volunteer in the bookshop please make an appointment with the PA to the CEO for your initial interview.

Each book that is donated is inspected, cleaned (sandpaper and furniture polish), priced and placed on the shelves. Sufficient books are put aside on a continuous basis to stock the book display at the three fairs. Volunteers with special interests and/or knowledge help with the pricing of the books and with relevant research. Very rare books are researched well and if we believe we can sell them ourselves, we do so, or otherwise they are sent to auction.

It is not strange to see groups of volunteers having long conversations, whilst sanding the books to make them look presentable. Discussions about which books need to be set aside for the fairs, which books should be placed on the shelves, storing books, pricing books, books, books, books. These all take place among a group of passionate and enthusiastic volunteers.

On occasion, when books are not selling, or we believe they won’t sell, then we make a donation of these books to schools in our area. In this way we spread a culture of reading and offer back to our community a little in the way of support. To quote Cassandra Clare, “One must always be careful of books," said Tessa, "and what is inside them, for words have the power to change us.” On very rare occasions books that have mould are pulped.

Pop on down to our Msunduzi Hospice bookshop. If you would like to browse, or are looking for something specific, we are almost certain you will find it here.

We care because you matter.

Memory Work at Msunduzi Hospice

Memory box

Msunduzi Hospice has a small paediatric programme which is staffed by a social worker and two memory workers. We are often asked about memory work and what it is and how it works. Here is a short article compiled by the paediatric team in response to some of these questions.

Memory work is program that was adopted and adapted by Msunduzi Hospice to assist the children who are affected and infected in order to gain resilience. Children who themselves are HIV positive or have some other life limiting illness, or whose parents/guardians are HIV positive and/or have some other life limiting illness. The programme includes Memory books, memory boxes, and children’s group sessions along with family counselling.

Memory books are books(or folders) where the children write about their family history. They write about their background, where they come from, their culture and religion. They write about the good and bad times in their lives (their important memories). They write about their parent’s history, their parents family, if they were married and about special times in the lives of their parents. They write about their hopes and dreams (both those of the children and those of their parents, if they are still alive), they discuss their wishes for their future. They may also spend time with a family tree where that can see/learn about their place in their immediate and extended family (they create a sense of belonging).

A Memory box works alongside the memory book and is a physical box in which important documents (birth certificates, marriage videos – of their parents, funeral videos, Identity documents and other notes of sentimental of practical value)are kept. These documents or items may be given to the children while the parents are still alive, or may be sought out by the children as part of the grieving process. These items can have important value for the children for both the development of resilience as well as for practical and legal value.

Part of this programme is the use of holiday group sessions with the children. Each child appreciates these group sessions for different reasons, but some of the common benefits are as follows:

- They help the children to express themselves and to share their feelings about sickness and death which have happened in their families. It helps the children to develop coping skills in order to adjust to illness and death within the family;

- They help the children to have time outside of their regular environment and to have fun with other children;

- Children are educated about their rights and responsibilities;

- Using tools such as the “River of Life” diagram children are encouraged to identify times or occasions in their lives which were difficult, sad filled with turmoil and to identify those times which were filled with peace, tranquillity, happiness etc. The ability to identify these times and to track the events surrounding them and to see the distance between then and now, helps the child to measure progress, change and growth in their own lives;

- It also helps to bring about a spirit of togetherness, sharing of ideas and trust towards each other;

- It builds self esteem.

Sometimes a story can help see the value of this set of interventions.

Peter (10 years old) lived with his dying mother. As part of the regular care provided to children of patients a memory worker attended the family and started working with Peter and his mother – a memory book was started. Peter was unable to cope with the fact that his mother was dying and decided to move out of his mother’s house and move in with his father. This created a sense of distance between Peter and his mother (both physical as well as emotional) and he was fearful of facing his mother’s impending death. Peter attended one of the Holiday Group sessions at Msunduzi Hospice and following this group work begun visiting his mother for short periods over weekends. Slowly, over time and with more counselling, he has developed a better relationship with his mother and has decided to move back in with his mother and to assist in her care. The overcoming of his fear of death is an important part of building resilience as well as developing those skills that will be useful when his mother does die.

Compiled by Pretty Zondi (Social Worker), Bernard Sefadi and Vuyisile Majola (Memory Workers).

Absolute Angels

Hospice Care

“Where are you working”? he asked.

