The 24th of September is celebrated in South Africa as Heritage Day.

The idea being not only to acknowledge the great variety of cultural identities that exist in South Africa, but also to celebrate these as a fundamental aspect of the cultural identity of us as a people. One aspect of this celebration has materialised as Heritage day.

On Heritage day, we celebrate the diversity that makes us a nation. We celebrate the uniqueness of different cultural identities and how they contribute towards nation building.

At Msunduzi Hospice, we respect and celebrate this cultural diversity that makes up our nation. This is displayed in many different ways at the organisation. We also recognise that our patients, no matter how ill they may be, remain part of a cultural identity and share a unique heritage that must be respected while we provide care.

The official World Health Organisation definition of Palliative care reads as follows: ‘Palliative care is an approach that improves the quality of life of patients (adults and children) and their families who are facing problems associated with a life-threatening illness. It prevents and relieves suffering through the early identification, correct assessment and treatment of pain and other problems, whether physical, psychosocial or spiritual.’

Despite there being no overt mention of culture, there is an implicit understanding that our cultural identity has a vast impact on how we understand and react to illness and the treatment of that illness. When we provide training to health care professionals in palliative care, one of the aspects that we focus on is to encourage these healthcare professionals to see illness from the perspective of the patient. How is the patient experiencing this? This must happen despite one’s own cultural background. If the patient believes that their illness is caused by bacteria, then we, as health care professionals, need to respect that. If the patient believes that their illness is caused because they have sinned against God, then we, as health care professionals, need to respect that. From the patient’s perspective this is important. It has a direct impact on how they will want to be treated, who they want to treat them and their attitude towards what is being done by health care professionals.

Alleviating suffering involves addressing issues beyond physical symptoms. Palliative care uses a team approach to support patients and their caregivers/families. This includes addressing practical needs and providing bereavement counselling. It offers a support system to help patients live as actively as possible until death. We strive to help patients and their families through specialised care to live and die well. This is best done by being respectful of different cultural traditions, understanding our own cultural traditions and being open to learning from other cultural traditions.

It is not the place of the health care professional to critique the cultural background of the patient or their family. We are not in the business of changing world views.

It is this approach that is exercised by Palliatively trained health care professionals, such as those employed by Msunduzi Hospice, that allows our staff to walk alongside the patient, to offer comfort (pain control and symptom management) in a manner that reflects the particular cultural values of the patient. When it comes to counselling and education of the patients and their families, this is provided in a manner that respects their cultural background. This is our Palliative care heritage and we offer it to those who wish to be our patients.

We recognise that everyone and every culture (heritage) has something of value to offer the world and our country. We can all learn from one another if we approach one another with a receptive and respectful attitude. We can all be enriched by these encounters.

Warren Oxford-Huggett

(CEO)