“I am about to take up a newly created post in a position, as a Proposal Writer, at Msunduzi Hospice”. I replied excitedly.

That day - the friendliness (of what would ordinarily have been another casual, every-day, congenial exchange) changed instantaneously. That which followed - changed me. It had a profound affect on me, and, I learnt on that day what it is that truly matters in this life of mine. It became a special moment in time, and one I will surely never forget.

“Those hospice nurses. (he whispered softly - followed by a short thoughtful pause) … And those social workers, (he blurted out – followed by silence deafening pause) … they are Absolute Angels”. Then he stared long, and hard, at his shoes - seemingly looking for ANY small detail which could distract him from his own outpouring.

And, in trying desperately to stop his emotions from overtaking him, I watched, the bigness of that burley man’s (rough inner palm) - as it haphazardly brushed away - an isolated - very sad - and very, very vulnerable – tear. A single tear that had escaped his pain filled eyes.

A hurt so tangible - it was but seconds that his words “Absolute Angels” – became etched in my memory forever. Moreover his voice breaking, and so filled with pain - it had touched my heart, in a way – Indescribably, memorable. Those angels had cared for his late father in law. A random, coincidental encounter. I think not. A wow moment in my life. I do believe so.

An exchange between two people - but more importantly - a moment in time so powerful, that when I turned to walk away - I knew that I was, and had just been blessed. Absolutely blessed. 100% blessed. And so, as I looked forward to this new chapter in my working life, I became acutely aware of how privileged I was to find myself (in some small way) to be able to care for people. And in the days leading up to my commencement as Proposal Writer at Msunduzi Hospice, I reflected on that exchange.

I became deeply conscious at the magnitude of the importance of the position – what failure would mean - and I was scared.

(Janine – grant writer)



The concept of telemarketing may be a little old fashioned and out of date with all the access to social media so many of us enjoy today. However, at Msunduzi Hospice, telemarketing is a small component of our overall marketing strategy.

When the phone rings and you hear the voice of our telemarketer, please do not do what so many of us do and simply end the call. Please take a moment to listen to the details provided and to make a decision to support this worthy charity.

It is the continuous support of generous people like yourselves that has enabled our care for the past 35 years. It is your support today and in the future that will ensure that our care continues to be provided (free of charge) to all those who are able to benefit from it.

When one examines the Annual Financial Statements of Msunduzi Hospice you will notice that approximately 48% of our gross income for the last financial year was raised through our own efforts (excluding grants from government, and corporate funders). Of this 48%, telemarketing made up about 2%-3%. A small number, but still a contribution towards our sustainability. The goal of every Non-Profit Organisation is to be as sustainable as possible, to be able to whether the storms of funding declines and changes in political and economic environment. Telemarketing is one small way in which we enhance our efforts to achieve this.

Your support, when you are called, will go a long way to helping us in this effort. Committing to a regular donation of as little as R50.00 per month will make a difference. In the greater scheme of things these small donations may seem trivial, but collectively they are what sustains us. Please take the call. Make a pledge.

We care because you matter.

(If you would like copies of financial statements, proof registration as an NPO and/or PBO, please contact the office and we will gladly forward copies of these documents on to you – E-mail Shilo (PA to the CEO) on hospice@hospicekzn.co.za. It is your right to remain informed.)

Taking a break

Take a break.

As a child I remember an advertisement on TV (and other media) that went something like this, “Have a break, have a Kitkat.”

I am not sure if this punch line is still in use, but the value of having a break remains an imperative in the lives of those who provide care for others. I am currently on such a break and enjoying the wonderful countryside that South Africa has to offer.

Those of us in the care industry and in particular those of us in the Non-Profit care industry can sometimes get so caught up in caring for others that we forget to look after ourselves. One such way of doing this is to ensure that occasionally, as the need arises and is available, that we take a break, go on leave, switch off our cell phones and e-mails etc. Get our heads, minds, hearts, souls out and into something that invigorates, refreshes and recharges us for the difficult and stressful work that we engage in.

I realise in myself when such a break is needed. I begin to lose my composure and this affects my decision making. When I notice this it is important for me to take a break, even if it is just one day here and there. During this time I engage in those activities that refresh me, such as reading, watching good TV serials, taking a trip to visit family, or simply sitting at home and watching time pass (meditation). I then return to the office better able to deal with the pressures of running a successful NPO in this day and age.

What is true for me is true for my entire team. The care team are often caught up in the direct needs of our patients, that they sometimes forget to care for themselves. They too need to take a break. The finance and income generating team can become so busy around year end or putting on an event that they burn themselves out and this can and does lead to problems. Taking a break ensure the success of our activities and the accuracy of our records. Leave is a right, but it is a right that must be taken in order to achieve its full benefit.

So, as I enjoy a break, probably evening eating a Kitkat, I encourage everyone to take needed breaks. If you are passionate about your job, motivated about achieving good things in your chosen profession, then you owe that passion and motivation the occasional break. Hard work and commitment and dedication are refreshed and renewed by well deserved and taken breaks (leave).

Go on – have a break.

We care because you matter.

Palliative Care is Teamwork

Team work

I recently sat chaired a panel interviewing people for a social worker vacancy here at Msunduzi Hospice. The panel consisted of myself (CEO) as well as our Palliative Care Manager (a nurse) and our senior social worker.

A number of questions had been prepared and these were duly asked of the various candidates by the three of us on the panel. It is almost obligatory that one of the questions was on team work (there were actually two this time). “How well do you work in a team?” and “How would you contribute towards making a team work better?” The candidates responded to these questions in various ways. However, the point of this blog is to reflect on the value we place on teamwork.

Palliative care relies on a team approach towards the patient/family that meets a diversified set of needs expressed by the patient/family and meets them in a holistic manner.

When a patient is diagnosed with a life limiting illness (often more than one illness) a patient experiences (in some form) a sense of vulnerability. They do not always know what to expect and, despite the best intentions of their doctors, the patient is often left having little or no control over their illness, its treatment, and prognosis. This sense of vulnerability can extend to the family as well. It is into these situations of uncertainty, vulnerability and fear that the Hospice care team is invited (through the patient, family doctor etc.). To approach these situations without the support of a team is to set one’s self up for failure and more tragically to not be able to meet the needs of the patient/family.

Most Hospice care is managed through an Inter-Disciplinary Team (IDT) which, in our case consists of nurses, social workers, care givers, memory workers, volunteer doctors and other professions invited as needed. Once a week this team discusses the needs of the patient/family, makes suggestions to one another, implements those suggestions, monitors the effect, and reports back. The process then begins again and continues, adapting to the expressed and/or observed needs of the patient/family. Central to this process is the patient/family, with whom the team has discussions, requests information, provides information and ensures, to the best of their ability, that the patient/family is an active member of the care team themselves. This begins (only begins) to alleviate the sense of vulnerability and risk that the patient/family experiences when facing such difficult times in their lives.

So the importance of asking questions about team work during job interviews is clear. Team work extends beyond patient care. In most Hospices there are various teams of people doing various tasks in order to achieve a common goal. At Msunduzi Hospice we have, for example, a very large team of fund raising staff and volunteers. The staff are responsible for implementation and accountability. They are wonderfully supported by a number of volunteers who share ideas and creativity and make use of this opportunity to interact with like minded individuals while supporting a worthwhile cause. The success of our various functions and events is testimony to this team work. Each member of the team bring their own skills, resources, ideas, etc. to the task at hand and together a great deal is achieved.

Team work extends beyond the individual Hospice towards the province and the nation. In the province of KwaZulu-Natal there are 20 other Hospices which together contribute towards meeting the need for Palliative care services. This, despite the fact that we meet a very limited aspect of that need because of various resource matters and the locations of these Hospices. In South Africa there are about 110 Hospices. Together these Hospices work towards meeting the needs of the patients in the country. Together, we share resources (where possible) and ideas and we refer patients to one another as the patient moves to be with loved ones. The very essence of Palliative care, as seen in the individualised care of the patient/family, happens at a local, provincial and national level. Teamwork makes this happen.

Despite some of the challenges around working in a team, needing to sometimes compromise positions for the greater good of the patient/family. Team work makes Palliative care possible. Bringing to the patient/family individuals who are able to meet the need of the patient/family. Discussing as a team the best way to meet these needs. Sharing ideas (and resources) empowers the team to make the best decisions in the best interests of the patient/family making sure that the patient/family is a fully involved member of the team is what sets Hospice and Palliative care apart.

Help make this happen.

We care because you matter.

Palliative Care Standards

Focused on achieving quality palliative and hospice care.

In recent months a great deal of attention has been focused on compliance. Compliance with laws and regulations. Compliance and ethical operating procedures are important in any business, but they are more important in the Non-profit world. Here we are dealing with donated money, donated time and with the lives of individuals for whom we care.

The Hospice Palliative Care Association of South Africa, some time back, developed a set of standards. These standards are applicable to all hospices in South Africa and all Hospices are encouraged to develop towards compliance with these standards. These standards are assessed internally up to a certain level and then externally for final accreditation by the Council of Health Services Accreditation of Southern Africa. “A focus on quality is important to patients and families, clinical staff and volunteers, managers, donors and policy makers. There are many organisations offering home-based care in South Africa, mostly based on some alternative interpretations of palliative care. It was therefore imperative for the national association to take the lead in the process of pursuing quality, so that the credibility of member hospices could be enhanced in the eyes of the formal healthcare sector and existing and potential donors.” (Palliative Care Standards 3rd edition: 2014)

Msunduzi Hospice is pleased to be able to say that we have been accredited by Cohsasa since 2009.

We put time and effort into maintaining this accreditation and we believe it is important for us to do so. Accreditation gives us credibility in the eyes of our donors. Current and potential donors are able to confidently know that we maintain a high set of ethical, financial and caring standards. Doing so means that the care that we offer is of a high quality (measured, not by ourselves, but by an external organisation). The operation procedures are in place that allow us (in most cases) to address issues as they arise.

A standard is a predetermined expectation set by a competent authority that describes the minimally acceptable level of:

  • Structures in place;
  • Performance of a process;
  • Measurable outcome that is practically attainable (Council for Health Services Accreditation of Southern Africa – Cohsasa);

Structures that need to be in place include human and material resources and documented policies. These policies are put into practice by the consistent performance of set procedures (Process) that ensure patient/family/staff and volunteer safety. Frequently, the measurable outcome or evidence that a stated policy regarding patient care is effectively implemented is found in the patient records. (Palliative Care Standards 3rd edition: 2014)

Just as important is our financial audit which takes place annually. This is another piece of evidence that contributes towards our credibility in the eyes of those who support us.

The participation in such events as the Nedbank/Pietermaritzburg Chamber of Business social enterprise of the year competition also lends credibility to our organisation.

We may be challenged on the time and effort we put into these activities. Do they not detract from patient care, from being with those who need us most? We certainly do not think so! The time, effort and resources that are expended on these processes play an important role in ensuring that the care that we offer is quality care, focused on the most direct needs of the patients, and using the available resources most effectively. The focus on these standards and their implementation allows us to engage in quality improvement activities that seek to continually respond to issues of the day as well as raise the level of quality care/services we provide. Quality improvement is an important aspect of Msunduzi Hospice and our patient care.

In a world were corruption appears to be the order of the day, we are proud to say that we stand firm on ethical operating procedures, audited by external (non-affiliated) agencies proving that we are a reliable and trustworthy charity that deserves and will use your donation effectively, meaningfully and honestly.

We care because you matter.

Celebrating Nurses Day

Nurses day
Nurses touch our lives in so many ways.

Each year on 12 May we celebrate International Nurses Day. A day on which the amazing contribution of the nursing profession is recognised and celebrated.

If we were to take a moment to reflect on our own interactions with nurses I believe we would be amazed at their role in our lives. Nurses often come in for a great deal of criticism. Complaints about nurses and nursing care are many and varied. If were to consider for a moment the incredible responsibility that nurses have in our health care we may be less likely to raise such complaints. Having to interact with individuals at the worst or most fearful moments of their lives can be incredibly stressful. The ability of most nurses to rise above this stress and still offer a caring and compassionate service to us when we need them most is to be celebrated.

The theme for nurses day in 2018 is ‘Nurses – A Voice to Lead – Health is a Human Right.’ The focus being that no matter the location or the setting, healthcare should be accessible to all. Nurses are able to take a lead in this as they are often easier to approach than doctors and other health care professionals. Nurses are the public face of healthcare and should be approached as such. In a sense, nurses bring health care to us.

At Msunduzi Hospice, our care team is made up of nurses, social workers, memory workers and care givers. It is this Interdisciplinary approach that sets us and Palliative care apart from other care. On nurses day we recognise the amazing work done by our team of nurses and the impact that they have on so many patients and family members. Having to drive to visit our patients in not so comfortable vehicles, over not very good roads, in all kinds of weather, this dedication is recognised and honoured.

When one considers that each month approximately 15 of our patients die, the stress that this places on our care team is phenomenal. It must also be remembered that in most cases we are working with more than the patient, we work with and support the family or household members as well. It is not only the patient who feels vulnerable in times of illness but also the family. The care provided by the care team extends beyond the patient to include the family and this can and does result in additional stress on the care team. This excludes the amount of work done after death by both nurses and social workers to assist the family through the grieving period.

So today, as we celebrate international nurses day, we salute you and say ‘Thank you’ to our nurses and care team here at Msunduzi Hospice. We extend this thanks to all nurses everywhere and we recognise their amazing contribution in our lives in so many ways.

Nurse on.

Hospice Week "Because I Matter"

Have the conversation. Hospice week 2018. Because I matter.

Every year during the first week of May we commemorate Hospice Week. This commemoration is about advocacy, about awareness, about showing off the work of Hospices throughout South Africa. Often, the work of Hospices is done quietly with little or no fanfair. It is work that is done with individuals, with families in times of grief and mourning. There is little to say publicly about these things. These are deeply intimate and personal experiences that should not be brandided about in order to generate a little publicity. The life and dignified death of an individual and the process that their loved ones go through is not for public consumption.

So why celebrate Hospice week? Why write this blog or say what is going to be said? No matter how personal the life and death of an individual is, it is a loss to the community and it is in the spirit of addressing the needs of the many that this article is written. The theme for Hospice week this year is “Because I matter.”

It is because I matter that this article is written. It is because the lives of everyone in our community matters, that this article is written. With this theme there is an increasing focus on preparations that need to be made in order to secure a dignified death. In particular about having a conversation about your specific needs around your own death.

Advanced Care Planning is an increasing aspect of our health care. Does your family know what you want to happen to you as you approach death. I refer you to an article on the ehospice website 'Advance Health Care Planning Day.' It is often culturally inappropriate or simply deeply uncomfortable to talk about one’s wishes regarding death (or more generally, regarding a future time when you are unable to communicate). This taboo needs to be broken. This discomfort can lead to complicated grieving processes in the loved ones left behind. In keeping with the theme for Hospice week, Because I Matter I must have this conversation. Because I matter, and my loved one’s matter, this conversation needs to take place.

There are numerous resources available and I refer to the Conversation Project, among others. Take advantage of these and other resources to facilitate this conversation. Talk to legal experts on drafting a will, talk to doctors about your end-of-life wishes. Make sure your family, loved ones, significant others, know what you want. Document all of this. If you or a loved one is a patient of a Hospice, have this conversation with a member of the Hospice team.

This YouTube video high lights the need to have this conversation. Even for someone involved in this care, we are sometimes afraid or approach the matter with reluctance. But the conversation is necessary. As we commemorate Hospice Week 2018, have the conversation. Not only Because I matter, but because you matter as well.

World class Jazz and Comedy to celebrate Msunduzi Hospice 35th anniversary.

Jazz/Comedy evening

This year marks a very special milestone for the Msunduzi Hospice Association as we celebrate our 35th Anniversary. It has been an absolute pleasure for us to be of service to those patients with life threatening and/or life limiting illnesses and their families within the Msunduzi Area during these past years and we look forward to many more. In celebration of the Msunduzi Hospice 35th Anniversary, we are hosting a Night of the Stars Jazz and Comedy Dinner which will be taking place on Saturday, 12th May 2018 at the Golden Horse Casino.

Our exciting entertainment line-up for the evening include Jazz Legend Melvin Peters, as well as world renowned Jazz Artists Karen & Chats Devroop.

Melvin Peters is a jazz pianist, composer, arranger, clinician and church organist. He started classical piano lessons at the age of six and continued through high school. While studying towards a Bachelor of Music degree at the University of Natal, he began jazz piano lessons under the tutelage of Darius Brubeck in 1983. After completing a Master of Music degree in Jazz Performance in 1989, he was appointed lecturer in Jazz Studies at the University of Durban-Westville in 1990. He taught here for ten years and during this time was awarded a scholarship to study at Harvard University in 1998. He has performed extensively in Europe, the United Kingdom and the United States. Melvin Peters has worked with leading South African jazz musicians, including Winston Mankunku and Barney Rachabane. Career highlights include performances with jazz luminaries Herb Ellis and Ginger Baker, as well as the opportunity to share the stage with the legendary Dave Brubeck at Harvard University in 1999. He has collaborated with Abdullah Ibrahim in the formation of the Cape Town Jazz Orchestra, for which he was appointed Music Director. He is currently the jazz examiner for the University of KwaZulu-Natal and the University of South Africa. He is the organist and choirmaster at St Paul’s Church, Durban.

Back by Popular Demand are our Comedians from the Mamba Republic Team. Reuniting the talents of Ben Voss (Beauty Ramapelepele) and Internationally acclaimed author John van de Ruit (Spud), Mamba Republic takes a savagely funny look at all that is wrong and very wrong in the Rainbow Nation. With their unique blend of sharp wit, hopeless optimism and clever characterisation, the duo sink their fangs into the fiascos, farces and foibles of South African life. Whether it is their unique take on fees must fall, state capture, online dating, the economy, sport, technology, racism, an alternative national anthem, or even the most unusual football match in living memory, Mamba Republic will have you rolling in the aisles at the utter absurdity of life at the foot of Africa.

Tickets are available at R325.00 per person, corporate tables of 10 are also available. Tickets are available online from Quicket or from the Msunduzi Hospice Association office.

Grief and Bereavement at Msunduzi Hospice

The complexity of grief
(With thanks to google images)

Have you ever felt helpless, watching someone you care for grieve?

Perhaps you have felt or experienced a devastating loss yourself?

How do you cope?

How do you help?


Msunduzi Hospice is pleased to offer a two day Grief and Bereavement workshop at Msunduzi Hospice (200 Zwartkop Rd) on 14 and 15 May at a cost of R690.00 per person. There are also 4 CPD points available from SACSSP.

This workshop gives participants the opportunity to explore these and other questions. It examines how we react to loss and the normal grief process. It also looks at what may complicate the grieving process and some of the signs to look out for.

The workshop is interactive and allows participants to share experiences.

Please note that we recommend that if you have recently experienced (within the last 12 months) a significant loss yourself, it may be too soon to participate in this workshop.

Anybody wanting to understand grief and bereavement better is invited to apply to attend this workshop. Please contact Heidi who let you have an application form and answer any questions you may have.

Msunduzi Hospice is well known for the care that we provide and this remains our priority. However, we also would like to share some of these skills with members of the community of Msunduzi (Pietermaritzburg).

This sharing often takes the form of workshops and courses which we offer on request to members of the community. Hospice is an integral part of the community and sharing this workshop and others is a way of sharing skills and helping the community to help themselves.

We care because you matter.

What exactly does Msunduzi Hospice do?

Palliative Care.
One of our nurses with a patient.

I have worked in the care tea at Msunduzi Hospice for roughly ten years now and over this time have often been asked, "what does Hospice do?". Even after ten years I find it difficult to answer that question comprehensively; to be quite honest, I really only fully figured out what it is that we really do after a year or two at Hospice. To start off with I thought we simply drove around visiting people, giving advice, chatting an sometimes drinking tea. It was the best job I ever had.

Ten years ago, I would have told you that we visit people with illnesses like cancer and try to help them and their families. Now when I am asked what Hospice does my more professional and polished 'in a nutshell response' is that we provide palliative care to people facing life threatening illnesses. This does not begin to explain it, though, and I often find myself elaborating on the services that Hospice provides in order to explain how we deliver this palliative care. So here, as briefly as I can manage it, are the basic services that the care team provides:

Clinical support: we have a team of nurses who visit roughly once a week (depending on need). In the Edendale are we also have caregivers who assist the nurses with visiting patients.

Clinical Support includes:

  • Giving advice on any medical issues, e.g.: pain and symptom management, what to expect from treatment, the illness and its progression.
  • Offering advice and education on how to provide physical care of the ill person, wound care, infection control etc.;
  • Loan of equipment such as wheelchairs, commodes, bath chairs (equipment loan is exclusively for our patients);
  • Preparing families for the death of a loved one by explaining what to expect and how to deal with this event and the time leading up to it. Included is what to do after a death has occurred;
  • Emotional support: as all people are different it is impossible to quantify or list how emotional support is offered but this a huge part of what the Hospice Care Team does. Nurses and Caregivers will offer emotional support at each visit but we also have social workers who will do more in depth counselling when the need arises. Coming to terms with you own mortality, or that of a loved one, can be a difficult process and something we are very aware of. With palliative care we do not focus only on the patient but also look at supporting the family emotionally as well.
  • Social and spiritual care: Our social workers are often involved with these aspects of care. They, among other things, offer advice on how to access grants and pensions, look at finding placement when this is needed, offer family counseling and try to facilitate the cooperation of family members in the care of the patient. When there is a need for spiritual care we may need to refer to external resources but the basics of spiritual care is also offered;

Another important aspect of social care is caring for the children of patients. The social workers assist with counselling but we also offer memory work for the children. Our two memory workers help children to deal with the difficult situation they find themselves in when a parent or caregiver is ill. A huge part of the their work is also emotional support for these children; under the supervision of a social worker, they also run children's groups and healing sessions.

Bereavement care: This is offered to family members for a period after the death of a loved one. The care team will periodically make contact with family members to see how they are coping. More in depth bereavement care is available if needed and is headed up by one of our social workers.

There are some limitations to what services Hospice can offer and this often comes down to the availability of resources and ensuring that we distribute resources equally among our patients. We have strict admission criteria and also cannot travel too far out of town. We also cannot provide transport for patients, we cannot provide scripts or treatment and we do not have the staff to offer daily care for patients. However, despite these limitations, the care team really does try and meet the need of patients and their families and the list of services we offer can fall short of explaining what it is we actually do.

I can't remember exactly when it started dawning on me that those cups of tea and the chats about this and that are more than they seem to be. They are actually the first step to forging a relationship to be able to do what it is that we actually aim to do. What we really do (or try to do) is come alongside people at a time when their lives are upside down and try and give them some guidance and direction so that they can start to turn their lives right way up again. I think, perhaps, a better "in a nutshell" description of what Hospice does is that we quietly walk alongside families who are facing life threatening illness and provide support and care to enable them to cope with the challenges that such illness brings.


In 2017 we had some exciting developments with training. Various Hospices have been asked to do training in palliative care for the Department of Health. Apart frm the funding given for this, this is a wonderful opportunity to get the word out about palliative are. We look forward to sharing what we know about palliative care with health care professionals from a variety of facilities. Every journey starts with a first step and we hope that this journey will continue until palliative care is available to all who need it in South Africa.

Our community trainer has also been very busy with requests for our 5 days, non-accredited, Home Based Care training for community members. We hope that this will continue in 2018. Any queries can be addressed to Winnie Gasa, our community trainer.

This year we have decided not to schedule any of our usual workshops and courses as we have had poor responses and have had to cancel most of our training last year. However, we will run the workshop/course on request for a minimum of 10 people. Any queries can be addressed to Heidi Collyer.

The courses/workshops available are as follows:

  • Introduction to Palliative Care for Professionals;
  • Introduction to Palliative Care from Carers;
  • Grief and bereavement workshop;
  • Children and grief workshop;
  • Basic Hospice Course;
  • Counseling workshop.

Thanks you

By Heidi Collyer.

First appeared in the Msunduzi Hospice Newsletter - March 2018

Celebrating 35 years of Msunduzi Hospice

A short explanation of Hospice
Hospice - choosing a smoother ride for the journey.

The occasion of our 35th anniversary is an opportunity to reflect on what has been achieved by Msunduzi Hospice and what challenges lie ahead of us. For a charity to survive for 35 years in often harsh and difficult circumstances is an achievement in and of itself. However, charities should not exist for themselves; they should exist for the purpose for which they were established. In the case of Msunduzi Hospice, this is to provide quality hospice and palliative care to people living in the Msunduzi community who are suffering from life-limiting or life threatening illnesses. In most cases these are cancer, HIV, AIDS, TB and a variety of other illnesses which in some way limit the life expectancy of the patient. We exist to try and make the lives of those with these illnesses a little easier, free from pain and distressing symptoms and to help them live as complete a life as possible. We care because you matter.

Msunduzi Hospice has always enjoyed the support of a large number of people in and around Pietermaritzburg. In the days of our establishment (35 years ago) it was people who were concerned about the care of those with cancer who set out to learn and equip themselves to establish a Hospice. We are deeply indebted to our founder members and trust that we continue to fulfill the vision they had. We are, and always will be, a charity which relies on the support of the community. All our functions each year, fairs, events etc. are incredibly well supported by the community of Pietermaritzburg. It is this support that enables our continued ability to provide the care that so many people need. It is a sadness that we are not able to provide everything that our patients need because of a limitation of resources. The need far outweighs our ability to respond.

Corporate Social Investment (CSI) is important in order to ensure the continued success of Msunduzi Hospice. We currently enjoy a great deal of support from a large number of companies, businesses and individuals in Pietermaritzburg. In this, our 35th year, we call on all those who already support us, as well as those who do not, to make Msunduzi Hospice their charity of choice in 2018. Help enable our next 35 years of providing care. In 2017, 490 patients received care and 1680 family members. Almost 30,000 visits were made and 98,000 interventions provided. The return on the social investment made by so many has had a large impact on the lives of so many patients and their families.

From small and humble beginnings, we have developed over the years, through good times and difficult times, to become a leading example of a well manged and service-orientated charity. The recognition by the Nedbank/PCB Social Enterprise of the Year Award 2017 shows this and our continued accreditation by the Council of Health Standards Accreditation of South Africa (Cohsasa) is further evidence of these sound management practices and focused service delivery ideals of Msunduzi Hospice.

The main event to commemorate this momentous occasion in the life of Msunduzi Hospice is the combined Jazz/Comedy evening at the Golden Horse on 12 May (details will be made available). The support of the community of Pietermaritzburg is once again called for in  all our events that take place this year: our three fairs, our wine tasting and various other initiatives that will be publicised in the press and through mass mailings. Msunduzi Hospice also provides a few courses and workshops for individuals and corporates. Please contact us for details. A minimum of ten participants is required for these workshops.

Additional support for the work of Hospice can be made by supporting our charity shops and by making donations of previously loved items to our depot, where they are sorted, priced and placed in our shops for sale to the public. To become self-reliant, in as much of our fund raising as possible, is the ultimate goal of Msunduzi Hospice. You can support this endeavour. Other donations of commonly used items, such as paper, pens, dish washing soap, washing powder, brasso, furniture polish, etc. will help reduce running costs and enable sustained patient care. All donations of cash will be deeply appreciated. Please contact us for details on how to make these donations. A conference centre in a lovely garden is also available for hire, please contact us for details.

Support for Hospice can also be demonstrated by becoming a volunteer. We have a few focused areas where people can donate their time and skills to help support the work of Hospice in the community. Please make an appointment with the CEO to discuss these opportunities. Help is always needed in our Depot, Shops, and fund raising events.

The future is never a clear path and Msunduzi Hospice, as all charities, needs to navigate an environment filled with uncertainty and challenges. The founder of the modern Hospice movement, Dame Cecily Saunders said, "You matter because you are you, and you matter to the last moment of your life. We will do all we can, not only to help you die peacefully, but also to live until you die." This is the work of Hospice and this is the work of Msunduzi Hospice for the next 35 years. The need continues to exist for the services that we provide and we exist to meet this need of providing people in our community with access to pain control, symptom management, and a dignified death. Everything else we do, the fund raising, the publicity, etc., is all in support of this goal. Help make this possible for the next 35 years.

We care because you matter.

Written by Warren Oxford-Huggett

First appeared in the Msunduzi Hospice newsletter March 2018

Why a Hospice blog?

Butterfly logo for Msunduzi Hospice

So this is something new for both myself as CEO as well as for Msunduzi Hospice. A blog.

Having spent some time evaluating our social media presence late last year we took a decision to try and improve that presence and the new website which accompanies this blog, the blog and an updated Facebook page are the results of that discussion. The presence of Msunduzi Hospice on social media is vital. The more we interact with the public and the community of Pietermaritzburg the more we realise that there is a great misunderstanding of the work of Hospice in general and of Msunduzi Hospice in particular. I refer to a short WhastApp discussion that I had with a member of the community some time ago.

The message I received was a description of the mother’s need for assistance with her daughter who was disabled. In general, if we have resources available this would have presented no problem to us and we would have followed up, first with a telephone call to make further assessments and then possibly with a visit, depending on the outcome of the calls. I responded to the message saying that I would ask one of the care team to call and that if resources permitted we would visit. The response from the mother was a surprise thinking that the care of the disabled was the work of hospice. I responded that the care of the dying was the work of hospice.

This may be an over simplification of the work of hospice, but it does illustrate the poor understanding of the work of hospice in the general mind of the public. I trust this blog and future blogs will begin to address this misunderstanding. The work of Hospice is to provide Home Based Care to people diagnosed with a life limiting and/or life threatening illness. It is unfortunate that the need far outweighs our ability to respond to it.

We continue to rely on your support to make our services possible.

We care because you matter.